Below is the feed back from my advisor. He did add some examples to guide me so it may look confusing as to what is my writing and his examples.
Antoine,
Please look at my notes below. Besides finishing up the theoretical framework figure, you have two areas to expand on. Once those two areas below are completed (and there are no grammar or reference issues) we can seek topic approval. Continue to collect current references to support your points being made below. Make sure to list your references in each section. Follow APA formatting closely.
Electronic Journal Articles (APA, p. 198)
LaPlante, J. M. (2011). Seven habits of unsustainable budget building: A state policy perspective. Journal of Public Budgeting, Accounting and Financial Management, 23, 215-267. doi:123456.abcd/x
LaPlante, J. M. (2011). Seven habits of unsustainable budget building: A state policy perspective. Journal of Public Budgeting, Accounting and Financial Management, 23, 215-267. Retrieved from http://pracademics.com/jpbafm.html
Book (APA, p. 202)
Ross, M. (2010). Branding basics for small business: How to create an irresistible brand on any budget. Bedford, IN: NorLights Press.
Chapter in an Edited Book (APA, p. 202)
Quinn, R. E. (2008). Moments of greatness: Entering the fundamental state of leadership. In J. V. Gallos (Ed.), Business leadership: A Jossey-Bass reader (pp. 142-154). San Francisco, CA: Jossey-Bass.
Dissertation (APA, p. 208)
Kirwan, J. G. (2005). An experimental study of the effects of small-group, face-to-face facilitated dialogues on the development of self-actualization levels: A movement towards fully functional persons (Doctoral dissertation). Retrieved from ProQuest Digital Dissertations and Theses database. (UMI No. 3159996)
Government or Corporate Websites (APA, p. 205 � See technical and Research Reports)
Office for Business & Community Economic Development. (2010). Small business profile list. Retrieved from http://www.bced.umn.edu/MapSB1.cgi
Dr. Lazar
2.1 Project
Write approximately one paragraph that describes the action research project and the basis for it being addressed.
Some Healthcare administrators are not aware of the need for skilled sterile processing staff within hospitals (LeBouef, 2011). New York and New Jersey currently have laws requiring sterile processing certification while Oregon, Oklahoma, South Carolina, Pennsylvania, Connecticut, and Massachusetts are debating whether 100% of sterile processing staff working in a hospital will require sterile processing certification (Colacci, 2014). Sterile Processing Departments (SPD) vary in department size, educational training, staffing levels and several of these departments lack the resources and knowledge needed to help decrease infection errors (Rodack, 2012). The problem is that some healthcare administrators have limited understanding of the relationships between types of sterile processing staff, department size, and instrumentation error rates to manage effectively sterile processing in hospitals. The Sterile Processing Department is the area of a healthcare organization responsible for cleaning, disinfecting, and sterilizing reusable medical devices used on patients.
2.2 Contribution to Society
Using citations, answer the following questions in order:
1. How does your project improve a current practice?
2. If your action research project is successful, how could your project impact your field of interest?
3. What are the practical implications of your project? For example, what will be the impact of this project on your sample, your site location, or your workplace?
The purpose of this action research project incorporating a quantitative correlational design is to examine the relationships between types of sterile processing staff, the department size, and instrumentation error rates to manage sterile processing in hospitals. The independent variables are types of sterile processing staff and the size of the department. The dependent variable is instrumentation error rates. The targeted population will consist of health administrators and their sterile processing staff from a large hospital system located in the southern part of the United States. The action part of this project includes a presentation of the research to healthcare administrators to help them make informed decisions as it relates to managing sterile processing departments in their hospitals. In addition, I will present summary of the data to state legislators. The legislators could use the results of the project as a stepping-stone to create a case whether to require sterile processing staff to become certified or not. This learner believes the in the end, the patients will benefit in getting better reprocessed surgical instrumentation from the sterile processing techs because the sterile processing staff will be better educated and possibly certified. The research could improve the quality of work delivered by the University of Mississippi Health system�s employees. The system could become more proficient and have fewer infections.
2.3 Need and Evidence to Make Change
Provide current information on your needs assessment or analysis for change. Include the cost-benefit analysis if indicated by design.
The sterile processing certification exams were develpoed to ensure sterile processing had verifiable competencies to perform the tasks in sterile procesing (Chobin, 2012). Many of the staff hired into the sterile processing areas are not formally trained.
