A 15-facility healthcare organization utilized organizational change management techniques to aid with the adoption of a clinical information system to accomplish desired cultural transformation. The aim of this article was to provide a description of team member and physician attitudes toward change during conversion to a new clinical information system of electronic documentation. The tool developed and utilized was a change readiness survey to assess randomly selected team member and physician perceived readiness for the transition to an electronic documentation system. This article reviewed the rationale for using organizational change management techniques to facilitate adoption of a new clinical information system and discussed development of a change readiness survey tool. It explored the findings from the first 3 years of the survey.

The aim of this study is to examine the way preschool teachers relate to, and apply the concept of teaching in various aspects. Furthermore, this study has the purpose of portraying the constructions of the concept of teaching, that give meaning and a course of action in their goal-directed work. The following questions are the starting point for the study: How do preschool teachers interpret the concept of teaching in the preschools practice? How do preschool teachers construct the concept of teaching in their team of co-workers? In what ways is the concept of teaching expressed in projects on the preschools educational documentation (processvägg)? To conduct our study a qualitative research method is applied. We interviewed eight preschool teachers from six different preschools in Stockholm county with sound recording. Further we accumulated photos and notes of each preschools educational documentation. The theoretical framework includes an social constructivistic perspective along with the concepts of the impact of language as well as discourses power. The aim and questions of the study is answered through the appliance of the theoretical framework which is presented in the study’s result and analysis part. The main results of the study are presented in three main categories that present the conclusion that preschool teachers do not perceive the concept of teaching as unclear. However there are different interpretations and discourses that, in collaboration, can cause a difference in how teaching is constructed, practiced and expressed. The preschool teacher's responsibility and leadership is shown to have an impact on how the concept of teaching is constructed. The impact of construction is shown through the use of language and discourses power in their team of co-workers, from planning to expression in practice and in educational documentation.

The Reggio Emilia Approach (REA) and Head Start (HS) value high-quality early education, support for families, and community partnerships according to the literature. Exploring principles of REA in relation to the HS program model may reveal alignment that will inform high-quality developmentally appropriate practices that are meaningful and enhance learning outcomes. This multiple case study explores the REA in alignment within three Head Start programs in New Mexico, Massachusetts, and Tennessee. Participant groups include one education director, one education leader, and four teachers in each of the three locations. In New Mexico, the HS program was located on a Native American pueblo. In Massachusetts the HS program was located in a diverse urban community, and the HS program in Tennessee was located in rural east Tennessee. Data to demonstrate participant’s alignment with nine REA principles include a survey, an interview, and observations without children present at each location. All participants responded with some alignment to the REA principles, yet lack of clear understanding was found among a majority of participants. Classroom observations revealed stronger alignment with REA principles in New Mexico. An interesting finding was that across cases there was one teacher who had more experience with including Reggio-inspired principles in her teaching practices. Teachers were interested in professional development beyond HS mandates. A small ungeneralizable sample is a limitation, which suggests future research using the survey and development of the 3 observation tool with a larger sample. Implications suggest future professional development introducing the REA may inform teaching practices in Head Start programs.

Although guidelines and minimal standards for the care and documentation of wounds in home health care settings in the United States are available, there is a lack of compliance among many home health care agencies (HHAs) with regard to the accuracy of wound documentation and care of wounds. Failure to follow guidelines for wound care according to Centers for Medicare and Medicaid Services and Home Health Outcome and Assessment Information System standards could result in loss of revenue for HHAs, improper treatment of wounds, and legal ramifications. The purpose of this doctoral project was to develop and validate a staff educational module on wounds and wound documentation for an HHA. Benner's from-novice-to-expert model was the conceptual framework for understanding nurses' matriculation. The practice-focused question focused on whether a wound staff educational module increased the home health care nurse's knowledge about wounds and wound documentation. A 5-level Likert scale was used by an expert panel to validate the staff educational module. Descriptive analysis was used to evaluate the data. The results of the survey supported implementing the educational module with recommendations (overall percentage 93% [4.4]). The findings of this project contribute to social change by increasing nurses' knowledge of wound care, improving the quality of wound care, increasing reimbursement and revenue, and decreasing the cost of care for wounds.

