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A Basic Interpretative Study of Educators in the Childcare Profession: Collegiality as a Base of Job Satisfaction
Get PDFThis basic interpretative study explored 12 childcare teachers’ perceptions of job satisfaction and how their motivation has had an instrumental impact on their 10 years or more of job sustainability. In examining the childcare teachers’ perceptions of job satisfaction, the primary research question guiding this study was, “What are the motivational factors that childcare teachers perceive to have contributed to their job satisfaction and retention?” The theoretical framework underlying this study was the Self-Determination Theory, a theory that describes how interactions between early childhood teachers and the system within their work influences motivation in their teaching and their authentic well-being as an educator (Deci & Ryan, 2010). The research participants were childcare teachers with a CDA and had 10 years or more of childcare teaching experience as a childcare teacher. Semi-structured interviews provided a rich, thick description of the experiences of the participants. The basic interpretative study took place in the natural world of the childcare profession with the focus on the context of job satisfaction (Rossman & Rallis, 2003). The constant comparison analysis indicated four major themes: motivation of being a childcare teacher, a community of collegiality, a definition of job satisfaction, and inspiration of becoming a childcare teacher. Evidence also emerged that the participants would recommend the early childhood profession to other potential childcare teachers because of their job satisfaction despite their low wages and lack of recognition for their work. Based on the motivational factors of the childcare teachers’ perceptions of job satisfaction, a model was initiated with the purpose to improve recruitment and retention of childcare teachers. Collegiality is the basis and the foundation of the model, which is paramount for a functional and supportive community of collegiality (DuFour, DuFour, Eaker & Karhanek, 2004). The motivational factors of the model are: organizational climate, professional development, intrinsic motivation, and credentials. In addition, the Model of Motivational Factors could increase student achievement with less childcare teacher turnover. Future research should focus on what the childcare teachers perceive as obstacles in the early childhood profession and what they would recommend to recruit and retain childcare teachers. Their recommendations could merge and connect with this study’s motivational factors. Their recommendations for recruitment and retention of childcare teachers would be their voice on a personal level, which could be the basis for the study
A Quality Improvement Initiative to Increase Hypertension Treatment Adherence Among Hispanic Patients With Limited English Proficiency
Get PDFThe purpose of this project was to improve hypertension (HTN) treatment adherence among limited English proficient Hispanic patients with uncontrolled HTN. Limited English Proficiency (LEP) significantly reduces HTN control among Hispanics by diminishing their understanding of HTN diagnosis, treatment adherence, and complications. A language sensitive education session focusing on antihypertensive medications, reduced sodium intake, and appointment keeping was implemented among LEP Hispanic patients 21 to 85 years of age, with uncontrolled HTN, receiving care at a federally funded south San Antonio clinic. The Hill-Bone Compliance to High Blood Pressure Therapy Scale was utilized to measure adherence in the following domains: medication, low sodium diet, and appointment keeping. At the end of the project, 30 patients completed the intervention. Baseline characteristics were similar for the group. After 10 weeks, HTN control improved by 7%, the mean systolic blood pressure decreased by 5.44 mmHg, and mean diastolic blood pressure decreased by 2.57 mmHg. Results of paired t-tests showed statistical significance between pre and post intervention scores for medication adherence (M = 6.47, SD = 4.20, t (29) = 8.45, p \u3c .05), low sodium diet adherence (M = 3.60, SD = 2.47, t (29) = 7.98, p \u3c .05), and appointment keeping adherence (M = 2.50, SD = 1.72, t (29) = 7.98, p \u3c .05). The intervention led to significant improvements in HTN control among LEP Hispanic patients, supporting the need for language sensitive patient education in the clinical setting
Improving Early Child Developmental Screenings in a Primary Care Setting: A Quality Improvement Project
Get PDFA dramatic growth of physical, motor, cognitive, communication, emotional, and social development will occur during the 3 years of life. Of children ages 3-17 years of age, 13% have some type of developmental or behavioral condition that goes undiagnosed before the age of 10. Children with multiple health and social risk factors, or those with chronic health disorders, are at greater risk to develop early child delays or disabilities. In the U. S., developmental screenings are only completed 21% of the time during well-child visits. Therefore, the purpose of this quality improvement project was to increase the adherence of health care providers’ completion of developmental screenings at the recommended ages during well-child visits. The American Academy of Pediatrics recommends the use of validated screening tools for examining developmental delays and screening for autism at specific ages. For this project, the Parents’ Evaluation Developmental Status and the Modified Checklist for Autism in Toddlers-Revised were implemented into a primary care setting. The interventions included implementation of the 2 screening tools over a period of 3 months, administration of parent educational materials, and training on recommended screening schedules. Chi-square and descriptive analysis results concluded significant improvement screening and referral rates. This project revealed that child development screenings could be implemented successfully into a busy primary care clinic without interruption of the workflow. Completion of these screenings provided an opportunity for parents and providers to work closely together to discuss any developmental concerns and ensure that referrals were processed as soon as issues were detected
Provider Adherence to Prescribing the Elimination Diet
