Improving the use of the nursing process: the impact of charting methodology developed from King's conceptual framework on the use of the nursing process

The purpose of this study was to assess the effects of changing a nursing documentation system, developed from King's Conceptual Framework, on the use of the nursing process. The null hypothesis was that there would be no significant increase in the reflection of the use of the nursing process on the nursing care plan or nurses' notes, as a result of using a nursing documentation system developed using King's Conceptual Framework (1981). The design involved the development of a questionnaire that was used to review health records pre and post implementation of a documentation system developed based on King's Conceptual Framework and Theory of Goal Attainment (1981). A Record Completeness Score was obtained from some of the questions. The null hypothesis was rejected. The results of the study have implications for nursing administration and the evaluation of nursing practice. If the use of a documentation system developed from a conceptual framework increases the reflection of the nursing process on the patient's health record, nursing will have the means to measure patient outcomes/goal attainment. All health care organizations and levels of government are focusing on methods to monitor and control the health-care dollar. In order for nursing to clearly determine the costs associated with nursing care, measurement of patient outcomes/goal attainment will need to be possible. In order to measure patient outcomes/goals attainment nurses will need to be able to collect data on their practice. It will be critical that nursing have a documentation system in place which facilitates the reflection of the nursing process within a theoretical framework.

Conceptual Analysis of Web 2.0 Technology Use to Enhance Parent–School Relationships

Parent–school relationships contribute significantly to the quality of students’ education. The Internet, in turn, has started to influence individuals’ way social communication and most school boards in Ontario now use the Internet to communicate with parents, which helps build parent–school relationships. This project comprised a conceptual analysis of how the Internet enhances parent–school relationships to support Ontario school board administrators seeking to implement such technology. The study’s literature review identified the links between Web 2.0 technology, parent–school relationships, and effective parent engagement. A conceptual framework of the features of Web 2.0 tools that promote social interaction was developed and used to analyze websites of three Ontario school boards. The analysis revealed that school board websites used static features such as email, newsletters, and announcements for communication and did not provide access to parents for providing feedback through Web 2.0 features such as instant messaging. General recommendations were made so that school board administrators have the opportunity to implement changes in their school community with feasible modifications. Overall, Web 2.0-based technologies such as interactive communication tools and social media hold the most promise for enhancing parent–school relationships because they can help not only overcome barriers of time and distance, but also improve the parents’ desire to be engaged in children’s education experiences.

The effectiveness of interpretive methods in informal educational facilities : an experimental study with reference to marine parks

Interpretation has been used in many tourism sectors as a technique in achieving building hannony between resources and human needs. The objectives of this study are to identify the types of the interpretive methods used, and to evaluate their effectiveness, in marine parks. This study reviews the design principles of an effective interpretation for marine wildlife tourism, and adopts Drams' five design principles (1997) into a conceptual framework. Enjoyment increase, knowledge gain, attitude and intention change, and behaviour modification were used as key indicators in the assessment of the interpretive effectiveness of the Vancouver Aquarium (VA) and Marineland Canada (MC). Since on-site research is unavailable, a virtual tour is created to represent the interpretive experiences in the two study sites. Self-administered questionnaires are used to measure responses. Through comparing responses to the questionnaires (pre-, post-virtual tours and follow-up), this study found that interpretation increased enjoyment and added to respondents' knowledge. Although the changes in attitudes and intentions are not significant, the findings indicate that attitude and intention changes did occur as a result of interpretation, but only to a limited extent. Overall results suggest that more techniques should be added to enhance the effectiveness of the interpretation in marine parks or self-guiding tours, and with careful design, virtual tours are the innovative interpretation techniques for marine parks or informal educational facilities.

Educational issues perceived by expectant lesbian couples /

Despite the increasing public profile of lesbian childbearing, public health resources for expectant women often bear heterosexist assumptions and create barriers to accessing information relevant to lesbian mothering experiences. This descriptive, exploratory study examined one lesbian couple's perceived educational needs for effective support, barriers to access, strategies for locating care, and the impact of childbearing on their lives, as well as their reflections on inviting ways to offer supportive practices in a public health context. A case study approach used feminist ethnographic methodology and purposeful convenience sampling. A prenatal and a postnatal open-ended interview were completed with 1 white, middle-class, able, lesbian childbearing couple, each ofwhom has birthed as coparent and biological mother in this couple relationship. Despite this couple's immense situated privilege, they struggled to locate the support they sought for childbearing in a way that offered optimal emotional and physical care from the preconceptual to postpartum stages and which maintained confidentiality or anonymity as desired. They created meaningful care through personal networks. The findings were framed using invitational and feminist theories: how people, places, programs, processes, policies, and politics contributed to educational support. A three part conceptual framework emerged which identified components of access to support: perceived safety of resources, disclosure status, situated privilege, and public or private availability of information. The consequences of lack of public access to comprehensive childbearing care for lesbian women and their communities are described. Educational possibilities addressed systemic heterosexism through the development of sensitive educators, meaningful curriculum, program planning, explicit policies, community partnerships, and political leadership with respect to both institutional and research venues.

