In today's hospital environment, good care has become synonymous with positive patient outcomes. Marring this landscape is the alarming rate of hospital acquired (nosocomial) infections. Urinary tract infection (UTI) is one of the most common hospital acquired infections. The major cause associated with these infections is the use of indwelling urinary catheters. Bacteria invade the lower urinary tract by ascending through or around the catheter. Morbidity associated with urinary catheter-associated UTI can be minimized by prudent decisions concerning catheter usage and good catheter care. The principle route of dispersal of nosocomial infections is likely from patient-to-patient via transiently contaminated hands of hospital personnel. The purpose of this evidence-based project was to determine if hospital-acquired catheter-associated urinary tract infection rates among patients admitted to an acute care facility could be decreased through staff education and consistent application of nursing care using selected perineal infection control interventions. The setting was a 43-bed medical/surgical floor in a 321 bed not for profit Magnet hospital in Northeast Florida. Twenty-four registered nurses and 18 patient care technicians completed targeted in-service education on general nosocomial infections, perineal care, and hand hygiene. A catheter dwell time notification system was also implemented. Chart review data was obtained from 383 admissions (197 pre-intervention, 133 after the educational intervention, and 53 after the dwell time notification). There was a significant difference in catheter-associated urinary tract infection rates after the interventions (11.17 pre-intervention, 10.53 after the educational intervention and 0.392 after the dwell time notification). A longer length of time in practice an on this hospital unit was associated with lower infection rates.

The purpose of the present study was to determine whether a set of teacher demographic, knowledge, and instructional variables is related to preschool children’s literacy development. Specifically, the study investigated how these teacher variables impact children’s language development scores on the four subscales of the Preschool Language Assessment Instrument, Second Edition (PLAI2) and the four subscales of the Test of Language Development – Primary, Fourth Edition (TOLD-P:4). There were two major research questions in the study: (a) Will the predictor set of CLASS emotional support, CLASS classroom organization, CLASS instructional support, level of education, years teaching pre-kindergarten, and answers on a teacher knowledge questionnaire (TKQ) correlate with the TOLD-P:4 language assessment subscales of relational vocabulary, syntactic understanding, sentence imitation, and morphological completion? (b) Will the predictor set of CLASS emotional support, CLASS classroom organization, CLASS instructional support, level of education, years teaching pre-kindergarten, and answers on a TKQ correlate with the PLAI2 language assessment subscales of matching, selective analysis, reordering, and reasoning? Results indicated no noteworthy correlations between the predictor variable set and the subtests of the TOLD-P:4; hence, the variable relationships posited in research question 1 were not supported by the data. Results for research question 2 indicated support for the variable relationships posited. Specifically, canonical correlation yielded two roots of noteworthy size (Rc 2 values = .19 and .09 for roots 1 and 2, respectively). Canonical structure coefficients indicated positive correlation between the teacher predictor variables of education, experience, knowledge, and the CLASS domain of emotional support with students’ scores on the PLAI2. At the same time, the amount of teaching experience that teachers had in the childcare industry was found to be negatively correlated to PLAI2 subscale scores. Findings are discussed relative to the literature on professional development.

The purpose of this study was to determine and examine the impact of student support services (SSS) on academic success at a historically black college. The study was grounded in the theoretical framework of Astin’s Input-Environment-Outcome Model (IEO), Scholssberg’s theory of marginality, holistic theory , facilitation theory, and the theory of sensory simulation (Dunn, 2002; Anderson et. al., 2011; Dennick, 2014 and Pritchard, 2013) A mixed method approach was used to quantify and explicate triangulated data, which included the N-LSSI survey, archival data, and focus group interviews. The N-LSSI survey used a 7-point Likert Scale, and students from The College completed the instrument. The longitudinal nature of the study meant that the assumption of independent observations required by ANOVA was violated. Therefore, I used MANOVA to analyze SSS and Non-SSS student academic achievement data (i.e., GPA, Accuplacer test scores). This analysis also determined whether significant differences existed between the SSS and Non-SSS student participant groups based on means of the predictors. Qualitative data were organized, evaluated, and interpreted using open, axial and selective coding with MAXQDA, a qualitative data analysis software program. The results of the analyses showed there were no significant differences between the two student groups relative to GPAs. In contrast, Accuplacer math scores, reading scores, and writing scores were significantly different. The retention differences between SSS and Non-SSS students were significant in 2011 and 2012, while graduation data revealed significant differences in 2012. Results from the N-LSSI survey produced no significant difference between SSS and Non-SSS satisfaction with The College, while focus group interviews revealed student satisfaction levels were virtually the same.