Get PDFAllergy-related diseases, chemical sensitivities, and food intolerances have increased dramatically over the last 20 years in both the pediatric and adult populations, contributing to escalating rates of morbidity. Despite an abundance of literature supporting the negative impact food reactions can have in multiple disease states, food reactions continue to be seen as a modern enigma in medicine and are often met with great skepticism. There are a variety of interventions available to identify food reactions in both adults and children; yet, the traditional elimination diet remains the standard of care. Regardless of its utility and clinical effectiveness in the healthcare setting, the elimination diet is significantly underutilized by healthcare practitioners. The purpose of this project was to improve provider adherence rates with prescribing the elimination diet for patients with select diagnoses supported in the literature. The project was implemented in a Functional Medicine Clinic in Austin, Texas, with the goal of increasing adherence with prescribing the elimination diet in select patients from the current rate of 17% to over 80%. The project’s interventions included creating a patient user-friendly elimination diet teaching guide for patients and electronic medical record integration to aid practitioners in prescribing and documenting the intervention. Implementing holistic, safe, cost-effective evidence-based interventions like the elimination diet to improve patient outcomes demonstrate how the Doctor of Nursing Practice prepared the Advanced Practice Registered Nurse to utilize their skills, knowledge, and experience to transform the future of healthcare
Spirituality in a Faith-Based Institution: Faculty Experiences of Facilitating the Spiritual Development of Students
Get PDFPractices of spirituality, particularly amongst faculty who teach at faith-based institutions of higher education, are underexplored in the current body of literature. This qualitative study uses an interpretive phenomenological analysis (IPA) approach to examine faculty members’ attitudes about the role of spirituality in higher education and the pedagogical and mentoring approaches that faculty members in a faith-based institution use to facilitate the spiritual development of students. Participants described spirituality as foundational to student wholeness and naturally emerging from scholarship, as an opportunity for students to increase self-awareness and to have respect, empathy, and compassion for others. Findings of this study identify how spirituality naturally works its way into the higher education environment, including both the university’s involvement to facilitate spiritual development, and faculty involvement to support spiritual development through pedagogical approaches and through the teacher-student relationship. This study also makes the connection between faculty members’ personal definitions of spirituality and how students are seen and treated
Learning to Heal: The Impact of a Restorative Justice Program on Crime Victims
Get PDFIn the United States, someone is murdered, raped, robbed, or assaulted every 26 seconds (Federal Bureau of Investigation, 2015). Violent victimization is a uniquely disorienting dilemma because it is the result of harm from another human being. Extensive research has shown that crime victims’ complex emotional and psychological needs are not adequately fulfilled by the dominant retributive system of justice. The other paradigm of justice that has received extensive consideration from theorists and scholars, with research that now covers multiple continents and 3 decades, is restorative justice.
Restorative justice theory and practice have become effective complementary, and at times, alternative approaches to assist victims, offenders, and communities in the healing process after the experience of crime. Several studies have indicated that when restorative justice is coupled with retributive justice, victims’ needs for information, participation, emotional restoration, apology, and meaning are more adequately fulfilled. While previous research has addressed victims’ satisfaction with restorative justice initiatives, it is unclear how restorative justice programs serve to transform victims’ emotions and schemas of meaning after crime.
This instrumental case study addressed a gap in the literature by exploring the process of learning used by victim volunteers participating in an established restorative justice program designed to foster healing for those impacted by crime. Using constructivist grounded theory methodology, this case study illuminated the complexity of the experience of 15 victim volunteers, and one staff member, in the Bridges To Life restorative justice program. An interpretive theory entitled therapeutic restorative justice that was comprised of three categories (i.e., fragmentation, evaluation, and integration) and numerous associated properties emerged in the analysis of this research. The strategies victims used to assist in their ongoing healing were also identified within the interpretive theory. Increasing knowledge about the learning process used by victims in the Bridges To Life restorative justice program can be used to improve professional practices, theories, and policies that are relevant to victimized populations
Call Center Experience Optimization: A Case for a Virtual Predictive Queue
Get PDFThe evolution of the call center into contact centers and the growth of their use in providing customer-facing service by many companies has brought considerable capabilities in maintaining customer relationships but it also has brought challenges in providing quality service when call volumes are high. Limited in their ability to provide service at all times to all customers, companies are forced to balance the costs associated with hiring more customer service representatives and the quality of service provided by a fewer number. A primary challenge when there are not enough customer service representatives to engage the volume of callers in a timely manner is the significant wait times that can be experienced by many customers. Normally, callers are handled in accordance with a first-come, first-served policy with exceptions being skill-based routing to those customer service representatives with specialized skills. A proposed call center infrastructure framework called a Virtual Predictive Queue (VPQ) can allow some customers to benefit from a shorter call queue wait time. This proposed system can be implemented within a call center’s Automatic Call Distribution (ACD) device associated with computer telephony integration (CTI) and theoretically will not violate a first-come, first served policy
Teacher Retention in Zimbabwe: Love for Teaching or Incentives?
