Inductions of labor that occur prior to 39 weeks' gestation can pose increased risks for the mother-baby dyad. In the target setting, there is a gap in knowledge among the pregnant women about options for delivery, hospital policies and procedures, and what to expect in the labor and delivery experience. Because of this gap in knowledge, the pregnant patient is unable to make informed decisions regarding her needs, expectations, and care. This lack of knowledge has resulted in a 40-50% rate of inductions of labor at the target site, which is well above the 2014 national average of 25%. In response to this gap, an evidence-based initiative was developed that focused on appropriate use of inductions of labor to increase safety and quality of care of the pregnant patient in a suburban women's hospital located in southeastern Georgia. The design used for this project was the development of an evidence-based, theory-supported educational initiative that underwent a formative and summative evaluation by a 10 member, interdisciplinary expert panel. Watson's theory of human caring provided the theoretical basis for the educational program. The interdisciplinary expert panel found that the initiative was educationally sound. The materials were found suitable for the intended audience and easy to understand. It is projected that the initiative will not only benefit the pregnant woman but will also increase the interaction, collaboration, and respect of members of the healthcare team. Implications for positive social change include the development of an educational program that will result in patients being more informed and becoming active participants in their care which will result in better outcomes for the mother and baby dyad.

In an urban high school in California, students are generally unskilled in critical writing. The problem has been associated with instructional barriers encountered by teachers. In this qualitative case study, English Language teachers provided their perceptions of such barriers and shared perspectives for solutions based in professional development. Grounded in the theories of Halpern, Saiz and Rivas, Weigle, and Harris and Graham, the conceptual framework emphasized instructional models that develop metacognition in writing, which can increase students' critical thinking. Selection criteria required participants who were English Language Arts teachers of writing critical thinking. Data from 4 participant interviews were coded, labeled, and collapsed into themes on the teachers' perceived barriers towards teaching critical thinking. Interview data were triangulated using field notes that revealed that limited teacher pedagogy, lack of student application, and an overall scarcity of school support prevented educators from teaching critical thinking in writing. The findings indicated a lack of an understanding from students, teachers, and administration of the instructional elements needed to develop successful critical thinking in writing. This study promotes positive social change by illuminating the instructional barriers by these 4 high school English Language Arts teachers. In addition, a professional development program, informed by the findings of this inquiry, will present teachers and administrators with strategies to increase critical thinking and writing. These coaching and mentoring strategies comprise a sustainable systemic program that will improve student critical thinking and writing.

Middle-school students in Nova Scotia are perceived to have low self-efficacy for achieving learning outcomes. Strong self-efficacy beliefs developed through effective curricula have been linked to improved academic performance. However, there is a need for the formal evaluation of effective curricula that aim to improve self-efficacy. The purpose of this project study was to investigate a 10-week, after-school mentorship (ASM) curriculum that has never been evaluated. The outcomes of the curriculum design are to strengthen self-efficacy beliefs via relationship building exercises, public speaking training, and character education. Bandura's theory on self-efficacy, which states that treatment influences can alter the strength of self-efficacy, informed the conceptual framework. Evaluation questions explored apparent changes in the self-efficacy of the students from the perspective of 7 adult-caregivers and the program's instructor. Interview data were triangulated with quantitative descriptive statistics on the self-efficacy scores of 10 middle-grade students before and after program participation using the Children's Hope Scale. Comparison of the mean, median, and mode pre- and posttest scores did not show statistically significant differences in self-efficacy beliefs of the students. However, analysis of interview data revealed that children's self-efficacy beliefs grew, the largest increase being in those described as reserved at the beginning of the program. This study promotes positive social change through an increased understanding that can inform efforts to increase self-efficacy in middle-school students