This study examined exceptional student educators’ (ESE) personal practical theories (PPTs) and how they impact complex decision-making when it comes to students with disabilities and their families. A case study methodology was selected to explore how four ESE teachers and leaders developed their PPTs as well as how they planned, interacted, and reflected upon decisions made during one workweek. The guiding questions of this study were: what are the PPTs of ESE leaders and teachers, what factors influence the development of PPTs, and how do PPTs impact special educators’ work with students with disabilities? To address these questions, four participants were selected based on their role within the district, their experiences working with students with disabilities, and their reputation for being high quality educators. Data were collected using a PPT workbook as well as in-depth, semi-structured interviews. The results of this study included five PPTs for each participant and eight common themes. These themes included: care for students and families, safety of students, administration and teacher professional development, ensuring high expectations for students, personal and professional advocacy, mentoring and collaboration, reflection and problem solving, and problems with inclusion. These results are presented in this dissertation in support of an argument for the need for increased pre-service and in-service for ESE educators, increased professional development for administrators, and increased training for inclusion teachers working with students with disabilities. Engaging in a practice of exploring and refining teacher and leader beliefs and assumptions using the PPT process may increase the reflective practice of teachers and perhaps result in a more appropriate form of evaluation for educators.

The purpose of this project was to evaluate the effectiveness of a practice-based dermoscopy training program for dermatology healthcare providers in order to improve their technique of performing clinical skin exams for the early detection of melanomas. The overall incidence of melanoma continues to rise. More than 75% of all skin cancer deaths are from melanoma. Advanced melanoma spreads to lymph nodes and internal organs and can result in death. One American dies from melanoma almost every hour (American Cancer Society [ACS], 2009). Early diagnosis and excision are essential to reduce morbidity and to improve patient survival. This one-group before-and-after study design utilized a convenience sample of three dermatology healthcare providers (DHPs). The primary investigator conducted a retrospective review of the pathology logs for each provider. The time frame for the review was a three-month period in 2010, which represented the same time frame that the study was conducted in 2011. The DHPs participated in a four-hour training workshop that included pattern analysis recognition using dermoscopy. Following the workshop, each DHP was given a DermLite 3Gen DL100 to use in practice when performing clinical skin examinations. All DHPs completed a data collection sheet to document their pattern of decision making with and without a DermLite. The outcome of interest was the use of dermoscopy by DHPs to demonstrate an increased detection of melanoma when compared to naked-eye examination. The outcome was evaluated 12 weeks post-workshop training. There were 120 evaluations made with the DermLite as compared to the naked eye. The overall agreement was 0.52, AC1 coefficient (95% CI) was 0.36 (0.30, 0.42), p < .001, and kappa coefficient (95% CI) was 0.27 (0.20, 0.43), p < .001. Overall, the risk of lesion under exam being suspicion for skin cancer was higher on 27.5% (33 out of 120) of the evaluations and lower on 20.8% (25 out of 120) evaluations. The risk of lesion was evaluated the same on 51.7% (62 out of 120) of the evaluations. This is an indication of “Poor” agreement between the two methods. The diagnosis and disposition made using DermLite compared to naked-eye results for both coefficients provided an “Intermediate to Good” agreement between the two methods in assigning diagnosis and disposition. This indicates that there is no difference between DermLite and naked-eye evaluations. More studies are needed in order to provide better evidence on the value of dermoscopy in clinical practice at the Dermatology and Laser Center. Future projects should be more explicit regarding the methods used and lesion selection in order to better understand the benefits of dermoscopy.