Get PDFThis qualitative interpretive study investigated the lived experiences of qualified teachers who have remained in teaching for more than 10 years in Zimbabwean rural secondary schools. In understanding how teachers make meaning of their remaining in teaching, the focus is also on the role and place of teachers in society. The experiences were investigated using a dialoguing unhu theoretical framework based on the writing of Lortie (1975) and unhu philosophy. Teacher participants were drawn from three rural secondary schools in Chirumhanzu district in the Midlands province of Zimbabwe. In addition, two teachers who left teaching in Zimbabwe and are resident in the United States also participated in the study. The teachers had a minimum of 10 years teaching experience. Through semi-structured interviews, teachers were asked and shared information about their decisions to become teachers, how they decided to remain in teaching despite the growing challenges the field is facing, and how they viewed the role of incentives and other motivational mechanisms in their decision to remain in teaching. Data collection was done through interviews, journaling, memos, pictures, and artifacts. Data analysis was done using the phenomenological protocol to ensure trustworthiness and credibility, checking of transcripts, member checking strategy, field journal, and vii triangulation was used. Practicing epoche (suspension of judgments) helped in the bracketing of personal experiences, biases, and assumptions (Hays & Singh, 2012; Patton, 2015). There were several findings that influenced teachers to remain in teaching as cited by teachers: (a) affordability/quality of life, (b) family responsibilities and parental support (c) stepping stone, (d) good relationships, (e) love teaching/kids, and (f) economy and politics. Although they admitted that they face challenges in their professions, they also said that their proclivity to hard work and teaching has kept them going. Further analysis of the themes resulted in higher levels findings explaining why teachers have remained in the profession for more than 10 years. Four higher level findings emerged: the importance of community culture and relationships, the removal of incentives led to dissatisfaction but did not affect love of teaching, the local school context or environment influence, the value of the existence of unhu and respect, and the lack of alternatives to lead a satisfying lifestyle. A love model of teacher retention was developed from the findings to explain teacher retention in rural Zimbabwean schools. Retention of teachers was a result of altruistic, intrinsic, and extrinsic factors. Psychic rewards (Lortie, 1975), play a central role in retaining teachers in the Western context; however, community influence, dialogue, and unhu have been shown as greater influencer to teacher retention in this study as teachers love their jobs and enjoy working with kids. Knowing that they are making a difference is a source of motivation for teacher retention. Love for teaching was undermined by incentives that gave teachers a false sense of satisfaction. It is imperative for responsible authorities, parents, and administrators to be aware of positive factors that hold sway in the retention of teachers and work towards their improvement
Individualized Glycemic Targets for the Elderly Residing in Long Term Care Facilities
Get PDFOf people age 65 and older residing in a long-term care facility, 1 in 4 has Type 2 diabetes (Smide & Nygren, 2013). Care and management of this population is a challenge for nurses and other providers. Results of a needs assessment in a local long-term care facility identified deficiencies in the provision of evidence-based Type 2 diabetes care for this target population. American Diabetes Association Guidelines (2017) recommend application of individualized HbA1c targets for the elderly residing in long-term care facilities, especially for those with compromises in clinical and functional status. This two prong quality improvement project strove to educate nurses about these residents’ needs, and incorporate the use of best practice diabetes standards in the nurse practitioner’s practice. Specifically, emphasis was placed on HbA1c and finger stick monitoring, eye exams, and foot care. Results indicated that educational in-services designed for nurses were an effective approach to improving knowledge concerning care of complex Type 2 diabetes patients. Although ophthalmology and podiatry referrals were not ordered routinely because of APRN, staff, and organizational resistance; utilization of standardized orders improved routine Type 2 diabetes care pertaining to ordering HbA1c, renal panel, and urine to albumin creatinine ratio. The APRN now has the awareness to evaluate discrepancies between HbA1c results and finger stick values. QI projects in long-term care facilities may be difficult to implement and sustain related to staff turnover, understaffing, high patient acuity, and organizational and provider opposition. APRNs must advocate for continual utilization of evidence-based practice guidelines for all LTC residents
How Decision Makers Learn to Choose Organizational Performance Measures
Get PDFThis study, framed by decision making, program theory, and performance measurement theory, explored the knowledge and experience that enable decision makers to identify organizational performance measures. It used a mixed method, exploratory sequential research design to discover the experience, knowledge, and skills (EKS) senior decision makers felt were important in learning to choose organizational performance measures. From the analyzed interviews, a survey was designed to measure the importance of the EKS characteristics. Qualitative analysis identified 55 life, work, or educational experience; knowledge; or skill characteristics and 23 effective measure characteristics. Regression analysis and PCA were used to extract 6 components. One-way ANOVA found no significant differences in these factors between gender groups, age groups, and process complexity levels, but found differences for decision-making tenure. MANOVA found no significant differences by the same dimensions. The limited sample size and high number of variables confounded component extraction. Further research with a suitable sample size is required before findings can be generalized