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THE IMPACT OF A NURSE-DRIVEN EVIDENCE-BASED DISCHARGE PLANNING PROTOCOL ON ORGANIZATIONAL EFFICIENCY AND PATIENT SATISFACTION IN PATIENTS WITH CARDIAC IMPLANTS
Title
THE IMPACT OF A NURSE-DRIVEN EVIDENCE-BASED DISCHARGE PLANNING PROTOCOL ON ORGANIZATIONAL EFFICIENCY AND PATIENT SATISFACTION IN PATIENTS WITH CARDIAC IMPLANTS.
Creator
King, Tracey, Sole, Mary Lou, University of Central Florida
Abstract / Description
Purpose: Healthcare organizations are mandated to improve quality and safety for patients while stressed with shorter lengths of stay, communication lapses between disciplines, and patient throughput issues that impede timely delivery of patient care. Nurses play a prominent role in the safe transition of patients from admission to discharge. Although nurses participate in discharge planning, limited research has addressed the role and outcomes of the registered nurse as a leader in the...
Show morePurpose: Healthcare organizations are mandated to improve quality and safety for patients while stressed with shorter lengths of stay, communication lapses between disciplines, and patient throughput issues that impede timely delivery of patient care. Nurses play a prominent role in the safe transition of patients from admission to discharge. Although nurses participate in discharge planning, limited research has addressed the role and outcomes of the registered nurse as a leader in the process. The aim of this study was determine if implementation of a nurse-driven discharge planning protocol for patients undergoing cardiac implant would result in improved organizational efficiencies, higher medication reconciliation rates, and higher patient satisfaction scores. Methods: A two-group posttest experimental design was used to conduct the study. Informed consent was obtained from 53 individuals scheduled for a cardiac implant procedure. Subjects were randomly assigned to either a nurse-driven discharge planning intervention group or a control group. Post procedure, 46 subjects met inclusion criteria with half (n=23) assigned to each group. All subjects received traditional discharge planning services. The morning after the cardiac implant procedure, a specially trained registered nurse assessed subjects in the intervention for discharge readiness. Subjects in the intervention groups were then discharged under protocol orders by the intervention nurse after targeted physical assessment, review of the post procedure chest radiograph, and examination of the cardiac implant device function. The intervention nurse also provided patient education, discharge instructions, and conducted medication reconciliation. The day after discharge the principal investigator conducted a scripted follow-up phone call to answer questions and monitor for post procedure complications. A Hospital Discharge Survey was administered during the subject's follow-up appointment. Results: The majority of subjects were men, Caucasian, insured, and educated at the high school level or higher. Their average age was 73.5+ 9.8 years. No significant differences between groups were noted for gender, type of insurance, education, or type of cardiac implant (chi-square); or age (t-test). A Mann-Whitney U test (one-tailed) found no significant difference in variable cost per case (p=.437) and actual charges (p=.403) between the intervention and control groups. Significant differences were found between groups for discharge satisfaction (p=.05) and the discharge perception of overall health (p=.02), with those in the intervention group reporting higher scores. Chi square analysis found no significant difference in 30-day readmission rates (p=.520). Using an independent samples t-test, those in the intervention group were discharged earlier (p=.000), had a lower length of stay (p=.005), and had higher rates of reconciled medications (p=.000). The odds of having all medications reconciled were significantly higher in the intervention group (odds ratio, 50.27; 95% CI, 5.62-450.2; p=.000). Discussion/Implications: This is the first study to evaluate the role of the nurse as a clinical leader in patient throughput, discharge planning, and patient safety initiatives. A nurse driven discharge planning protocol resulted in earlier discharge times which can have a dramatic impact on patient throughput. The nurse driven protocol significantly reduced the likelihood of unreconciled medications at discharge and significantly increased patient satisfaction. Follow-up research is needed to determine if a registered nurse can impact organizational efficiency and discharge safety in other patient populations.
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Date Issued
2008
Identifier
CFE0002188, ucf:47915
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0002188
Coaching in an Interactive Virtual Reality to Increase Fidelity of Implementation of Discrete Trial Teaching
Title
Coaching in an Interactive Virtual Reality to Increase Fidelity of Implementation of Discrete Trial Teaching.
Creator
Vince Garland, Krista, Wienke, Wilfred, Pearl, Cynthia, Dieker, Lisa, Vasquez, Eleazar, Sundeen, Todd, University of Central Florida
Abstract / Description
In teacher preparation, more effective pathways and practices are needed for preparing, placing, and supporting beginning teachers and principals (Darling-Hammond, 2010; U.S. Department of Education, 2009b). A common issue in the field of special education is the lack of skill transfer from one setting to another (Dieker, Hynes, Hughes, (&) Smith, 2008). It has been posited that (")practicing up(") is not ethical in that novice teachers must attempt to teach with a limited knowledge of...