This infinite, unanimous dissonance : a study in mathematical existentialism through the work of Jean-Paul Sartre and Alain Badiou

This thesis seeks to elucidate a motif common to the work both of Jean-Paul Sartre and Alain Badiou (with special attention being given to Being and Nothingness and Being and Event respectively): the thesis that the subject 's existence precedes and determines its essence. To this end, the author aims to explicate the structural invariances, common to both philosophies, that allow this thesis to take shape. Their explication requires the construction of an overarching conceptual framework within which it may be possible to embed both the phenomenological ontology elaborated in Being and Event and the mathematical ontology outlined in Being and Event. Within this framework, whose axial concept is that of multiplicity, the precedence of essence by existence becomes intelligible in terms of a priority of extensional over intensional determination. A series of familiar existentialist concepts are reconstructed on this basis, such as lack and value, and these are set to work in the task of fleshing out the more or less skeletal theory of the subject presented in Being and Event.

A qualitative narrative inquiry of the experience of accessing community supports among women who have experienced trauma

Abuse related trauma can have serious consequences on individuals' health and their state of well-being and may result in decreased access to different determinants of health. The purpose of this qualitative narrative inquiry using secondary data was to explore the experience of accessing community supports among eight women who had experienced abuse-related trauma. A conceptual framework drawn from the literature on social inclusion and social exclusion and a narrative inquiry method were used to explore epiphanies, customs, routines, images, and everyday experiences (Clandinin & Connelly, 2000) among the women. A Three-Dimensional Space Narrative Structure was used to explore the participants' personal or internal conditions, feelings, hopes and reaction as well as their social experiences in interaction with others in community. The participants described experiencing the impact of trauma in their past and present circumstances, a lack of accommodation of difference, challenges in maintaining a sense of self in a world of assumption and labels, impact of trauma on the determinants of health, and uncertainty about the future. The findings from the study demonstrate experiences of social exclusion among the participants in the past, further isolation and social exclusion in the present when personal life issues were ignored by community support services, and uncertainty about what the future will bring for them. The findings indicate close relationships between the women's personal lives and their social connections which need to be considered to mitigate social exclusion and enhance social inclusion.

Reflective practice and the novice nurse /

The importance of reflective practice to the novice nurse was explored in this study. The novice nurse, for the purpose of this study, was defined as a Registered Nurse who graduated from an accredited nursing program within a 1 2-month period prior to the data collection date and who had no prior experience as a Registered Nurse before graduation. All of the nurses enrolled in this study were female. This study explored the perceived link between transformational learning and reflective practice, and whether there may be a need to standardize a conceptual framework and definition for reflective practice in nursing academia. The literature that was reviewed for this study indicated that there were inconsistencies in the application of reflective practice within academic curriculums. The literature did identify that the majority of academic scholars have agreed that reflection is paramount in the development of critical thinking skills, self-awareness, and selfdirection. And, while all of these skills drive professional practice and effect excellent patient care, institutional health care has been reticent to support the value of reflective practice because of a lack of empirical data sets. The 4 novice Registered Nurses who participated in this study were asked 4 openended questions that provided a foundation for comparing the novice nurses' experiences, interpretations, and perceptions of reflective practice. These nurses participated in individual audiotaped interviews with the researcher. The study was based upon Heath's (1998) model of "Theory hitegration via Reflective Practice." The results demonstrated that reflective practice was significant to the novice nurse and was used as a tool to identify further learning needs. Transformational learning through reflection was described by the study participants. The findings within this study are consistent with previous work done in the area of reflection and the novice nurse.

