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WGU CEM1 TASK 1: CLINICAL PRACTICE EXPERIENCE ASSIGNMENT WGU CEM1 TASK 1: CLINICAL PRACTICE EXPERIENCE ASSIGNMENT Permalink: https://nursingpaperessays.com/ wgu-cem1-task-1-…ience-assignment / COMPETENCIES 7067.1.1 : Theoretical Underpinnings of Nursing Informatics The graduate analyzes the theoretical and conceptual underpinnings of the nursing informatics scope and standards to improve patient experience and health outcomes. WGU CEM1 TASK 1: CLINICAL PRACTICE EXPERIENCE ASSIGNMENT 7067.1.2 : Informatics for Patient Care The graduate determines how technology and informatics can be optimized to improve the patient experience and lower healthcare costs. 7067.1.3 : Informatics for Health Administration The graduate analyzes core administrative systems to support the management of safe, cost-effective, and high-quality healthcare. 7067.1.4 : Informatics for Population Health The graduate analyzes data from population-based systems to mitigate public health threats and decrease incidence of disease. 7067.1.5 : Data Collection and Management The graduate designs data collection tools and processes to capture, analyze, and report health indicators and outcomes. 7067.1.6 : Data Analysis and Visualization The graduate refines data to visually represent, forecast, monitor, and report progress in meeting healthcare outcomes. INTRODUCTION To fulfill the clinical practice experience (CPE) requirements for this course, you will complete the attached “Clinical Practice Experience (CPE) Record.” You will need to electronically sign and date the record. Finally, you must upload the completed “CPE Record” as a separate attachment and the required deliverables from that record to your e-portfolio. You should complete this task and the “CPE Record” before submitting ARM1 Task 1. WGU CEM1 TASK 1: CLINICAL PRACTICE EXPERIENCE ASSIGNMENT REQUIREMENTS Your submission must be your original work. No more than a combined total of 30% of a submission can be directly quoted or closely paraphrased from sources, even if cited correctly. Use the report provided when submitting your task as a guide. WGU CEM1 TASK 1: CLINICAL PRACTICE EXPERIENCE ASSIGNMENT You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course. A. Upload your completed and signed “CPE Record” for evaluation as a separate document. The record should include the following: • the date each activity was completed • your electronic signature verifying that all activities have been completed Note: The “CPE Record” should be uploaded as a separate attachment and should not be included in your e-portfolio. B. Upload all of the following required deliverables to your e-portfolio and provide a link to the e-portfolio: • CPE schedule table of tasks and timelines • annotated bibliography of 5 recent and relevant sources • narrative essay of your interviews with technology users and experts • technology summary that provides the top five technologies you would recommend for transforming nursing or enhancing healthcare outcomes • three screenshots to document your Phase 1 GoReact video reflection, that includes an image of your reflection video and an image for each of your peer responses • a brief, written reflection summary of your video reflection below your screenshot • completed “Summary Yrs_RN” worksheet • completed “Summary Tot_Scores” worksheet • completed “Summary Demographic” worksheet • completed “Summary Responses” worksheet • completed “Pivot Table Education Level by Work Setting” • completed “Pivot Table Age Group by Race” • completed “Bar Chart on the Mode” on all questions on the “Barriers Survey” • completed “Pie Chart of Age Group” • completed “Sunburst Chart” of Sex • completed “Column Chart” of Education Level • completed “Funnel Chart” of Race • completed “Treemap Chart” of Work Setting • three screenshots to document your Phase 3 GoReact video reflection, that includes an image of your reflection video and an image for each of your peer responses • a brief, written reflection summary of your video reflection below your screenshot Note: The files for Phases 2 and 3 should be uploaded as screenshots. File Restrictions File name may contain only letters, numbers, spaces, and these symbols: ! – _ . * ‘ ( ) File size limit: 200 MB File types allowed: doc, docx, rtf, xls, xlsx, ppt, pptx, odt, pdf, txt, qt, mov, mpg, avi, mp3, wav, mp4, wma, flv, asf, mpeg, wmv, m4v, svg, tif, tiff, jpeg, jpg, gif, png, zip, rar, tar, 7z WGU CEM1 TASK 1: CLINICAL PRACTICE EXPERIENCE ASSIGNMENT RUBRIC A. : CLINICAL PRACTICE EXPERIENCE (CPE) RECORD WGU CEM1 TASK 1: CLINICAL PRACTICE EXPERIENCE ASSIGNMENT NOT EVIDENT The “Clinical Practice Experience (CPE) Record” is not provided. Or 1 or more