Poor nursing documentation of patient care was identified in daily nurse visit notes in a health care setting. This problem affects effective communication of patient status with other clinicians, thereby jeopardizing clinical decision-making. The purpose of this evidence-based project was to determine the impact of a retraining program on the quality of documentation of patient care in nurses' notes in a home health agency in central Texas. A retrospective audit of quality of nursing documentation using the Nurse and Midwifery Content Audit Tool (NMCAT) was done. A pre- and posttest design was used. A convenience sample of de-identified nurses' notes (80 pre- and 80 post) was selected from active patient records in the agency (n = 160). Descriptive and inferential statistics from the project showed that there was improved quality for the 15 criteria representing quality nursing documentation. After the educational intervention, documentation of patient's status if changed or unchanged improved to 80%, and patient's response to treatment improved (57% to 85%), entries were written as incidents occurred improved (53% to 64%). The nurse refers to the patient by name improved (0% to 66%). These findings were an indication of practice change, validating the need for periodic audits of nurses' notes in the agency in order to demonstrate compliance with quality standards. Based on the project findings, a retraining program is recommended to improve structured nursing documentation in a home health agency. This project is likely to contribute to social change as it enhanced the information communicated to other health care providers, coordination of care, and patient outcomes.

Nursing administrators are exploring interventions to increase student retention rates in order to decrease college costs, improve faculty effort and time developing courses, decrease administrative resources, and to continue their accreditation. The purpose of this study was to determine whether or not there was a correlation between the Test of Essential Academic Skills (TEAS) reading comprehension scores, American College Test (ACT) reading comprehension scores, Comprehensive Computer-Adaptive Testing (COMPASS) reading comprehension scores, and the cumulative college grade point average (GPA) of the first-year nursing student. The theoretical foundation for this study was Tinto's retention theory, which claims that students' past academic performance predicts retention. A correlation approach within a cross-sectional nonexperimental design was used by analyzing data from admission testing and the first-year cumulative GPA from 151 associate degree nursing students from a private college in the Southeast Missouri area. According to study results, there was no correlation between GPAs and reading comprehension scores. Additionally, ACT, TEAS, and COMPASS reading comprehension scores did not correlate with student retention rates. Administrators in the associate degree nursing program can use the results of this study to determine what interventions might determine the success of the first-year nursing student. Positive social change will result from a more diverse set of admission criteria for acceptance into the program and will assist the admissons committees to find the best candidates for the program.

This sequential mixed methods study addressed the need for research that both described and explained how teachers of varying experience respond to administrative evaluative feedback. Formative evaluation theory of Scriven and professional growth models of Steffy and Fessler served as theoretical models for data analysis. An online survey asking teachers how they changed their practices and what accounted for their response was received from 270 teachers in 1 Midwestern state. Of these, 9 teachers of varying experience were interviewed. The quantitative data showed that most teachers do not change practices on the 8 state teaching standards in response to feedback. An independent sample t test revealed statistically significant differences between teachers of varying experience in 3 standards: support of district goals, classroom management, and instruction. . An ANOVA found no significant effect between teaching experience and the length of time since the feedback was provided to the teacher. Qualitative data found a variety of social, personal, organizational, and student-based needs that accounted for teachers' response to feedback. In teachers that made changes to practices, administrator suggestion was the most important factor, but conversations with colleagues were also important. However, most teachers did not receive formative feedback. Organizational factors such as state initiatives to change instruction influenced teachers of more experience than novice teachers. These findings can help administrators improve the formative effect of their feedback. Understanding how evaluative feedback leads to changes in teaching practices should improve feedback systems in schools across the nation which subsequently should lead to in more effective teaching practices.

The problem addressed in this project was the lack of experienced RNs needed in the acute care setting to deliver safe, quality patient care, while effectively managing resources and providing job satisfaction. The purpose of this project was to determine if an education module designed to educate charge and rover nurses on the Collaborative Care Model (CCM) would enhance staff nurses' abilities to provide safe, high quality care to patients, and improve staff nurse retention on one unit in an acute care setting. The theoretical frameworks utilized to guide the education module included: Lewin's theory of planned change, Benner's novice to expert model, and AACN's synergy model for patient care. The project question asked if an educative process designed around the CCM for charge nurses and rovers would result in improvement and sustainment of nursing quality indicators on the unit and improve staff nurse retention. The educational modules included two, four-hour education sessions with power point presentations and interactive assignments presented on two separate dates. Analysis of effectiveness was determined by comparing initial and post education nursing quality indicators (Hospital Consumer Assessment of Healthcare Providers & Systems Dashboard and the Human Resources Score Card) for the unit. Results showed that staff turnover was reduced from 41% to 35.9% and patients' perceptions of teamwork increased from 47.4% to 60.9% following the education modules. This project contributes to positive social change by providing education to promote quality care and staff nurse retention.