Exploring the effects of change on nursing practice in acute ambulatory care settings : a qualitative study

As a result of the current changes taking place in the delivery of acute care services, the emergence of acute ambulatory care (AAC) settings is expanding. According to a literature review, the volume, acuity, and complexity of patient care in these settings is increasing while the time the patients spend under the care of nurses is decreasing. Two forces, hospital downsizing and advancing technology, are identified as the major contributors to the shift in acute care delivery. The effects that these changes are having on the clinical nursing practice of registered nurses working in AAC settings are not known. Given that AAC settings are rapidly expanding, it can be anticipated that the delivery of nursing care will continue to be compressed into a shorter time frame. Therefore, the following qualitative research question was formulated: What are the problems and issues related to clinical nursing practice in acute ambulatory settings? The purpose of this study was to explore the problems and issues associated with change and clinical nursing practice including the educational needs of nurses working in MC settings. Specific objectives of the study included the following: (a) to explore the problems and issues related to nursing practice in select AAC settings; (b) to explore the similarities and differences in perspectives related to role expectation between nurse managers, nurse educators, and staff nurses; and (c) to develop a conceptual framework that will guide the construction of an instrument needed for further research. This study used semistructured individual interviews and focus group sessions to collect data from the three categories of registered nurses. More specifically, data were collected from one nurse manager, two charge nurses, two nurse educators and fifteen staff nurses, working in three different MC settings of a major teaching hospital. Collected data were separately analyzed by the researcher and an external rater following grounded theory methodology. By using open and axial coding, the problems and issues identified by nurses were grouped into several major and minor themes. In final analysis, by using selective coding, the four core themes (intensification, moderation, frustration, and adaptation) were extracted. Each core theme was presented and discussed in relation to hospital downsizing and advancing technology. The relationships among the four core themes were discussed and depicted in a model termed the "Impact and Consequence Model on Nursing Practice in MC Settings." Implications for further research are discussed and research hypotheses, based on the research findings, are presented.

The evaluation of a predialysis class on client knowledge and attitude toward compliant behaviours

In this quasi-experimental study, the theory of reasoned action was used as a conceptual framework to assess the outcome effect of a predialysis class. A pretest, posttest design was used to determine changes in client knowledge about their condition and its treatment, and their intention, attitudes and social norm towards compliant behaviours. The related compliant behaviours were following a low-salt diet and taking medications as proscribed. Thirty-eight End Stage Renal Diseases (ESRD) clients were self-selected into the treatment or control groups. Both groups received the standard predialysis education from members of the multidisciplinary renal team. In addition, the treatment group also attended the predialysis class. Subjects' health locus of control, anxiety and demographic variables were measured as possible extraneous variables. Study subjects from both groups demonstrated a high internal and powerful others health locus of control and a normal range of anxiety. Although not statistically significant ill = .64), the experimental group demonstrated higher knowledge level and greater intention to follow a low salt diet UL= .73). They developed more significantly positive attitudes towards following a low salt diet and increased subjective norm influence after attending the predialysis class. Attending the predialysis class did not have an effect on subjects' intentions, attitudes or subjective norm towards taking medications as prescribed. Conclusion: The predialysis class was only marginally effective in increasing client knowledge, but influenced clients' attitudes towards following a low-salt diet. Based on the results, recommendations for improvements to the class have been suggested.

Mechanisms for sustainable accountability : a case study of a nonprofit educational organization

A qualitative case study of the capacity to be accountable in one nonprofit intennediary educational organization yielded an emergent conceptual framework of four mechanisms: structural, governing, communicative, and educative mechanisms to build and sustain the capacity of accountability. Drawing attention to the purposeful creation of structures that support accountability, purposeful navigation of the complex matrix of accountability relationships, and purposeful transfer of knowledge to infonn future accountability, this study calls for mindfulness in practice in broader educational contexts. Protocols to pass on knowledge gained in building the four capacities reveal a new dimension of accountability: continuity. In this model, the educative mechanism is the life force that feeds the other three mechanisms to increase accountability and sustain it over time.

Rethinking Fiscal Decentralization Policies in Developing Economies: A Case Study of Ghana

