Patient falls are an ongoing concern for health systems in the US and in the setting where this project took place. Inpatient falls affect consumers and health providers because falls often result in patient morbidity and mortality, legal risk, increased length of stay, and increased costs. The purpose of this project was to evaluate the existing fall prevention protocol at the site where this project took place and to make recommendations for an evidenced-based fall prevention protocol. The professional practice model was the conceptual model that guided the exploratory descriptive project. A review of the site's fall prevention policies and procedures revealed a new fall prevention protocol was in place and included bed alarms, and chair alarms to ring on nurses' phones although observation of nurses revealed that there were problems maintaining the protocol the entire day and 66% of patient falls occurred when the bed alarms were not set. The resulting recommendation was for additional education and a bundled approach with nurse education, patient and family education and a fall risk assessment that was easy to use. Nurses were then surveyed before and after education on the current protocol and the Morse Fall Risk (MFRs) to determine their willingness to use the simpler version for fall risk assessment. Before education 18 nurses confirmed they would use the protocol and MFR tool and all 20 agreed to use it after the education session. An implementation of a bundled approach to the fall prevention protocol that nurses incorporate into their daily practice will lead to a positive social change and as a result may increase patient safety by reducing patient falls.

The purpose of patient education is to provide patients and their families with the tools needed to care for themselves after discharge from the hospital, but shortened hospital stays, limited health literacy, language, and age can impede the patient's comprehension of the information provided. Researchers have found that the lack of effective patient education is related to 30-day hospital readmissions. The Power of 3 educational tool, designed by Sanchez and Cooknell, addressed the factors that impeded effective patient teaching by using the adult learning theory and low health literacy concepts. The Power of 3 was implemented as a quality improvement project in the Total Joint Center in October 2014. The purpose of this project was to assess the effect of an adult learning-based educational tool on the readmission rates for venous thrombus embolism and infection and on the effect on mobility in total joint surgery patients. This goal was accomplished by performing a retrospective chart review on 90 randomized patients, 45 before and 45 after implementation. The Power of 3 demonstrated a statistically significant change in the length of time a patient remained out of bed on the day of surgery after implementing the educational tool (0.75 hours vs. 1.514 hours, p = 0.0182, CI 95%). In addition, the number of patients that nursing staff documented who were out of bed was also statistically significant on the day of surgery (12 patients vs. 24, p = 0.0461, CI 95%). This educational tool can facilitate patient teaching by addressing language and educational barriers between patients and health care workers.

Improving Quality-of-Life in Older Adults with Depression and Diabetes through Medication Compliance Education by Valreen Hinds-Beharrie MSN, Adelphi University, 1997 BSN, Adelphi University, 1986 Project Submitted in Partial Fulfillment of the Requirement for the Degree of Doctor of Nursing Practice Walden University March 2016 Diabetes and depression are prevalent diseases that cause morbidity and mortality. Diabetes is a heterogeneous metabolic disease in which hypoglycemia is a central feature. Depression is associated with increased counter-regulatory, hormone release, and alteration in glucose transport function. Depression occurs in some individuals with diabetes and is associated with poor metabolic control, inadequate control of diet, and poor adherence to medication that can decrease quality of life. The prevalence of depression in Type 2 diabetes mellitus patients is significantly higher in the over 55-year-old population than in the general public. The purpose of this quality improvement project was to assess whether a medication compliance program would improve the quality of life of older adults diagnosed with depression and diabetes. Orem's self-care deficit theory provided a theoretical framework to guide and assist the patient with depression and diabetes to meet self-management regimen. The project question investigated whether a compliance education program could improve the quality of life of adults with depression and diabetes. A convenience sample of 28 patients diagnosed with depression and diabetes participated in the program. Outcome data were collected pre and post-intervention via the World Health Organization's Quality of Life Questionnaire and calculated using percentage difference, revealing an improvement in quality of life. There were compelling improvements in physical health (+28.5%), social relationships (+32.3%), and environment (+25%). Measurable improvements were also seen in physical health (+15.1) and in general health (+3.6). These findings may serve to influence practice and can lead to positive social change in this population by decreasing the risk of complications and improve the well-being of these dual diagnosis patients.