Here are a few examples from your peers:
Health care in the U.S. faces new challenges on a regular basis. Health care administrators must continue to confront these issues in order to ensure adequate care for the patients and the stakeholders they serve. Basically, the challenges associated with a busy, sophisticated and dynamic U.S. health care system exists to some degree in all health-related fields of practice (Boucher et al., 2013). Changes in the U. S. health care system are impacted by changes in legislation, technological advances and shifting patient demographics. As a result, some allied health academic programs are questioning how to better prepare their students to meet the evolving and diverse health care needs of society (McLaughlin et al., 2014). With changing demands, expectations, and new technology, care delivery will most likely change as well.
The ability to apply learned information to a variety of contextual situations is required for entry-level clinical performance (Scott et al., 2011). Therefore, higher education institutions and professors are constantly challenged to find teaching strategies that engage allied health students in the classroom and in the clinic (Findlay-Thompson & Mombourquette (2014). Both Findlay-Thompson et al., (2014) and Scott et al., (2014) agree that the effective transfer of information into clinical functioning could help to close the gap between theory, didactics and functional clinical performances. The level II fieldwork experience provides students with the opportunity to focus on the patients they will serve, not their grades.
The need to rethink classroom activities and learning environments so students can develop the clinical skills needed for out of classroom success is a topic of interest and discussion by a large number of allied health professionals, educators and students alike (McLaughlin et al., 2014). As a result, a variety of allied health professional educators are being asked to consider diverse teaching strategies within program curricula that can help to transform the novice student into the entry-level health care professional. Entry-level competence is necessary to effectively address the dynamic health care needs of society.
The aging health care workforce, an increase in the elderly population, along with health care reform will most likely increase demand for many allied health professionals. Furthermore, roles and necessary skills sets for existing practitioners will increase as well (Health Care Association of New York State, 2014). Regardless of changing roles and responsibilities, focus should always be on appropriate interventions and interactions with patients and cohorts.
Hospitals and health systems continue to move towards innovate care delivery models that require interdisciplinary collaboration, clinical care coordination, quality improvement and other health-reform related tasks (Boucher et al., 2013). Also, the Health Care Association of New York State (2013) indicates that allied health professionals make up the majority of the US health care workforce and that the demand for these specialists is expected to continue to increase.
Employment of occupational therapists is projected to increase 29 percent from 2012 to 2022 (U.S. Bureau of Labor and Statistics, 2014). The Accreditation Council for Occupational Therapy Education (ACOTE) has developed minimum standards that all occupational therapy programs must meet to be accredited. Consequently, the Health Care Association of New York State (2013) reports that occupational therapy professionals are one of the most difficult allied health clinicians to recruit. Furthermore, the American Occupational Therapy Association (AOTA) overseas college and university occupational therapy program curricula nationwide.
Despite the changes in the US health care system and societal needs, little has changed in the way health care education is delivered to aspiring health care professionals (McLaughlin et al., 2014). Improving the teaching process and improving how occupational therapy program curriculum is delivered will better prepare students for real-time occupational therapy and as future health care leaders.
Within the domains of academics, research and health care, allied health professionals with an increased knowledge and clinical performance base can contribute an enormous amount of talent and energy to the health care arena. Competencies and skills acquired and practiced during the education process will contribute to increased aptitude and capabilities for occupational therapy students entering the U.S. health care system as entry-level professionals (Miller et al, 2014). Fieldwork education is critical to professional education because it links education and practice and is an extension of the occupational therapy curriculum.
A cost/benefit analysis is N/A at this time.
Example 2:
The Global Burden of Disease (GBD) study conducted in 2010 demonstrated that upwards of 3.9 billion people (of all ages) worldwide suffer from oral health conditions. Untreated dental caries is the most common oral health condition reported. Thirty-five percent of the world�s population experiencing the associated impacts, including pain, loss time from work or family life, and other health consequences. The GBD estimates that conditions involving oral health result in an average loss of 224 years per 100,000 people, falling between moderate heart failure and the moderate consequences of stroke. (Queen Mary, University of London, 2013.)
Dental caries are challenging regardless of global location as between 60 and 90% of school-aged children have experienced this disease in the industrialized world. Individuals have limited access to oral health-related support in the developing world. Thus, teeth experiencing decay may remain untreated. Individuals with severe pain may have teeth removed. (National Childhood Oral Health Foundation, 2014.)