In the United States, approximately 30.3 million or 9.4% of the population have been diagnosed with diabetes mellitus. Of these, 8.3 million remain undiagnosed. There are approximately 2 million people incarcerated in detention centers, jails, and prisons across the United States with approximately 80,000 inmates living with diabetes. Correctional officers are not educated to identify and respond to inmates with evolving medical complications, such as low or high blood glucose, which can lead to preventable adverse events, including permanent injury or death. The purpose of this project was to develop an evidence-based education module to teach correctional officers how to recognize the signs and symptoms of low or high blood glucose levels of inmates with uncontrolled diabetes and to rapidly respond with basic medical treatment. The module was validated by 6 experts with 87% agreement prior to being presented to 49 corrections officers in a 1-hour lecture format with cases, guided by Knowles's adult learning theory. A paired t-test demonstrated the average knowledge scores significantly increased from 56% before to 76% after the education module (t = 7.16, p = 0.0001). Although the baseline and follow-up knowledge were low among this group, this project measured only short-term learning outcomes. Because the impact of knowledge acquisition could diminish or disappear with time, future studies to measure the long-term effects of the education on avoiding adverse events are necessary. This project contributes to positive social change by providing correctional officers with an increased likelihood of identifying early and responding appropriately to inmates with an evolving medical emergency.

Nursing workforce competency in informatics is crucial to providing safe patient care, improving quality, and reducing healthcare costs. Assurance of informatics competency in a workforce with increasingly diverse educational preparations, demographics, and informatics skills poses significant challenges. The question addressed was the lack of nursing informatics competency assessment tool relevant to bedside nursing. The purpose of this project was to develop and review a new nursing informatics competency assessment tool designed to address the individual educational needs of newly hired nurses. The tool was designed to measure nurses' competency in computer literacy, informatics literacy, and informatics management skills recommended in the American Nurses Association's Standards and Scope of Practice and Technology Informatics Guiding Education Reform. This tool supports practices at the bedside by providing individualized education according to the results of a self-assessment. The project was guided by the Benner's model and the Rosswurm and Larrabee framework. Content validity was established by item analysis, relevancy scale, and validation by the identified experts from the organization's Nursing Informatics Department (n = 4); the Department of Education, Practice, and Research (n =8); the Clinical Outcomes Department (n = 1); and bedside nurses (n = 14). The administration recommended this tool be incorporated into its strategic plan. This project promoted positive social change by developing a tool to assess informatics competencies in newly hired nurses and guide educators in developing future educational strategies. These efforts will assist in creating a workforce that is prepared to deliver healthcare safely, efficiently, and cost-effectively in the increasingly technology-savvy environment of U.S. healthcare in the 21st century.

Enrollment in master level programs has been increasing nationwide, particularly in online programs which tend to enroll older and more ethnically diverse students who are likely to be balancing work, finances, and family responsibilities with their educational pursuits. The challenges related to this balance has resulted in higher attrition rates and lower completion rates. In this quantitative study, the relationship between employer support and first-year retention for master's students enrolled in online programs at a for-profit university was examined. Bean and Metzner's model of nontraditional student attrition was used as the theoretical foundation. Archival data from the online institution were examined to determine the extent that 1st year retention is predicted by employer support when controlling for demographics, student background, external factors, integration/socialization, and intent to graduate. Findings from the logistic regression analysis showed 4 variables that significantly predict 1st year retention, employer support, household income, overall satisfaction, and importance of graduating from the institution. Students who received employer support were almost 2 times more likely to be retained at 1-year. Positive social change can result from having educational institutions encourage students to seek employee educational benefits. Having students seek these employer benefits may lead to higher graduation rates, higher pay, and job satisfaction for employees.