Show moreIn teacher preparation, more effective pathways and practices are needed for preparing, placing, and supporting beginning teachers and principals (Darling-Hammond, 2010; U.S. Department of Education, 2009b). A common issue in the field of special education is the lack of skill transfer from one setting to another (Dieker, Hynes, Hughes, (&) Smith, 2008). It has been posited that (")practicing up(") is not ethical in that novice teachers must attempt to teach with a limited knowledge of appropriate pedagogy and skill (Dieker et al., 2008). The new challenge becomes finding an effective mechanism that provides essential learning experiences and opportunities to refine teaching techniques to the highest standards of fidelity in a safely controlled and coordinated environment (Odom, 2009).Perhaps because of the ethical concerns in honing teacher skills on actual children, and despite the strong demand for professionals who are trained in discrete trial teaching (DTT), few studies have been published on training methodologies and fidelity of implementation (Fazzio, Martin, Arnal, (&) Yu, 2009). The training of teachers to implement evidence-based interventions such as DTT with fidelity while they are working with students with ASD cannot be over-emphasized in a teacher preparation program (Scheuermann, Webber, Boutot, (&) Goodwin, 2003; Simpson, 2004; 2005). The researcher utilized the TLE TeachLivE simulation classroom laboratory at the University of Central Florida as a mechanism to infuse cutting-edge technology and learning activities within program/project coursework. The TLE TeachLivE virtual classroom serves as a venue for pre-service and practicing teachers to safely gain proficiency and enhance fidelity of implementation of evidence-based practices. Participants experienced an immersive, real-time environment that featured interactions with Austin, an avatar that portrayed a student with autism. A trained interactor remotely controlled the behavior and responses of the avatar with which teachers engaged for practice sessions consisting of ten discrete trials. Between sessions, participants received individualized clinical coaching (ICC) on their performance. Upon termination of the intervention, two generalization probes were conducted to measure retention of fidelity over time within actual classroom settings. Results indicated that all five participants strongly benefited from learning DTT with ICC in the TLE TeachLivE learning platform.Across participants, the overall mean gain in fidelity from baseline phase (14%) to intervention phase (80%) was 66%. The fidelity means of participants in the generalization phase held to 90%, thus supporting the use of virtual environments for teacher preparation. Mean time among participants to attain higher than mastery level performance of 90% in intervention was 1.25 hours. This resulted in shorter training times than previously researched training programs (Arnal et al., 2007; Fazzio et al., 2009; Leblanc, (&) Luiselli, 2005; Thiessen et al., 2009). This investigation endeavored to reduce the potential of diminished pupil learning gains as a necessary consequence when honing skills in the appropriate delivery of instruction of discrete trial teaching.
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Date Issued
2012
Identifier
CFE0004450, ucf:49327
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0004450
AN INVESTIGATION OF COUNSELOR EDUCATORS' ATTITUDES TOWARDS EVIDENCE-BASED PRACTICES AND PERCEIVED BARRIERS TO THE INCORPORATION OF EVIDENCE-BASED PRACTICES IN COUNSELOR EDUCATION CURRICULA
Title
AN INVESTIGATION OF COUNSELOR EDUCATORS' ATTITUDES TOWARDS EVIDENCE-BASED PRACTICES AND PERCEIVED BARRIERS TO THE INCORPORATION OF EVIDENCE-BASED PRACTICES IN COUNSELOR EDUCATION CURRICULA.
Creator
Patel, Samir, Hagedorn, Bryce, University of Central Florida
Abstract / Description
The overall purpose of this study was to investigate counselor educatorsÂÂ' attitudes towards evidence-based practices (EBPs) and perceived barriers to the inclusion of EBPs in counselor education curricula. Additionally, this study aimed to assess whether counselor educatorsÂÂ' level of agreement towards the presence of motivational interviewing (MI) principles in the counseling relationship impacted attitudes towards EBPs. As such, this...