The Centers for Disease Control and Prevention (2011, 2013) report that 28% of children ages 2-5 in the United States have experienced dental caries in their primary teeth. The Healthy People 2010 Objectives associated with oral health created a goal of 9% of similarly aged children having dental caries. Additionally, Healthy People 2020 has goals associated with reductions in dental caries (U.S. Department of Health and Human Services, 2011.)
Children from a low socioeconomic background are more than twice as likely to have tooth decay, compared to children of families with higher income. (Centers for Disease Control and Prevention, 2013.) Black and Hispanic children and those with lower socioeconomic backgrounds have more severe dental decay in their primary teeth and access less oral health-related treatment, compared to White children. Adams and Larkin (2012) report that data regarding the oral health-related statistics of Indiana�s Hispanic children is extremely limited. As a result, the full scope of Indiana�s dental health problem and the associated public health-related needs are challenging to quantify. Leaders within the Indiana Oral Health Coalition (D. Buyer, personal communications, January 14, 2014) report that Indianapolis, Indiana mirrors national statistics in terms of incidence and severity of oral health issues in the Hispanic population.
Research conducted on the topic of dental caries in children has focused largely on health-related disparities and socioeconomic factors, not on the potential impact of parental influences and behaviors. (Hooley, Skouteris, Bogain, Satur, and Kilpatrick, 2012.) By completing the here-described research, I expect to inform public health practitioners and dental health professionals regarding health promotional best practices that, when implemented might positively affect the behaviors of Hispanic parents regarding their children�s oral health.
References
Example 3
Organizational leaders, employees and key stakeholders are concerned how occupations stress affect staff and researchers have also agreed that not only is it of great concern, but is a serious problem and has identified health care workers as being most susceptible to occupational stress (Cooper & Cartwright as cited by Ongori & Agolla, 2008; Brock & Buckley, 2012). The cost of occupational stress is very high in many organizations. For instance, the International Labour Organization (ILO) latest research reports that inefficiencies arising from occupational stress may cost up to 10 percent of a country�s GNP and that in total, stress may account for 1-3.5% of GDP (ILO, 2001).
According to KPMG�s 2010 Managed Care Industry Report, the largest health insurers in the U.S. had combined profits of $14.4 billion in 2009, despite losing 2.7 million members who previously had insurance. Highly stressed employees are costing employers a significant amount to finance
health care costs and 48% of employers are reporting that occupational stress affects business performance and profitability (Brock & Buckley, 2012; Cannon, 2010; ILO, 2001; Kasperczyk, 2010). Stressed-out employees may be more likely to become sick and absent from work (Cannon, 2010). A 2001 study by Mental Health American showed that 1 million employees to miss work daily due to stress, which leads to an increase of loss productivity and poor work quality and job performance (Cannon 2010; NMHA, 2010). These statistics show that stress ranks as one of the most costly employee health conditions in the U.S., costing employers approximately $200 billion per year in lower work productivity, rising health care cost and worker compensation, and absenteeism (Cannon 2010; Kasperczyk, 2010). Additionally, occupational stress is the most cited reason why employees leave their job, which is an indicator that occupational stress contributes to the high cost organizations pay for turnovers (Cannon, 2010).
Occupational stress affects employee turnover, productivity and performance (Morgan, et al, 2005). In different organizations including health care facilities, managers are in a dilemma over what interventions to implement to lower the cost associated with occupational stress (Brock & Buckley, 2010; ILO, 2001; Kasperczyk, 2010). It is therefore essential to explore and understand occupational stress of CNAs in long-term care and the affect it has on job performance (Ongori & Evans, 2008) which ultimately may affect care quality outcomes. Understanding the effects that occupational stress have on CNAs can help administrators and management staff (Simpson, 2010; Ejaz, Noelker, Menne & Bagaka 2008) determine if the identified factors are associated with low quality care outcomes from data collected within the facility. This process can also provide management with data necessary to develop coping strategies within their perspective facilities for those staffs that are providing daily care to residents (Lazarus, 2001; Cannon, 2010; Kasperczyk, 2010; Shirey, 2009). As recommended by The National Nursing Assistant Survey, providing data from this research will be instrumental in providing much needed data and will close a gap in literature by providing data on how occupational stress affects quality of care (NNAS 2009; AHCA, 2011).
2.4 Theoretical Foundation
Describe the theory or theories that serve as the backbone of your project. Provide references for each theory.
