Evidence-Based Clinical Pathways To Manage Urinary Tract Infections in Long-Term Care Facilities:A Qualitative Case Study Describing Administrator and Nursing Staff Views

Objectives: This article examines the views of nursing staff and administrators in long-term care facilities (LTCFs) regarding a clinical pathway for managing urinary tract infections (UTIs) in LTCF residents. Design: A qualitative (case study) design was used. Setting: Data were collected from 8 LTCFs in southern Ontario and 2 in Iowa enrolled in a larger randomized controlled trial of clinical pathway for managing UTIs in LTCF residents, conducted between September 2001 and March 2003. The clinical pathway, designed to more effectively identify, diagnose, and treat UTIs, and reduce inappropriate antibiotics use for asymptomatic UTIs, introduced 2 decision tools to determine when to order a urine culture and initiate antibiotic treatment for suspected UTIs. Participants: We conducted 19 individual interviews with administrators and 10 focus groups with 52 nurses. Findings: Nurses generally thought that the pathways were well developed and easy to use, and administrators believed they were an important educational resource. Barriers to their use varied by group-initial lack of buy-in from nurses (medical directors), additional work (directors of nursing), and the need to change the protocol to exclude certain residents based on prior health conditions and/or pressure from physicians or families (nurses). Conclusions: Both administrators and staff, once familiar with a new clinical protocol to improve UTI management in LTCFs, generally supported its use. © 2007 American Medical Directors Association.

A speculative systems model of the dynamic interaction among students, faculty and administration in the community college, with particular reference to intrinsic motivation and the teacher-administrator interface

The challenge the community college faces in helping meet the needs of the living open system of society is examined in this study. It is postulated that internalization student outcomes are required by society to reduce entropy and remain self-renewing. Such behavior is characterized as having an intrinsically motivated energy source and displays the seeking and conquering of challenge, the development of reflective knowledge and skill, full use of all capabilities, internal control, growth orientation, high self-esteem, relativistic thinking and competence. The development of a conceptual systems model that suggests how transactions among students, faculty and administration might occur to best meet the needs of internalization outcomes in students, and intrinsic motivation in faculty is a major purpose of this study. It is a speculative model that is based on a synthesis of a wide variety of variables. Empirical evidence, theoretical considerations, and speculative ideas are gathered together from researchers and theoretici.ans who are working on separate answers to questions of intrinsic motivation, internal control and environments that encourage their development. The model considers the effect administrators·have on faculty anq the corresponding effect faculty may have on students. The major concentration is on the administrator--teacher interface.For administrators the model may serve as a guide in planning effective transactions, and establishing system goals. The teacher is offered a means to coordinate actions toward a specific overall objective, and the administrator, teacher and researcher are invited to use the model to experiment, innovate, verify the assumptions on which the model is based, and raise additional hypotheses. Goals and history of the community colleges in Ontario are examined against current problems, previous progress and open system thinking. The nature of the person as a five part system is explored with emphasis on intrinsic motivation. The nature, operation, conceptualization, and value of this internal energy source is reviewed in detail. The current state of society, education and management theory are considered and the value of intrinsically motivating teaching tasks together with "system four" leadership style are featured. Evidence is reviewed that suggests intrinsically motivated faculty are needed, and "system four" leadership style is the kind of interaction-influence system needed to nurture intrinsic motivation in faculty.

A study of the role learning and socialization during the transition from teacher to elementary school administrator

This thesis examined the role transition from an elementary teacher to an elementary principal. In particular, the training and socialization process of becoming an elementary principal was explored through the study of the hierarchical and political structure of a southern Ontario school board, and how this influenced the learning experiences of new elementary principals. A qualitative methodology, with a grounded theory design, was employed to investigate this process through interviews with 10 participants to examine their experiences and role learning occurs during their development. Specifically, participants perspective shifts, developmental experiences, understanding of group culture, and expansion of a board profile were highlighted in the data. One of the compelling results of the study was the degree to which principals of aspiring administrators influence the socialization of their subordinates. The beliefs and practices of the school principal determine the socialization orientation that teachers and vice-principals will experience during role learning. The results of this study also imply that role orientation needs to be understood as a continuum between custodial and innovative role assumption. Varying degrees of custodianship or innovation depended on the context of the administrative placement and the personal attributes of administrative candidates. Principals who are willing to share responsibilities, who are good communicators, and who wish to develop a collaborative relationship with their viceprincipals are the individuals the participants in this study described as making the best mentors.

