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The Arrival of Generation Z on College Campuses
Get PDFResearch Focus
The purpose of the study was to understand the academic needs, desires, and expectations of Generation Z in relation to their college experience as perceived by educational professionals. Colleges and universities may experience diminishing enrollment and possible closures if college administrators fail to address the needs and expectations of Generation Z students. Generation Z is entering college with a set of different expectations from their predecessors and it will be important for university administrators to understand this generation in order to attract and retain them. Pearson (2013) encouraged university administrators to take the time to identify their market segment and to develop a plan to serve them. University officials will continue to face new challenges in meeting the needs of an increasingly diverse student body and fulfilling an expansive institutional mission (Blake, 2007).
According to Blake (2007), these challenges include demographic changes that will continue to occur within the larger society and colleges will be expected to provide more creative ways of serving their students.
Generation Z will enter into college in the fall of 2018; research has shown that that their expectations are different and it is important for university administrators to understand them in order to attract and retain them. The researcher sought to answer the following research questions: What do teachers, counselors and administrators identify as effective strategies and services that foster student academic success? What are some of the more effective practices for working with Generation Z and why? What are some ineffective practices for working with Generation Z and why? What do teachers, counselors and administrators identify as the expectations of Generation Z about their college experience? And, why do they perceive these to be their expectations?
Research Methods
This qualitative study followed an interpretive design inquiry utilizing narrative inquiry protocol as the data collection methodology. The researcher followed interpretive design inquiry and narrative inquiry protocols because they aligned with the conceptual framework. Both the narrative inquiry protocol and the conceptual framework are stage-oriented positing that individuals move through time and are influenced by their environments. Narrative inquiry protocol provides first person accounts of the experiences that are in story format and have a beginning, middle and end. The protocol examined the story three dimensionally in terms of interaction, continuity and situation (Clandinin & Connelly, 2000). Six participants were interviewed twice, using semi-structured interviews. In the first interview, participants were guided by an interview protocol which asked a series of questions related to their experiences as educators working with students and parents of this generation. During the second interview the participants were asked a second series of questions and member checks were completed to ensure accurate information was gathered during the first interview (Marshall & Rossman, 2011; Merriam, 2009).
Three layers were incorporated to analyze the data that were gathered from the interviews. The main data analysis technique was Yin’s (2011) five phases of analysis. The second layer of analysis used Merriam’s (2002) recommendation of analyzing the data while transcribing. The final layer of analysis followed Spradley’s (1980) steps for creating a domain analysis to help connect the field notes and observations in the compiling phase.
Research Results/Findings
The findings were shared by first identifying the factors that impacted the development of the student and contributed to their overall school experience. These factors created eight major categories by which the conversations flowed: (1) Expectations, (2) Norms, (3) Student Welfare, (4) Campus Safety, (5) Parental Involvement, (6) Learning Styles, (7) Technology, and (8) Student Characteristics. The first level of categories was based on comments that connected to the larger overarching themes of the student experience at school. After completing a second round of interviews with all participants, the researcher went back to steps 1-3 of Yin’s (2011) five phases of analysis. From here the researcher was able to drill down into the categories through the participant statements and identified five themes. The themes are student well-being, technology, parent involvement, flexible classroom modalities, and campus safety.