The significance of professional development (PD) is acknowledged in research studies as essential to implementing rigorous state standards. Although the literature recognizes that PD is a crucial component in improving teachers' knowledge and skills, some teachers at a midsized urban public elementary school in the southern United States did not see the benefit of attending PD. The purpose of this study was to explore elementary special education teachers' perceptions of PD around assessment. Guided by a framework based on Chen and McCray's whole teacher approach to teacher PD, this basic qualitative study was designed to understand how these elementary special education teachers viewed the PD activities related to assessment at the local site. In-depth interviews were conducted with elementary special education teachers at LMP Elementary School who had attended PD about assessment. Interview data were analyzed using the content analysis method. Overall, findings revealed concerns regarding the quality of PD, lack of training, lack of evidence-based practice, teachers' intrinsic motivation and commitment, and teachers' autonomy. Findings were used to design a 3-day PD workshop that engaged learning techniques for special education teachers to assess and implement instructional methods to augment students with disabilities' academic achievement. Ultimately, this study has implications for creating positive social change by advocating and providing for special education teachers to be maximally engaged in PD aimed at enhancing outcomes for the students with disabilities they serve.

New Jersey is 1 of 46 states to enroll in President Obama's Race-to-the-Top Initiative. Participating states must adopt national standards, revise teacher evaluation procedures, and administer new state assessments. States are prioritizing quality professional development (PD) to prepare teachers for these rapid shifts. The overall problem studied was how high school teachers perceive the quality of PD in a high school in New Jersey. While substandard PD alone is not enough to lose tenure, it has recently become one of the evaluative measures for teacher performance according to a new tenure law signed in 2012 by Governor Chris Christie. Such added pressures could impact teachers' attitudes toward their professional growth. The study was based on Mezirow and Knowles' theory of adult learning as well as social constructivism. Several questions guided this study, such as how can teachers' perceptions shape the current PD program in the featured high school and if the current shifts in educational reform affect their perception. A case study was used as the research design, and interviews were employed as the main method of gathering qualitative data. Subsequently, 7 educators in various content-specialties were interviewed. Once the interviews were analyzed, transcribed, and coded, 5 significant themes emerged: (a) organized and relevant training, (b) in-class support, (c) continuity and constructive feedback, (d) accountability of transference, and (e) a culture of respectful collaboration and partnership. The implications for social change for this project would be that an effective PD program at the high school might improve the high school teachers' attitudes toward their own professional growth. Improved attitudes might motivate teachers to apply new knowledge, which will increase student performance, faculty morale, and community & family relations.

The No Child Left Behind Act (2002) and Race to the Top (2009) legislation have forged new school accountability measures and led to a sharp increase in demand for teacher professional development (TPD). However, data revealed that there is a disconnection between the training that teachers receive and its implementation, limiting its impact on student achievement. This qualitative case study's purpose was to reveal major barriers to TPD implementation and provide suggestions for crafting more impactful TPD. Based on the social constructivist foundation, this study sought to address the factors that increase teachers' receptiveness to more effective teaching techniques. It explored middle school teachers' perceptions of TPD, its connection to student achievement, and factors influencing implementation. Semi-structured interviews with open-ended questions helped to identify emergent themes. Nine participants were purposefully selected to gather data from perspectives across race, gender, and various teaching experiences. This study took an inductive approach using the constant comparison methodology of data analysis. Participants identified influencing factors regarding TPD, such as the inclusion of a follow-up component for accountability and feedback. Also, the participants insisted that TPD must be seen as non-punitive, relevant, engaging, and non-hypocritical; for example, a lecture cannot teach teachers about the ineffectiveness of teaching via lecture. These findings encourage positive social change by providing insight into crafting more impactful TPD. Ultimately, improved TPD encourages better teaching methodologies, increased teacher morale, and higher student achievement.