This thesis invites geographers to pay more attention to public policy research by addressing the need to rethink fiscal decentralization policies in Ghana. By applying “Simandan’s wise stance in human geography” and “Grix’s building blocks of social research design”, I developed a conceptual framework that unites two incommensurable ontological and epistemological research positions in geography—the positive and normative positions. I used the framework to investigate two key research questions. First, does fiscal decentralization actually work in Ghana? Through quantitative analysis of empirical revenue and expenditure data (1994-2011) of local governments in Ghana, this study reveals significant issues of inefficiency, inequity, and unaccountability. Local governments generate less revenue, and therefore depend largely on central government transfers for developing their jurisdictions. Worse yet, these transfers are highly unpredictable in terms of amount and timing. Even though a multivariate regression analysis revealed that these transfers are apolitical, the actual disbursement formula tends to focus on equality instead of equity. Additionally, the unclear expenditure assignments in each locality make accountability difficult. In view of these problems, I addressed the question: why is fiscal decentralization held out as a good thing in Ghana? By drawing lessons from Foucault’s and Escobar’s critical discourse analysis, I traced a genealogy of Ghana’s fiscal decentralization. I found that the policy is held out as a good thing in Ghana because of the triangular operation of multiplicities of power, knowledge, and truth regimes at the local, national and international scale. I concluded that although nation-states remains a necessary causal link in fiscal decentralization policy process in Ghana, direct and indirect international involvement have profound effect on these policies. Therefore, rethinking fiscal decentralization involves acknowledging the complex intermingling effects that global, national, and local territories produce.

Myths of Modern Education

My focus is on assessment criteria of language proficiency in community college education. To demand clear writing is an application of scientism; it seeks to keep separate the fact/value distinction of positivism. This dangerously undermines the democratizing possibilities of education, since clear writing, taken to its extreme, is ultimately anonymous and dehumanizing. The active student-as-citizen is, therefore, subsumed under the neoliberal dictate of the passive student-as-consumer. The process of language acquisition is reduced to a fictitious act of knowledge transmission and regurgitation, and, therefore, those subversive aspects of language learning, such as creativity and critical inquiry, are undermined. An initial overview of the tenets of modernity will provide a conceptual framework for this examination.

Postsecondary Teaching and Learning Development Needs: Motivators and Barriers Associated With Participation in Educational Development

This study investigated instructor perceptions of motivators and barriers that exist with respect to participation in educational development in the postsecondary context. Eight instructors from a mid-size, research intensive university in south-western Ontario participated in semistructured interviews to explore this particular issue. Data were analyzed using a qualitative approach. Motivation theory was used as a conceptual framework in this study, referring primarily to the work of Ryan and Deci (2000), Deci and Ryan (1985), and Pink (2009). The identified motivators and barriers spanned all 3 levels of postsecondary institutions: the micro (i.e., the individual), the meso (i.e., the department or Faculty), and the macro (i.e., the institution). Significant motivators to participation in educational development included desire to improve one’s teaching (micro), feedback from students (meso), and tenure and promotion (macro). Significant barriers to participation included lack of time (micro), the perception that an investment towards one’s research was more important than an investment to enhancing teaching (meso), and the impression that quality teaching was not valued by the institution (macro). The study identifies connections between the micro, meso, macro framework and motivation theory, and offers recommendations for practice.

Community and the Recognition of the Other: A Levinasian Examination of The City, Inc. 1987-1992

This case study examines how The City, Inc.’s work within North and South Minneapolis, Minnesota neighborhoods from 1987 and 1992 was framed within a compilation of articles drawn from prominent Twin Cities’ daily newspapers. Positioned within a conceptual framework based on the ethical philosophy of Emmanuel Levinas, this study explores how the idea of community, as constructed and reinforced through organizational initiatives and local print media, impacts the everyday relationships of those within and between communities. Framed within a discourse analysis, Levinasian ethics considers what aspects of community discourse restrict and oppress the relation with the other. The study concludes by suggesting how the identified aspects of conditional belonging, finding the trace, and building community can be valuable in offering an alternative to assessment-style research by considering the relationship and responsibility of the one for the other.

Christian Education and the Ethics of Authenticity

A qualitative study was undertaken to explore the concept of authenticity in Christian education. The study was situated in the context of Christian schools in Ontario. Some of these schools have experienced declining enrolment and all of these schools face the challenge of being distinctive in a secular culture. To investigate the potential of the concept of authenticity for reclaiming the vision of Christian education, interviews were conducted with 3 experienced principals of Christian schools. Data analysis yielded an emergent conceptual framework of authenticity consisting of 5 concepts: authorship, relatedness, reflection, autonomy, and excellence. Authenticity was found to be a useful tool for school analysis of both the deep structures and the surface structures within Christian schools. To offset unauthentic tendencies that can arise within these schools, this study calls for an intentional use of the lens of authenticity to expose these tendencies and revitalize core expectations. Through the narratives shared by the Christian school principals, the study also develops a picture of the role of authentic Christian education in the development of the authentic Christian person.