Conclusions from Research
For higher education professionals working with Generation Z students the following conclusions were made in association with the purpose statement and the focus of the inquiry as gathered from the participant interviews: (1) Universities must take the time to research and understand Generation Z in order to prepare and be a Generation Z ready college; (2) Universities must find a way to engage parents as partners in order to foster student academic success; (3) Universities should research, review, analyze, and implement academic services and tools that support student success across the student experience for this generation; and (4) Universities need to identify service models that provide support for overall student well-being
Depression Screening at a Mental Health Outpatient Clinic: A Quality Improvement Project
Get PDFProject Background: Depression is one of the most common mental health problems in the United States. Many individuals may seek treatment but go undiagnosed due to the lack of recognition by clinicians. Clinical guidelines recommend the use of a standardized depression screening tool within a clinician’s evaluation process. The Patient Health Questionnaire 9 (PHQ-9) is such a tool and recommended for use in the outpatient care setting. Aims of the Project: To increase depression screening of clients at a hospital-based outpatient behavioral health clinic. Purpose and Objectives: Implementation of the PHQ-9 into the clinic’s mental health assessment process to increase the rate of depression screening from 0% to 80%. To accomplish this objective the clinic’s therapist were educated regarding national guidelines and recommendations. Depression screening using the PHQ-9 was completed on a weekly basis with documentation of clients scores in an Excel spreadsheet. Results: The final participant sample included 42 clients admitted to the outpatient clinic during the 4-week period. At the conclusion of the project a total of 120 PHQ-9s were administered and 97 were completed, resulting in an average of 78.8% overall therapist’s administration rate for the PHQ-9. This rate increase was a significant improvement for the clinic. Implications for Practice: Consistent use of a standardized depression screening tool such as the PHQ-9 can facilitate identification, diagnosis and treatment of depression and aid in improving client outcomes
Building Shared Values in the Community: Culture of Health
Get PDFThe zip codes where patients live are stronger determinants of health outcomes than the frequency of visits with a primary care provider. Providers have a unique opportunity to extend health care beyond the clinic walls and engage in efforts to improve the communities where their patients grow, live, work, and age. In order to impact the health of patients, a culture of health needs to be developed. The Robert Wood Johnson Foundation culture of health action framework directed the build of a foundation of health as a shared value in a neighborhood with high morbidity and mortality rates in southwest San Antonio, Texas. This community quality improvement intervention was designed to equip participating community members with knowledge, skills, and supplies to be drivers for health as a shared value. Prior to implementation, community surveys assessed perceptions regarding health as a shared value. A one-time class offering opened discussion regarding the effects of stress on heart health. A 7-week class, Health to the Fourth Power, was developed to equip community stakeholders using healthful education, physical activity, community responsibility, and plant-based meal preparation. Post implementation survey results revealed moderate understanding of health interconnectedness. Health to the Fourth Power participants increased daily fruit and vegetable consumption, decreased body mass index, and decreased mean systolic blood pressures. It is imperative for medical providers to advocate for a culture of health in their patients’ communities
Establishing a Coumadin Clinic in a Rural Family Medicine Practice
Get PDFBackground. Coumadin is the most commonly prescribed oral anticoagulant worldwide and is safe and effective in the prevention and treatment of stroke and venous thromboembolism (Stoudenmire, DeRemer, & Elewa, 2014). Coumadin is dangerous when poorly managed due to high risk for bleeding and mortality. It is best managed using evidenced-based models of care such as point-of-care (POC) International Normalized Ratio (INR) testing (Garcia et al., 2008; Harrison, Shaw, & Harrison, 2015; Rossiter, Soor, Telner, Aliarzadeh, & Lake, 2013). Purpose. Establish a Coumadin Clinic in a rural family medicine practice with POC INR testing to improve anticoagulant management. Methods. A quality improvement project was conducted to implement all components of the Coumadin Clinic, to evaluate the time within therapeutic range (TTR) of INR for all patients on Coumadin therapy, and to evaluate patient and staff satisfaction. Components of the Coumadin Clinic were monitored for accomplishment using a checklist at each INR visit. Each patient’s pre-intervention TTR was compared to the post-intervention TTR and patient and staff satisfaction were evaluated by questionnaire. Results. Results indicate that 50% of patients had improved TTR following implementation of POC INR testing, staff completed each component of a complete Coumadin Clinic visit 84% of the time, and 100% of staff and 87.6% of patients were satisfied with anticoagulant management at the POC. Conclusions. A Coumadin Clinic using POC INR testing is an evidence-based model of care that is effective in Coumadin management.