Show moreThe overall purpose of this study was to investigate counselor educatorsÂÂ' attitudes towards evidence-based practices (EBPs) and perceived barriers to the inclusion of EBPs in counselor education curricula. Additionally, this study aimed to assess whether counselor educatorsÂÂ' level of agreement towards the presence of motivational interviewing (MI) principles in the counseling relationship impacted attitudes towards EBPs. As such, this researcher analyzed four research questions using two instruments and a demographic questionnaire. Two hundred sixty nine counselor educators (39.8% response rate) from the Association of Counselor Education and Supervision responded to an electronic survey, which consisted of the Evidence-Based Practice Attitude Scale (EBPAS; Aarons, 2004), the BARRIERS Scale (Funk, Champagne, Wiese, & Tornquist, 1991), and a demographic questionnaire. Specifically, this study investigated four research questions to determine: (a) the difference in attitude towards adopting EBPs among counselor educators with respect to specific individual factors (i.e. specialized training in evidence-based practices, years of professoriate experience, and primary counselor education focus); (b) the difference in perceived barriers towards adopting EBPs into counselor education curricula among counselor educators with respect to organizational factors (i.e. type of program, status of CACREP accreditation, and faculty position); (c) the influence of EBP attitude on perceived barriers to the inclusion of EBPs in counselor education curricula; and (d) the correlation between counselor educators reported level of agreement towards MI principlesÂÂ' presence in the counseling relationship and their attitude towards EBPs. Multivariate analyses of variance (MANOVA) were computed to analyze the data for the first two research questions, while linear regressions were utilized to compute the data for the last two research questions. In terms of individual factors, study results indicated that neither specialized training in EBPs nor years of professoriate experience resulted in significant differences with regards to attitudes towards EBPs. However, data analysis did reveal a significant difference between counselor educators with a clinical focus and counselor educators with a vocational focus. With regards to organizational factors influence on perceived barriers to the inclusion of EBPs in counselor education curricula, analyses revealed that neither CACREP accreditation nor faculty position resulted in any significant differences. Although, analysis did reveal that counselor educators in masters only programs perceived significantly less barriers to the inclusion of EBPs than did counselor educators in doctorate granting programs. Furthermore, results suggested a negative correlation between attitude towards EBPs and barriers towards the inclusion of EBPs in counselor education curricula, and a positive correlation between counselor educatorsÂÂ' agreement towards the inclusion of MI principles in the counseling relationship and their attitudes towards EBPs. Limitations of the study, implications for this study, and recommendations for future research as it relates to EBPs in counselor education and the counseling profession are addressed.
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Date Issued
2010
Identifier
CFE0003063, ucf:48293
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0003063
THE EFFECT OF BRIEF TRAINING IN MOTIVATIONAL INTERVIEWING ON CLIENT OUTCOMES AND TRAINEE SKILL DEVELOPMENT
Title
THE EFFECT OF BRIEF TRAINING IN MOTIVATIONAL INTERVIEWING ON CLIENT OUTCOMES AND TRAINEE SKILL DEVELOPMENT.
Creator
Young, Tabitha, Hagedorn, Bryce, University of Central Florida
Abstract / Description
Motivational Interviewing (MI) is an evidence-based practice that focuses on working through client ambivalence and increasing clientsÂÂ' motivation to change. The purposes of this study were to investigate the effect that a unique student-based training in MI had on counselor traineesÂÂ' ability to perform MI, and on client outcomes. This training program consisted of one initial four-hour training session, two hours of follow-up supervision, and...
Show moreMotivational Interviewing (MI) is an evidence-based practice that focuses on working through client ambivalence and increasing clientsÂÂ' motivation to change. The purposes of this study were to investigate the effect that a unique student-based training in MI had on counselor traineesÂÂ' ability to perform MI, and on client outcomes. This training program consisted of one initial four-hour training session, two hours of follow-up supervision, and formal feedback via MITI 3.0 scores. Counselor-trainee skill was assessed via the MI Knowledge Questionnaire, the Helping Responses questionnaire, and the Motivational Interviewing Treatment Integrity code 3.0. In addition, the following instruments were used to assess client outcomes ; attendance via observation assessments, the Session Summary, the Outcome Questionnaire-45.2, and the Client Satisfaction Questionnaire. The sample consisted of 43 graduate-level counselor trainees in their first or second semesters of practicum and 81 adult clients being seen in a university-based graduate student-training counseling clinic. Participants were purposefully assigned to either a treatment or control group. The counselor trainees in the treatment group received the unique training program, follow-up supervision, and feedback whereas the participants in the control group received a four-hour orientation to the student-training counseling clinic. There were four primary hypotheses proposed for analysis within this study (a) How does a brief training in Motivational Interviewing given to counselor trainees affect their ability to accurately perform MI?, (b) How does a brief training in Motivational Interviewing given to counselor trainees affect client functioning?, (c) How does a brief training in Motivational Interviewing given to counselor trainees affect client adherence?, and (d) How does a brief training in Motivational Interviewing given to counselor trainees affect client satisfaction with treatment? The statistical analysis of these variables yielded significant findings. Specifically, counselor-trainee skill in MI significantly improved in the treatment group as compared to the control group as assessed by the MITI with regard to the following variables: evocation, collaboration, autonomy/support, empathy, direction, MI non-adherent giving information, closed questions, simple reflections, complex reflections, total reflections, global scores, ratio of open questions, ratio of reflections, and ratio of MI adherent behavior. In addition, analysis revealed significant between group differences with client attendance. Specifically, between group-differences suggested that clients in the MI treatment group attended more sessions, missed fewer sessions, and completed therapy more frequently than clients in the control group. Detailed procedures and results as well as implications for the counseling profession and future research are explored within this study.