Change management theory forms the basis of this theoretical framework. Kurt Lewin introduced the three-step model to help organizations improve processes and to improve the moral of the work place in 1947 (Lewin, 1947). Most managers provide solutions to problems in the most economical way by first understanding the problem and utilizing the strengths and weaknesses of the individuals on their workforce to fix the problem (Taylor, 2010). The change management theory introduced by Lewin flows well for this research because it has proven developing new processes and educational intervention helps the productivity and the quality of the workforce using the three-step model. The three-step model includes unfreezing, moving or changing, and freezing (Burnes, 2004). Unfreezing the current process is needed so that the old behavior can be discarded, moving or changing is needed to look at all options to change and to motivate the workforce to embrace the change, and refreezing is the last part of three step model because this is when the new process is freezing the process along with the new change to stabilize the process (Burnes, 2004). The three-step change management theory was used by Karen Sutherland in Canada to determine whether the implementation of a bar-coding system could reduce the amount of medication errors in healthcare organizations (Sutherland, 2013). The three-step change management theory was also used in a study done by Sarah Payne to help her organization change from a manual health record to an electronic health record (Payne, 2013. I will apply the change management theory to determine whether structured training and certification can decrease error and infection rates in sterile processing technicians. For the aim of this action research project, the change management theory provides a theoretical foundation to examine the relationships between types of sterile processing staff, the department size, and instrumentation error rates to manage sterile processing in hospitals. (see figure 1).
Figure 1. The Conceptual framework based on Kurt Lewin�s (1947) three-step model.
2.5 Researcher Positionality:
� Insider
� Insider w/collaboration
� Reciprocal collaboration
� Outsider, collaboration w/ insiders
Define your role, position, and how positionality will impact your research study.
I will be an insider. I am a sterile processing consultant so I will be in my work environment. The fact that I am in the field makes me an insider as well. This also makes me a subject expert in the field.
Here are a few examples from your peers:
As OT Academic Fieldwork Coordinator and faculty at Touro College, Manhattan, NY the position of the lead investigator for this action research study is Insider/Collaborator.
One of the most important challenges in action research is that inside researchers need to perform their study distinct from their professional roles and responsibilities. The lead researcher will take measures to differentiate organizational and investigator dynamics.
The lead researcher taught courses OT 475 and OT476 for the Touro College-Manhattan Occupational Therapy Class of 2015 in the spring and fall semesters in 2013 with instructivist teaching methods. The lead researcher taught the same courses for the Touro College-Manhattan Occupational Therapy Class of 2016 using constructivist techniques in the spring and fall semesters in 2014.
The researcher�s role as occupational therapy academic fieldwork coordinator at Touro College in New York is to assign students to a variety of physical disability settings where students perform their three-month clinical rotations.
Fieldwork is considered an integral part of Touro�s occupational therapy program. Fieldwork provides students with the opportunity to practice new skills, observe client/patient behaviors, model practice after experienced clinicians and transfer didactic and theoretical knowledge to the clinical setting through active participation in the occupational therapy process (Touro: Occupational Therapy Program Academic Fieldwork Manual, 2013).
Completion of fieldwork is not only a Touro College graduation requirement but also an eligibility requirement for graduates to sit for the National Board for Certification in Occupational Therapy (NBCOT) exam and to obtain New York State licensure (Touro: Occupational Therapy Program Academic Fieldwork Manual, 2013).
Level II fieldwork experiences occur at clinical sites with which Touro has a legal, contractual agreement. Therefore, the student, clinical site and the school are mutually responsible to each other. For this reason, students must be in good academic standing to be eligible for Level II fieldwork assignments. Also, the student must successfully complete all sequential coursework prior to being assigned a fieldwork site (Touro: Occupational Therapy Program Academic Fieldwork Manual, 2013).
Although students can request and rank potential fieldwork sites, placement is based on a variety of factors. Touro�s Academic Fieldwork Coordinator and Program Associate Director, will formally review all student requests for specific fieldwork placements. A student�s assignment to a clinical site is considered a final decision. Once a student receives their assignment it cannot be changed. Failure of a student to follow through with their assigned placement will result in a delay in their required clinical fieldwork. A delay in clinical fieldwork may result in delayed completion of the remaining occupational therapy program courses, subsequent clinical affiliations and graduation (Touro: Occupational Therapy Program Student Fieldwork Manual, 2013).