Keywords: Coumadin, Coumadin Clinic, point-of-care, International Normalized Ratio, time within therapeutic rang
Officer Use of Force: A Multicase Study of Institutional Betrayal
Get PDFLaw enforcement officers in the United States are authorized to utilize force (Alpert & MacDonald, 2001); however, the use of force can cause physical and emotional trauma to the person against whom it is used, and to the person’s loved ones (WHO, 2002; Bloom, 2012; APA, 2013). The needs and rights of traumatized individuals must be addressed for healing to occur (U.S. DOJ, 2013). It was not known if the needs and rights of the survivors of officer use of force were being met. Filling a gap in the literature, this exploratory multicase study investigated 5 use-of-force incidents with demographically diverse participants that occurred between 2009 and 2014 in a county in Texas. The primary purpose was to explore the perspectives of individuals and perspectives of loved ones of individuals who had experienced officer use of force by inquiring about the impacts their experiences had had on them. In-person interviews, expert interviews, and document and archival materials were data sources. The aim was to understand and document what the participants experienced, where they sought relief, what challenges they faced, and the meaning they ascribed to their experiences. Two findings were that the incidents had long-lasting emotional and psychological impacts on participants. A third finding was that the experiences negatively impacted participant attitudes toward and confidence in law enforcement, and for some, in the legal system and social institutions in general. Participant responses made clear that the behavior of officers, their agencies, and the legal system constituted institutional betrayal. The fourth finding was that unlike other groups who experience violence (crime victims, domestic violence victims, child abuse victims, and law enforcement officers) the victims of officer excessive force are unidentified and unacknowledged as trauma victims and do not qualify for any governmentally legislated or agency-recommended services or support
Improving Postpartum Depression Screening and Treatment Referral Rates in an Ob-Gyn Clinic
Get PDFAbstract
Background: Up to 25 % of adult women are diagnosed with postpartum depression. This diagnosis may also lead to poor health outcomes for the mother and the infant. Four out of five women with a positive screening for postpartum depression do not receive care from a mental health provider.
Purpose: The purpose of the project was to improve postpartum depression screening and follow-up care to mental health services in a clinic providing obstetrical and gynecological care in the central Texas area.
Objectives: The primary objective of the project was to increase postpartum depression screening rates. The second objective was to improve postpartum depression treatment referral rates to mental health services.
Planned Interventions: Key activities included educating the clinic staff on the importance of screening for postpartum depression and implementation of screening and referral of patients with a positive screen on the Edinburgh Postnatal Depression Scale. Patients with a score of 10 or greater on the Edinburgh Postnatal Depression Scale were educated by the provider and referred to mental health services for follow-up.
Results: The postpartum depression screening rate increased by 15% and treatment referral rate to a mental health provider increased by 22% (p \u3c .05).
Implications for practice: Although the practice was following the recommendations of the ACOG and USPSTF for depression screening, no formal practice policy for screening was in place. Swift identification and treatment of postpartum depression can lead to improved health care outcomes for mothers and their infants
Improving Transitions of Care in Primary Care by Standardizing Discharge Summary and Medication Reconciliation Practices
Get PDFCommunication breakdown happens between transitions of care because healthcare disciplines function as silos. Medication and treatment plan changes are not always communicated to the next healthcare provider resulting in fractured care and preventable unnecessary cost. The purpose of this project was to create a standardized transition of care process from the acute care setting to the primary care setting in adult patients using evidence-based practice. The objectives of the project were the following: (1) to have a follow-up appointment within 14 days of discharge from an acute care setting, (2) to have a medication reconciliation performed and documented by the physician at the postdischarge follow-up visit, (3) to have a discharge summary verified by the physician at the postdischarge follow-up visit, and (4) to reduce 30-day hospital and emergency department readmissions by 25%. Planned interventions included staff education of transition of care process, acute care data collection, and patient follow-up. Evaluation plans included review of the electronic health record and hospital queries comparing pre- and postintervention data. Results showed a 24% increase in postdischarge follow-up appointments within 14 days, an average of a 26% increase in transition of care communication, and a 7% decrease in emergency room readmissions. Hospital readmissions increased by 7%. Implications for the practice include standardizing the process for all transitions of care, streamlining access to transition of care data, and having one affordable and user-friendly central database available to primary care practices