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Date Issued
2010
Identifier
CFE0003054, ucf:48361
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0003054
The Ability to Critically Evaluate Research Literature in Speech-Language Pathology
Title
The Ability to Critically Evaluate Research Literature in Speech-Language Pathology.
Creator
Gregorio, David, Carnaby, Giselle, Hoffman Ruddy, Bari, Crary, Michael, University of Central Florida
Abstract / Description
Research in Speech-Language Pathology provides the basis for understanding how and to what degree therapeutic techniques and interventions affect the health and quality of life of individuals with communication disorders. Across numerous fields of healthcare, research serves just as important a function and is used to guide the practices of professionals across the public health sector. Several disciplines, including chiropracty, nursing, and physical therapy, rely on the implementation of...
Show moreResearch in Speech-Language Pathology provides the basis for understanding how and to what degree therapeutic techniques and interventions affect the health and quality of life of individuals with communication disorders. Across numerous fields of healthcare, research serves just as important a function and is used to guide the practices of professionals across the public health sector. Several disciplines, including chiropracty, nursing, and physical therapy, rely on the implementation of Evidence-Based Practice (EBP) to ensure that the process of rehabilitation and the techniques employed therein are carried out though the synthesis of best clinical judgment, empirical evidence, and patient values. The field of Speech-Language Pathology also uses EBP as the foundation of intervention and rehabilitation. Research has shown, however, that clinicians in a variety of settings encounter barriers to the implementation of EBP. Such reported barriers include lack of access to current research literature, lack of time with which to review the literature, and difficulty determining the quality of research available. General aims of the present study were: (1) to explore speech pathologists' self-reported patterns of access and use of techniques presented in the current research literature, (2) to investigate their self-rated knowledge of and ability to critically evaluate the research literature, and (3) to examine their knowledge and ability through use of a problem-based survey design. 325 certified Speech-Language Pathologists (SLPs) were administered a brief web-based survey to collect information that might provide insight related to these research questions. Results of the study indicated that, on average, participants access the research literature and utilize techniques found therein with moderate frequency. Findings also reveal that self-rated capacity and research knowledge were significantly greater for respondents who had acquired their PhD and for those who had previously conducted formal research. Significant results were also found when evaluating differences among respondent's place of work by median change in self-rated research capacity. Furthermore, positive correlations were found between research knowledge and self-rated capacity and research knowledge and research evaluation. These findings call attention to the process through which research methodology is taught in higher education. The findings may also suggest that a more effective and functional model of instruction in this area is critical to the clinical implementation of EBP.
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Date Issued
2017
Identifier
CFE0006597, ucf:51269
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0006597
A Qualitative Inquiry Investigating the Inclusive Practices of Teachers within Catholic Schools
Title
A Qualitative Inquiry Investigating the Inclusive Practices of Teachers within Catholic Schools.
Creator
Bell, Alicia, Little, Mary, Vitale, Thomas, Gresham, Gina, Flanigan, Jacquelyn, University of Central Florida
Abstract / Description
This phenomenological investigation examined the inclusive practices used to instruct students with disabilities in inclusive classrooms by educators within a large Catholic diocese in the southeast US. This study used phenomenological research methods to examine the perspectives, practices, and policies of Catholic school educators in inclusive settings through interviews, observations, and artifact reviews of school data to triangulate findings within this research. Surveys completed by...