Currently, nonemployee students who take General Electric's (GE's) pollution control classes do not demonstrate consistent knowledge gains following training. The purpose of this project was to investigate whether the independent variables of level of education and choice in attending the class made a significant difference in the means of the dependent variables of anxiety and ability to focus. The project was influenced by the theory of andragogy, which explores the motivations and principles specific to the teaching of adults. The research questions for this study probed relationships between level of formal education among participants and their choice in whether to attend or not and potential anxiety towards training and their ability to focus on training. Data were collected from 756 adults who took a voluntary self-designed survey while registering for this class. A quantitative approach that included t tests and ANOVA tests revealed significant differences when comparing the adult behaviors of anxiety and ability to focus with the variables of choice in attendance of training and level of completed formal education. The results were used to inform a train-the-trainer program with the goal of mitigating discrepancies in knowledge transfer. As the impacts of pollution are understood, it is critical that those who are responsible for controlling pollution have the best training. Organizations that issue professional certifications need to be assured that those completing continuing education units deserve the awarded credits. Thus, any improvement to the consistency of knowledge transferred for GE's pollution control classes will support social change by enhancing the ability of students of the class to protect the earth's communities and climate and fulfill education obligations.

The post-9/11 security environment is one that confronts the United States, and specifically the U.S. Army, with complex problems that require development of leaders with improved knowledge, skills, and attributes to meet the challenges of defending the nation. The problem confronting the U.S. Army is that Army leaders lack a learning environment or methodology that enables effective self-development throughout their career. Research suggests that PLNs (PLNs) and a connectivist approach may address that problem, but these have been limited to civilian educational environments. This qualitative case study explored the use of PLNs with a connectivist approach for leader self-development in Army organizations. The case in this study was that of a cohort of 22 officers in a U.S. Army unit. Each officer developed a PLN and then employed a connectivist approach to connect, curate, create, and share knowledge. Data were collected using semistructured interviews and analyzed with a focus on themes that could inform future decisions by Army senior leadership on the self-development of leaders, and that could enable decisions that will reduce loss of life and destruction in wartime. The major themes developed in this study account for the approach and challenges to Army self-development, the motivation for and execution of connected learning, and the structuring and desired characteristics of self-development that employs PLNs and connectivism. Recommendations included integrating a semistructured approach to self-development into emerging educational approaches to Army leader development. More prepared Army leaders can respond to crises more effectively, reducing adverse effects, damage, and loss of life

Individuals with serious mental illness (SMI) exhibit low motivation to participate in educational leisure activities at Clubhouses accredited by Clubhouse International (CI). This correlational study examined the relationship between each of 4 motives, intellectual, social, competence-mastery, and stimulus-avoidance, to engage in leisure activities, and the perception of recovery from SMI. Knowles's theory of andragogy supported the concept of informal self-directed learning, which occurs with leisure activities. Literature indicates that participating in leisure activities such as those offered at Clubhouses aids in the recovery from SMI. Quantitative data were collected from a convenience sample of 75 individuals at 4 CI clubhouses using 2 Likert-scale instruments, the Leisure Motivational Scale (LMS) and the Recovery Assessment Scale - Domains and Stages (RAS-DS). Pearson correlation coefficients indicated significant moderate positive correlations between each of 4 motives, intellectual, social, competence-mastery, and stimulus-avoidance, to engage in leisure activities, and the perception of recovery from SMI. These findings were used to design a professional development program on motivation to teach the staff at a Clubhouse about how to engage members in leisure activities. The study has the potential to inspire positive social change by motivating members to improve their quality of life, learn social and work skills, develop friendships and a support system, reengage with society, and to become employed.

The college open door policy initiated in the 1960s made access to higher education available for more students in the United States. People who were once excluded from enrolling in college now have an opportunity to earn a college degree. Some first-time students, significantly underprepared in writing, have been required to enroll in developmental or remedial writing courses before entering college-level English despite research indicating that taking noncredit courses increases the time for college completion and the cost of college, while also reducing the likelihood of completion. This illustrative case study, guided by the constructivist approach to instruction, was designed to discover college faculty members' perceptions concerning university students' writing and the interventions needed to improve writing skills. The qualitative data were collected through audio-recorded semistructured interviews of 12 college faculty members that were transcribed and coded with Ethnograph software. The findings indicated that college faculty members believed most students lacked basic writing skills and did not take sufficient initiative for their learning. Faculty members also thought students' writing would improve if students assumed responsibility for their learning and used the resources available. This study provides insight into college faculty members' views of students' writing skills and recommendations for how these skills might be improved through collaborative efforts across the university, resulting in positive outcomes for both the students and university by increasing student graduation rates and reducing college debt.