Anemia Management for Patients Receiving Peritoneal Dialysis
Get PDFThe purpose of this quality improvement project was to develop an anemia management evidence-based intervention for patients receiving peritoneal dialysis (PD) and to educate staff on implementation of the anemia management protocol in a PD clinic in a southwestern county in Texas. Anemia is a common complication of chronic kidney disease (CKD) resulting from the inability of the kidneys to produce erythropoietin needed for red blood cell production. Erythropoiesis-stimulating agents such as Aranesp or Epogen may be administered to dialysis patients to stimulate erythropoiesis in the presence of kidney disease. Iron storage and iron availability remains imperative in effectively stimulating erythropoiesis for anemia management in the dialysis patient (Kliger et al, 2013). Anemia is one of the most common complications of CKD; over 48 million Americans have CKD attributing to millions with anemia of CKD origin (Centers for Disease Control and Prevention [CDC], 2017). A 6-month retrospective and current chart review of CKD patients’ undergoing PD was carried out at a PD clinic. An educational toolkit consisting of a pretest, anemia management protocol, and a post-test was developed and administered to staff. A patient educational toolkit consisting of instructional handout and a video was developed and administered to patients. Results indicated an improvement in staff knowledge about anemia management and an increase in patient hemoglobin (Hgb) and iron levels. This implementation was imperative to improving healthcare goals comparable with the Kidney Disease: Improving Global Outcomes (KDIGO) practice guidelines
A Quality Improvement Initiative to Implement the Geriatric Depression Scale in a Geriatric Inpatient Psychiatric Unit
Get PDFThe World Health Organization (2017) estimated that over 300 million people worldwide have depression. According to the Centers for Disease Control and Prevention (2013), 7 million Americans over 65 years old experience depression annually. The United States Preventive Health Services Task Force recommends the use of a depression screening tool in the adult population. The purpose of this evidence-based quality improvement project was to improve screening for depression in an inpatient geriatric psychiatric unit. The primary objectives included educating nursing staff on depression screening and using the geriatric depression scale (GDS) to assess patient\u27s level of depression at admission and discharge. The anticipated outcome was to implement the GDS and increase its usage from 0% to 70% within a 6-week period. Participants included fifty geriatric patients admitted to an inpatient geriatric psychiatric unit. Nurse manager motivation for change was a primary facilitator to the project. Results showed a 72% completion of the GDS at admission and a 34% increase upon discharge. Only 34% of the participants received both admission and discharge depression screening tools. Limitations included nursing staff lack of motivation, lack of committed senior leadership, and overall resistance to change. Staff buy-in is an important factor when implementing change, affecting the success of any project. Therefore, proper assessment of the culture\u27s climate and incorporating staff members in the change process will lead to better outcomes.
Recommendations include regular staff-training, motivational interviewing, and developing ready-made admission and discharge packets to include depression screening.
Keywords: Depression, geriatric depression scale, geriatric population, depression screenin
Quality Improvement on Depression Protocols in the Military Training Environment
Get PDFBackground: Active Duty military members are highly susceptible to depression and suicide due to separation from family during training and deployments, exposure to traumatic experiences in combat, and loss of friends during combat.
Purpose and Objectives: Depression and suicide remain a high priority among military personnel. This process improvement project aimed to improve the rate of depression screening and improve the assessment, treatment, and management of soldiers with depression in a primary care setting to prevent disease progression while waiting to be seen by a behavior health specialist.
Interventions: During the 6-week time frame, all active duty military and reservists seen in a primary care clinic were screened for depression using the Patient Health Questionnaire-2 (PHQ2). All positive PHQ2 screenings moved on to the more in depth Patient Health Questionnaire-9 to measure depression symptoms and severity. Based on symptom severity, initiated treatment plans included education, material resources, psychotherapy, pharmacotherapy, safety contracts and Behavioral Health referral.
Evaluation plans: Patient screening forms were gathered weekly to assess for 100% screening and 100% treatment initiation of all positive depression screenings. After the 6-week time period, a review of data was performed to assess adherence and sustainability.
Implications for practice: Diagnosis of depression before symptoms progress minimizes patient complications, morbidity and most importantly minimizes mortality. Utilizing the patient centered care model, patients and healthcare personnel can work together to provide the best treatment to improve the health of the service member while temporarily assigned away from their primary care providers at their home base