Show moreThis phenomenological investigation examined the inclusive practices used to instruct students with disabilities in inclusive classrooms by educators within a large Catholic diocese in the southeast US. This study used phenomenological research methods to examine the perspectives, practices, and policies of Catholic school educators in inclusive settings through interviews, observations, and artifact reviews of school data to triangulate findings within this research. Surveys completed by administrators and faculty members provided initial knowledge and perspectives of inclusive practices for instruction of students with disabilities (SWDs) within inclusive settings. Structured interviews and classroom observation were then completed with participants at the school to investigate the inclusive practices used within their classrooms and school for SWDs. All data were collected and analyzed from the observations of students with disabilities and educators in inclusive classrooms at the Elementary School site of this study, along with the data from surveys and interviews with the administrators and key faculty members at the school. The analyses across data sources resulted in five key themes attributed to inclusive practices within the school setting. The five themes that emerged were: (a) Catholic educators' belief to educate all students; (b) support provided of inclusive education; (c) planning for inclusive education; (d) differentiated instruction; and (e) consistency of vision and goals for inclusive education across the grade levels and throughout the school. This study exposed the key factors and practices that educators in a Catholic school attributed to successful inclusive practices for students with moderate to severe disabilities. This research provides initial research and data about inclusive practices in Catholic schools.
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Date Issued
2017
Identifier
CFE0006720, ucf:51895
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0006720
Defining Effective Teacher Practices among Students with Emotional Behavioral Disabilities
Title
Defining Effective Teacher Practices among Students with Emotional Behavioral Disabilities.
Creator
Mayes, Zerek, Martin, Suzanne, Boote, David, Butler, S. Kent, Berrio, Gabriel, University of Central Florida
Abstract / Description
This phenomenological study examined the lived experiences of special education teachers who worked with students with emotional behavioral disabilities (EBD) across various urban settings and educative environments. Given that the overall percentage of students receiving special education services has increased, the overall percentage of students with EBD served among all school-aged children and youth has remained below 1% (U.S. Department of Education, National Center for Education...
Show moreThis phenomenological study examined the lived experiences of special education teachers who worked with students with emotional behavioral disabilities (EBD) across various urban settings and educative environments. Given that the overall percentage of students receiving special education services has increased, the overall percentage of students with EBD served among all school-aged children and youth has remained below 1% (U.S. Department of Education, National Center for Education Statistics, 2018). The current failings of reform efforts to improve the academic achievement of students with EBD brings the roles, responsibilities and practices of teachers and their preparation into view. This study examined the impact of culture on the attitudes, beliefs, and practices of special education teachers. Semi-structured interviews were conducted with eight participants (N = 8). A thematic analysis resulted in three overarching themes. The three themes included: (a) the essentials: keys to student engagement, (b) the frustrations regarding effective program implementation, and (c) elements of an effective program. This study exposed multiple factors affecting the effectiveness of special educators' practices as well as offered recommendations for teachers, schools, districts, policies, and future research.
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Date Issued
2019
Identifier
CFE0007682, ucf:52510
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0007682
Virtual Coaching of Novice Science Educators to Support Students with Emotional and Behavioral Disorders
Title
Virtual Coaching of Novice Science Educators to Support Students with Emotional and Behavioral Disorders.
Creator
Garland, Dennis, Dieker, Lisa, Vasquez, Eleazar, Hines, Rebecca, Rosenberg, Michael, University of Central Florida
Abstract / Description
Due to a multitude of convergent circumstances, students labeled in the disability category of emotional and behavioral disorders (EBD) experience high rates of academic and behavioral failure. Such failure frequently leads to the students' dropping out of school, involvement in the judicial system, or a combination of those outcomes. Science is an academic content area that has the potential to enhance behavioral and academic success of students with EBD. Researchers, nonprofits, and...
Show moreDue to a multitude of convergent circumstances, students labeled in the disability category of emotional and behavioral disorders (EBD) experience high rates of academic and behavioral failure. Such failure frequently leads to the students' dropping out of school, involvement in the judicial system, or a combination of those outcomes. Science is an academic content area that has the potential to enhance behavioral and academic success of students with EBD. Researchers, nonprofits, and business leaders have provided an impetus for nationwide reform in science education. Concurrently, a corpus of legislation has influenced the preparation of new teachers to use evidence-based teaching practices while addressing the needs of an increasingly diverse student population. Using technology is one way that teacher educators are providing in-vivo learning experiences to new teachers during their classroom instruction. A multiple-baseline across-participants research study was used to examine the effectiveness of providing immediate feedback (within three seconds) to novice general science educators to increase their use of an evidence-based teaching strategy, known as a three-term contingency (TTC) trial while they taught. Feedback was delivered via Bug-in-the-Ear (BIE) technology and during whole-class instruction in which students with EBD were included. The teacher participants wore a Bluetooth earpiece, which served as a vehicle for audio communication with the investigator. Teachers were observed via web camera over the Adobe(&)#174;ConnectTM online conferencing platform. During the intervention, teachers increased their percentage of completed TTC trials, opportunities to respond, and praise or error correction. Student responses also increased, and maladaptive behaviors decreased.
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Date Issued
2013
Identifier
CFE0004847, ucf:49681
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0004847