Hispanic students often suffer from acculturative stress as they adapt to U.S. college environments; however, few scholars have examined the acculturative stress relationship among undocumented versus documented Hispanic college students. In this quantitative, correlational study design, adaptation levels related to acculturative stress between both statuses were examined. The theoretical foundations of this study are based on the social cognitive career theory. This investigation focused on determining how adaptation levels predict Hispanic college students' acculturative stress and whether this realtionship differ between documented and undocumented college students. The I-Adapt measure was used to measure participants' level of adaptability and the social, attitudinal, familial and educational or the Social, Attitudinal, Familial and Educational (S.A.F.E) measurement was used to measure their acculturative stress levels. The sample consisted of 165 Hispanic college students recruited from a private northeastern university. Contrarily to the main hypothesis, Regression analysis revealed that higher levels of cultural and crisis adaptability predicted lower levels of acculturative stress while higher levels of work stress adaptability predicted higher levels of acculturative stress. Future research should focus on further examination differences in adaptation toward acculturative stress and the aftermath of acculturative stress adaptation methods between documented and undocumented college students. The findings of this study can contribute to social change by informing immigration laws to adopt in order to protect college educated, skilled and productive immigrants.

Background: The National Institute Mental Health (2015) estimated there were about 44.7 million people diagnosed with a serious mental illness and 62.9% of those diagnosed were without mental health services. The loss of services was due to unemployment, reoccurring hospitalization, inabilities to care for themselves, and lack of participation in societal norms (World Health Organization [WHO], 2014). According to Insel (2011/2015), the U.S. cost of mental healthcare was an estimated $57.5 billion in 2006. This cost was not due to actual care but associated with the economic burden of job loss and the excessive use of community resources. The Affordable Care Act (ACA) and the Mental Health Equality and Parity Act (MHEPA) has positively influenced access to mental healthcare, but healthcare coverage continues to be deficient. Insufficient clinical documentation practices decrease insurance reimbursement potential. Purpose: The purpose of this quality improvement project was to enhance the current clinical documentation practices and policies and increase insurance reimbursement in an adult psychiatric inpatient unit in a private, non-profit mental and behavioral health organization. Theoretical Framework: The Kurt Lewin’s 3 Step Change Management Theory Methods: A quantitative design guided this project utilized an investigator-developed tool modeled from the CMS Inpatient Unit Worksheet as a data collection tool from the clinical chart documentation reviews. Results: Fisher’s Exact and Chi square tests measured the cross tabulation of pre and post comparison sample frequency of staff’s integration of an evidence-based descriptive documentation method into practice. The results presented with statistical significance of the progress narrative notes. The declined chart claims a p <0.001, and the numbers related to case scenario utilization of the documentation method was p = 1.00. Conclusion: The relationship between descriptive clinical documentation and insurance reimbursement was evident in the usage of the Data, Assessment/Action, Response, and Plan (DARP) method in the clinical documentation progress narratives notes. There was a 24% improvement in insurance reimbursement claims and a 17% decrease in charts declined for the study period.

This diploma thesis deals with the design of a kindergarten in Kunovice near Uherské Hradiště. The kindergarten has two above-ground floors. There are two classes on the first floor, each for 25 children. Part of this floor is a kitchen with copmlete equipment to provide all-day dining. On the second floor there is a small library with computers and teachers´facilities. The structural system is made of brick made of ceramic fittings covered with a flat and countertop roof. The work includes project documentation fot the construction.

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This thesis deals with the renewal of the cadastre documentation by mapping. It is analysing all stages of the reconstruction. These stages have been demonstrated on a sketch of cadastral area of Senetářov. On the basis of acquired results a digital cadastral map has been drawed up in the programme of MicroGEOS Nautil by automated techniques.

In my work I deal with how to do things. Instructional videos, printed paper instructions for using the product or performing an artistic event - all serve only as a platform for self-realization. The condition in the approach is not strictly following the established procedures. Rather, it is about reassessing what is essential at the moment.