Impact of social constructs on administrator understanding of social justice

Educational administrators are expected to relate social justice considerations to their actions and to the theoretical foundations of their practice. At the same time, social constructs-including those related to administrative practice, social justice, and societal norms-are important in helping administrators understand, frame, and describe administrative issues. Furthermore, as part of socially constructed language, these constructs represent discursive practices and accepted ways of knowing, valuing, and experiencing the world. Drawing on the multidimensional methods of critical discourse analysis as articulated in the writings of Michel Foucault, Norman Fairclough, and Allan Luke, and using deconstruction as a strategic device for reading and interpreting texts, this exploratory qualitative study examined how administrator knowledge, values, and experiences impact their understanding of social justice within the context of delivering social justice for students who experience bullying. Study findings reveal that school administrators interpreted social justice as equitable distribution, action, and results; fairness; and equity. Constructs embedded in these interpretations assumed common things such as universal acceptance of norms of social relations and conveyed administrator intent to secure the kind of social relations that enabled individuals to enjoy greater equality within existing social arrangements.

The downside of relying on research outputs to assess business faculty performance : comments from down under regarding facilitating and creating synergies between teaching and research : the role of the academic administrator

This commentary presents an Australian perspective on Balkin and Mello’s “Facilitating and Creating Synergies between Teaching and Research: The Role of the Academic Administrator.” It addresses one particularly important aspect of the separation of teaching and research in business schools; namely, the increasing dominance of discipline-based research output measures in overall business faculty performance, coupled with a reliance on journal rankings as de facto quality measures for research output. Some possible alternate approaches to research performance/impact measurement in our rapidly changing academic environment are also considered.

Community Series Administrator Guide

A technical guide for managing community series in DigitalCommons@UConn.

Schilderung des feyerlichen Einzugs Seiner Königlichen Hoheit Erzherzogs Carl, als Administrator des Maissner Kirchensprengels. Geschehen zu Maissen, den 27. Januar 1807

In Fraktur

The role of a nursing home administrator's education in influencing quality of care in US nursing homes

Nursing home literature links poor management practices to poor quality of care and resident outcomes. Since Nursing Home Administrators (NHAs) require an array of skills to perform their role, it is important to explore what makes a NHA effective. This research fills a gap in the literature and provides a possible option to improve the quality of care in nursing homes. Purpose of the study. The study examines whether NHAs with advanced education (defined as a Masters degree or more) are associated with better quality of care in licensed nursing homes (NHs). Design and Methods. Data was derived from the CDC’s 2004 National Nursing Home Survey, which is a representative sample of NHs across the US. A Donabedian- inspired structure-process-outcomes study model was created to explain how education relates to quality of care. Quality of care was defined as onsite oral care, employee influenza vaccination rates and staff recognition programs. Statistical analyses included multivariate logistic regression; covariates included facility-level variables used in similar peer-reviewed research but also included select measures from the Area Resource File to control for county-level factors. Results. Descriptive and analytical analyses confirm that NHAs with a Bachelor’s degree, Associate degree or high school diploma perform less well than NHAs with a Masters degree or more. NHAs with advanced education are more likely to have onsite dental care and recognition programs for staff than NHAs with a Bachelor’s degree (or less). Also NHAs with less than graduate education are more likely to provide off-site dental care. Employee vaccination rates are not impacted by education. Adding certification, tenure or years of experience to a NHA with advanced education gives them an advantage. In fact, certification and experience alone do not have a positive relationship to care indicators; however adding these to advanced education produces a significant result. Implications. This research provides preliminary evidence that advanced education for the NHA is associated with better quality of care. If future research can confirm these findings, there is merit in revisiting the qualifications. Education can be a legitimate option to support quality improvement efforts in US nursing homes. ^

Time-critical aid : questionable use of disaster assistance funds for Peru : report to the Administrator, Agency for International Development /

"B-220921"--P. 1.