In order to reduce the possibility of bias it should be noted that assigned clinical instructors within fieldwork sites have the sole responsibility for grading the Fieldwork Performance Evaluation for the Occupational Therapy Student; therefore, this researcher has no influence on student requirements, performances and grades once they have started their fieldwork affiliations.
References
Example2:
I am a White, non-Hispanic woman who speaks only limited Spanish. I will be working as an outsider collaborating with insiders from an Indianapolis-based Medical Center while exploring disparities in dental caries among Hispanic children. As an outsider, I will need to be aware of the cultural needs of the research participants. Ojeda, Flores, Meza and Morales (2011) and D�Alonzo (2010) recommend factors that outsider researchers can employ to demonstrate an awareness of cultural considerations while building and enhancing trust. There are several important cultural considerations to factor into a research program focused on exploring Hispanic parents� perspectives regarding children�s oral health. These factors include leveraging collaborators who are insiders, where possible, using culturally respectful incentives, ensuring that informed consent materials are provided in Spanish, preparing culturally-sensitive interview protocols / associated questions, and conducting interviews in Spanish.
In order to explore Hispanic parents� perspectives on children�s oral health, it will be necessary to collect data in Spanish. My rudimentary Spanish-speaking skills are not capable of understanding or capturing dialog associated with interviews or focus groups. I will also need to rely on Medical Center staff members (all of whom speak Spanish) or on a Spanish translator to lead interviews with research participants and focus groups, as the participants primarily speak Spanish. Any translator or staff will sign confidentiality agreements before conducting any interviews. The data analysis plan incorporates the use of high-quality transcripts created in Spanish and translated into English. I will ensure to maintain the confidentiality of research participant�s information. Finally, triangulation will be a particularly important part of the action research plan as described in similarly positioned qualitative case study research conducted by Perry and Calhoun-Butts, 2012.
References
Example 3:
Positionality, as defined by Herr and Anderson (2005), is the position that researchers take within the setting that they are studying. This is important because the position that the researcher take must be determined prior to the research so that the relationship is clear between the researcher and participants in order to think through issues of research validity and ethics (Herr & Anderson, 2005). Although most action research dissertations are by student insiders wanting to make a contribution to their own settings, this researcher, as defined by Herr and Anderson (2005) will be an outsider collaborating with insiders because the action research setting is within an outside organization. As a licensed nursing home administrator of a skilled nursing home facility, my position for the research can be viewed as an outsider within, which refers to my professional connection with the long-term care industry (Collins, 1990, as cited by Herr & Anderson, 2005)?
As a nursing home administrator/outsider with collaboration with management and CNA staff insiders of another skilled nursing home facility, my positionality can be viewed as bias; however, there is no knowledge that this researcher has on the research setting and or potential participants outside of what has been currently research for presenting an Action Research plan. To be an outsider means being non-conflicting, such as being non-biased based on the non-relationship or non-working relationship that this researcher has with the research topic or organization (Herr & Anderson, 2005). According to Herr and Anderson (2005), outsiders usually have little or no knowledge to the research setting; however, is relied on for methodological guidance. Outsider research contribution is knowledge based and includes professional/organizational transformation, improved/critiqued practice and organizational development (Chakravarty, 2012).
As an outsider collaborating with insiders, the researcher will also have the role of �peripheral member� which means that the researcher works �closely, significantly and frequently enough� with staff to be identified by participants and research members as being a person who enjoys limited trust (Chakravarty, 2012, p 256). This is important because building coalitions with the community, exposing actual information, fabrication other information and blocking or enabling access to important or necessary data may become essential way of survival for those participating in various roles (Chakravarty, 2012). This researcher�s field relationship would create particular kinds of opportunities for data collection, but may also prevent checking any further than the partial trust dynamic allowed (Bosk, 2004). Varying levels of trust from the participants is accomplished, depending on the social roles adopted by the researcher (Bosk, 2004). Although, as a researcher, my main role is to encourage stakeholders to continue the project after it is completed, the role of facilitator and planner will be
2.6 Research Questions and Project Goals/Objectives
List the research questions or project goals. These should align with the need for organizational structure or activities/outcomes of the project.
Research Question: What is the relationships between types of sterile processing staff, the department size, and instrumentation error rates?
Null Hypothesis (H0): There is no significant relationship between types of sterile processing staff, the department size, and instrumentation error rates.
Alternative Hypothesis (H1): There is a significant relationship between types of sterile processing staff, the department size, and instrumentation error rates.