The purpose of the study was to understand the role of and capacity for program evaluation from the perspectives of leaders in the Northeast Florida nonprofit sector. The study was a two-phased qualitative design and had three research questions related to the role of program evaluation, the capacity for program evaluation, and the influence of the relationship between providers and funders on these efforts. The first phase was a nominal group process using the Delphi survey method. The second phase involved in-depth interviews. Study participants were chosen based on specific criteria. The Delphi phase had four rounds of surveys. Findings from the Delphi phase of the study indicated that leaders in Northeast Florida perceived there were eight distinct roles of program evaluation. The roles included assessing impact of programs, advancing organizational learning, cultivating funding collaborations, informing program management decisions, enhancing communication with multiple stakeholders, facilitating quality assurance, determining resource allocation, and validating organizational credibility. Findings regarding the essential capacity elements needed for program evaluation efforts included having sufficient time, sufficient financial resources, a positive culture, functional program evaluation designs/methods, sufficient human resources, realistic expectations from the philanthropic community, ongoing collaboration, and ongoing training. Study participants reported that these capacity elements were lacking in the Northeast Florida nonprofit sector. Interviews produced similar findings as the Delphi survey. In particular, the use of reflective practice as a role within program evaluation efforts and as a program evaluation approach were core topics of interviews. Additional findings from the study were related to program evaluation capacity development strategies, the dynamics of the relationships between providers and funders, and the influence of these variables on the culture of the Northeast Florida nonprofit sector.

The purpose of this mixed methods study was to explore the impact of a student teaching internship upon the classroom intercultural competence (CIC) of teacher education students and alumni. Phase I employed quantitative methodology to compare the intercultural competence as measured by Ross, Thornson, McDonald, and Arrastia’s (2009) Cross Cultural Competence Inventory (3CI) for three groups. The 3CI is a 63-item survey that uses corresponding questions to assess intercultural competence. Survey items are scored with a 6-point, strongly agree-to-strongly disagree Likert scale (Thornson, 2010). The three groups included teacher education students enrolled in a field observation course, students enrolled in their student teaching internship, and teacher education alumni currently teaching in the Jacksonville metropolitan area. Participants’ 3CI scores were used as a diagnostic tool to facilitate the recognition of factors relative to their overall intercultural competence. Three quantitative research questions were tested: Is there a statistically significant difference between matched pairs of intern’s CIC as measured by the scales and subscales of the 3CI (Ross et al., 2009) after students complete their field observation experience as compared to their pre-field observation scores? This question was not supported (t(116) = 1.07; p > .05). Do matched pairs of interns who experienced an IST enhanced internship (Ross et al., 2009) as compared to matched pairs of interns whose student teaching experience was exclusively in a domestic classroom? This question was supported (t(38) = 1.68; p < .001; d = .252). Do in-service teachers who experienced an IST enhanced internship demonstrate increased CIC as measured by the scales and subscales of the 3CI (Ross et al., 2009) as compared to in-service teachers whose student teaching experience was exclusively in a domestic classroom? This question was not supported (t(25) = .93; p > .05). Each of the 6 subfactors was charted to portray a graphic illustration of the areas of strengths and weakness concerning classroom intercultural competence. In the qualitative component of the present study, interview methodology facilitated gathering qualitative data from intern and in-service teachers. This provided a context for enhancing the quantitative data and for addressing the unique nature of how different individuals learn to adapt to diverse students in the classroom. One qualitative research question was tested: To what extent do qualitative data collected from interviews reflect similar areas of growth as indicated by the scales and subscales of the 3CI (Ross et al., 2009) quantitative measurement? Interviews with these teachers led to the identification of significant factors related to intercultural communicative success in the multicultural classroom. Hence, research question 4 was supported.

The present study was conducted to capture the collective voice of expert organizational development consultants. Until now, very few studies have been conducted that take into account the collective voices of organizational development consultants. More specifically, the purpose of the present study is to explore and gain a deeper understanding of the approaches expert organizational development consultants use throughout their engagement with their clients in an attempt to add value to and enhance organizational capacity. To understand the process used by this distinct group of leaders, phenomenological qualitative inquiry was the methodology used to conduct this study. Data were collected through in-depth, face-to-face interviews with seven practicing expert consultants in the Jacksonville, Florida area. Seven themes emerged through careful analysis of the data, supported with relevant concepts from the professional literature. The study has meaningful implications for the study of organization development consulting. It concludes with recommendations for consultants and researchers in the field of organizational development and change.

Secondary Education reform efforts have focused on perpetual achievement gaps for more than a decade, highlighting the essence of state level standardized test scores in reading and math, among diverse student groups in relation to their white peers. The reauthorization of ESEA (2013), is a reform effort described as the Student Success Act, whereby the expectation of student success is described in terms of all students graduating from high school, both college and career ready. The concept of no child left behind remains at the base of the law, which designates federal funds for education programs designed to ensure equal access to educational opportunities for all students regardless of their demographics. In the 21st century, a major challenge of secondary school reform efforts is to guarantee equal access while supporting overall student success in accelerated learning environments. The major purpose of this study was to explore the perceptions of African American high school students’ on their experiences of success in accelerated learning programs, including Advanced International Certificate of Education (AICE), Advanced Program (AP), and International Baccalaureate (IB). Other key interest areas of influence on their perceptions of success included academic efficacy, ethnic identity awareness, and future aspirations. The theoretical frameworks of Bandura’s social cognitive theory (1986), Erikson’s (1968) identity development theory, McClelland’s (1961) human motivation theory, Benard’s (1993) resiliency theory, and Phinney’s ethnic identity development model (1992) framed this research study. Using a qualitative design, in-depth interviews were conducted to obtain thick, rich, detailed materials to gain a deep understanding of the self-concepts, beliefs, and views of how African American high school students think about key influences on their success in accelerated learning programs. Data analysis applying a thematic approach through an inductive and interactive systematic process of data coding and analysis generated themes regarding knowledge strengths, academic and cultural diversity, resource systems, stereotypical expectations, future focused, commitment to give back to the community, and networking for progress. Implications for secondary education policy makers include the need for a more comprehensive resource system, to address opportunity gaps in accelerated learning programs, and expectations gaps in the preparedness of diverse students for college and careers. Understanding African American high school students’ experiences of success may assist in fostering an environment of wholeness and inclusion, in turn possibly leading to a full health approach to student success, including the physical, psychological, mental, and spiritual/inspirational aspects of human development for optimal learning and increased academic and overall life success among African American high school students and all diverse student groups.

The purpose of this quality improvement project was to increase physical activity among postoperative adult liver transplant patients, improve documentation of daily activity, and ultimately influence quality of life (QOL). Quality of life has been shown to improve dramatically after liver transplant, as patients enter transplant severely debilitated with limitations on their physical activity which carry over following transplant. The literature supports that liver transplant patients should engage in physical activity which may improve QOL. Thirteen liver transplant patients were recruited within the seven days of their post-operative hospitalization. Twelve patients consented, were educated about the benefits of walking, given instructions for how to gradually increase their walking activity, and how to track this activity in a daily log. The International Physical Activity Questionnaire (IPAQ) that calculates level of physical activity (metabolic equivalent or MET score) was conducted at baseline and six weeks. Patients were also asked to rate their perceived quality of life on a ten point scale. Eight patients completed the study with four patients medically unable to complete the walking program. Baseline MET and QOL scores were compared between Time 1 and Time 2 (six weeks). The IPAQ baseline score increased from 407.5 MET to 1,711.5 MET, however, results were not statistically significant. Quality of life improved from Time 1 average score of 5.5 (SD=2.51) to Time 2 average score of 8.25 (SD=1.67) and was statistically significant (P=0.27). Liver transplant patients gradually increased their walking activity over a six week period and documented that activity daily. QOL was also purported to increase which is consistent with findings in the literature. Implementing a post liver transplant walking program is feasible and beneficial for patients and should be a standard of care.