of the required activities were not completed, or any of the activities are not dated. Or the verification of activities being completed was not signed by the candidate. APPROACHING COMPETENCE Not applicable. COMPETENT The “Clinical Practice Experience (CPE) Record” is uploaded and all required activities are completed and dated. The verification of activities completed is signed by the candidate. B. : E-PORTFOLIO DELIVERABLES NOT EVIDENT 1 or more of the required deliverables are incomplete or have not been uploaded. Or the link to the candidate’s e-portfolio is not provided. APPROACHING COMPETENCE Not applicable. COMPETENT Each required deliverable is completed and uploaded to the candidate’s e-portfolio. The link to the e-portfolio is provided. WEB LINKS GoReact Use to create the visual reflection. SUPPORTING DOCUMENTS Barriers Codebook (Student).xlsx Barriers Data Analysis Instructions.docx Barriers Data Visualization Instructions.docx CPE Record.docx GoReact Instructions.docx Technology Summary.docx Variable Variable Type Level of Measurement Response Categories Description/Survey Question StudentID N/A N/A N/A N/A Age _Grp Categorical Nominal 1=19-39; 2=40-59; 3=60 and older Age Group Sex Categorical Nominal 1=Male; 2=Female Sex Race Categorical Nominal 1=White; 2=African American; 3=Asian; 4=Other What is your race? Yrs_RN Continuous Interval/Ratio Number of years How many years have you been an RN? Setting Categorical Nominal 1=Patient Care; 2=Academic; 3=Community/Public Health; 4=Other What is your work setting? ED-Level Categorical Nominal 1=Associate; 2=Bachelors; 3=Masters; 4: Doctorate What is your highest level of education? The items below relate to Barriers Survey questions on the reasons nurses do not utilize research. Q1 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent Research reports/articles are not readily available. Q2 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent Implications for practice are not made clear Q3 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent Statistical analyses are not understandable Q4 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent The research is not relevant to the nurse’s practice Q5 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent The nurse is unaware of the research Q6 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent The facilities are inadequate for implementation Q7 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent The nurse does not have time to read research Q8 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent The research has not been replicated Q9 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent The nurse feels the benefits of changing practice will be minimal Q10 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent The nurse is uncertain whether to believe the results of the research Q11 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent The research has methodological inadequacies Q12 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent The relevant literature is not compiled in one place Q13 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent The nurse does not feel she/he has enough authority to change patient care procedures Q14 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent The nurse feels results are not generalizable to own setting Q15 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent The nurse is isolated from knowledgeable colleagues with whom to discuss the research Q16 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent The nurse sees little benefit for self Q17 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent Research reports/articles are not published fast enough Q18 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent Physicians will not cooperate with implementation Q19 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent Administration will not allow implementation Q20 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent The nurse does not see the value of research for practice Q21 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent There is not a documented need to change practice Q22 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent The conclusions drawn from the research are not justified Q23 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent The literature reports conflicting results Q24 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent The research is not reported clearly and readably Q25 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent Other staff are not supportive of implementation Q26 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent The nurse is unwilling to change/try new ideas Q27 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent The amount of research information is overwhelming Q28 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent The nurse does not feel capable of evaluating the quality of the research Q29 Categorical Ordinal 1=To No Extent; 2=To a Little Extent; 3=To a Moderate Extent; 4=To a Great Extent There is insufficient time on the job to implement new ideas Tot_Scores Continuous Interval/Ratio Total scores for individual questions New Calculated Continuous Variable – Total of Barriers Scores GETTING STARTED For this activity, you are going to analyze hypothetical data from a Barriers to Research Utilization by Nurses survey using descriptive statistics. This data has been provided for you, and step-by-step instructions on doing the analysis in excel are provided below. WGU CEM1 TASK 1: CLINICAL PRACTICE EXPERIENCE ASSIGNMENT BACKGROUND When collecting online survey data, the responses are generally textual data. Look at the Data_Raw worksheet to see the survey results. This raw data must be converted to numerical data for analysis. To accomplish this, a Codebook is created that contains the data and metadata (the information for each variable with coding instructions). For this activity, the Barriers Codebook has already been created for you. Review the Metadata worksheet to see an overview of the variables in this survey (column A), variable type (column B), level of measurement (column C), coding instructions (Response Categories, column D), and the original Survey Question (column E). Look to see how the data have been numerically coded for you on the Data_Coded worksheet. This was done by copying the Data_Raw worksheet, then using Find and Replace to code the responses numerically using the MetaData worksheet information. For example, in column D (Race), White was replaced with 1, African American was replaced with 2, Asian was replaced with 3 and Other was replaced with 4. Now the original data has been coded, you want to retain the coded data to preserve it for additional analyses or if errors are made. Note: These instructions use right-click to access the right-click menu. If unsure how to right-click on your computer, reach out to Student Success Center, IT services, or your course instructor. For example, Ctrl/click acts as a right-click on a Mac. CREATE YOUR OWN DATA FILE COPY This is where the real fun starts for this activity! You will first copy the Data-Coded worksheet to a working file that you can use for this activity. Desktop Excel Web Excel Copy the Data_Coded worksheet by right-clicking on the Data_Coded worksheet, selecting Move or Copy (see below) and checking the Create a Copy box. Copy the Data_Coded worksheet by right-clicking on the Data_Coded worksheet, selecting Duplicate (see below). Rename this copied worksheet Desc_Stats by right-clicking on the tab of the copied worksheet and selecting Rename and typing the new name . Right-click again, choose Tab Color, and choose a different color than red (red is a reminder to not use these worksheets). Next, click on the Desc_Stats worksheet and write a formula to total the scores on the Barriers Survey for each participant. The variable you will use for this is the Tot_Scores continuous variable in column AK. In column AK1, type the heading Tot_Scores . Next, enter this formula into cell AK2: =Sum(H2:AJ2) directly in the cell or the formula bar at the top, as shown. This formula will sum all the cells in Row 2 from Column H through Column AJ, which include all the “Q” items on the survey. WGU CEM1 TASK 1: CLINICAL PRACTICE EXPERIENCE ASSIGNMENT Make sure you see the formula bar displayed in this screenshot. If it is not there, click on the Formulas menu and check Show Formulas. To avoid having to write this formula 75 more times, Autofill the formula by holding your mouse over the small black square in the bottom right corner of cell AK2 . When your mouse pointer turns into a plus sign, click and pull the plus sign down through row 77. This autofills the formula and calculates the total score, while, adjusting the formula for each row. DESCRIBING THE DATA Continuous Variable Analysis For continuous variables (“Yrs_RN”, and “Tot_Scores”) you will compute measures of central tendency (Mean/Average, Median, and Mode) and measures of dispersion (standard deviation, minimum, maximum, and range). See the Continuous Summary (Example) worksheet in the Codebook for an explanation of the statistical tests you will use to analyze continuous variables, what it measures, and a sentence explaining the results. The following table contains the formulas for these statistical tests used to describe your continuous data. Row Stat Yrs_RN Tot_Scores 78 MEAN =AVERAGE(E2:E77) =AVERAGE(AK2:AK77) 79 MEDIAN =MEDIAN(E2:E77) =MEDIAN(AK2:AK77) 80 MODE =MODE(E2:E77) =MODE(AK2:AK77) 81 STANDARD DEVIATION =STDEV(E2:E77) =STDEV(AK2:AK77) 82 MINIMUM =MIN(E2:E77) =MIN(AK2:AK77) 83 MAXIMUM =MAX(E2:E77) =MAX(AK2:AK77) 84 RANGE =E83-E82 =AK83-AK82 85 SUM =SUM(E2:E77) =SUM(AK2:AK77) 86 COUNT OF RECORDS ( N ) =COUNT(E2:E77) =Count(AK2:AK77) Click on the Desc_Stats worksheet.Enter the formulas shown above at the bottom of the columns of data for Yrs_RN and Tot_Scores in the rows indicated in the table above and then hit Enter. Remember all cell references must be enclosed with parentheses. Transfer your results to the Summary Yrs_RN and SummaryTot_Scores worksheets. Desktop Excel Web Excel To confirm that your formulas are correct, view the formulas in your worksheet by using the instructions below. Hiding and protecting formulas is currently not supported in Excel for the web. To see the formula, click on the cell (such as E78, and view the formula on the top row. Next, write a summary interpretation for the variable analysis you did on Yrs_RN and Tot_Scores on the Summary_YrsRN and Summary_TotScores worksheets. Your summary should be similar to the one on the Continuous Summary (Example) worksheet where the variable Miles driven to work was analyzed (this is not in your dataset; it is just an example). WGU CEM1 TASK 1: CLINICAL PRACTICE EXPERIENCE ASSIGNMENT Great Job! This completes the first two pieces of evidence for this CPE. Now you need to capture screenshots of both of these worksheets and save them for uploading to your e-portfolio. To capture screenshots: Mac: Press Shift+Command+4. Drag the crosshairs to select the area of the screen you want to capture. After you release your mouse or trackpad button, find the screenshot on your desktop. Rename your screenshot to Summary Yrs_RN and Summary Tot_Scores so you remember what screenshots to upload to your e-portfolio. PC: Follow the “ Use Snipping Tool to capture screenshots directions ” to use the Microsoft Snipping Tool to capture, save, and share an image of all or part of your PC screen. The Snipping Tool is included in Windows Vista and later. Save your screenshots and name them BarChart Summary Yrs_RN and Summary Tot_Scores so you remember what screenshots to upload to your e-portfolio Categorical-Nominal Variable Analysis The best approach for analyzing categorical-nominal variables is to compute “frequencies” (counts) for each type of response. Your Codebook indicates the coding values for each response, which you will need for your formula. For example, to determine how many respondents were in the first age group (1=19-29 years), you will use the COUNTIF function to COUNT the cells in a range IF it has the number 1 in it. To do this, click on the Desc_Stats worksheet, then click in cell B78 and enter this formula in the cell or formula bar: =COUNTIF(B$2:B$77,1) . Hit Enter immediately after entering this formula. The dollar signs next to the row references will make it possible to autofill this formula down by keeping rows 2 through 77 constant and simply changing the response code for each response type. For example, note on your Metadata worksheet that Age_Group has three categories, so you will need to autofill this formula through rows 79 and 80 and change the IF condition to =COUNTIF(B$2:B$77,2) in row 79 and =COUNTIF(B$2:B$77,3) in row 80. If you don’t use the $ in front of the row number, Excel will automatically adjust the formula to the next row, which is incorrect. There is NO dollar sign in front of the B, as you will want Excel to auto-adjust across columns, but not rows. Note: You will format the numbers in the cells in the next section, which will fix percent and/or decimal points. Next, you should Autofill your formulas across columns C and D . You will need to skip column E and copy/paste this formula into cell F78 and autofill to column G . WGU CEM1 TASK 1: CLINICAL PRACTICE EXPERIENCE ASSIGNMENT Desktop Excel Web Excel When you are done autofilling down and across, click on the Formula Menu and check Show Formulas . Your formulas should match the ones shown below for your categorical-nominal variables: When you are done autofilling down and across, click on each cell check the formulas. Your formulas should match the ones shown below for your categorical-nominal variables: Because these are counts, format your categorical-nominal results as whole numbers, without decimal places or percent. Desktop Excel Web Excel First, select all cells you want to format by selecting cells B78 through D78 and then pressing the CTRL key (PC) or Command key (Mac) while selecting cells F78 through G78. (The CTRL key (PC) or Command key (Mac) is used when selecting cells that are not contiguous. The Shift Key is used when all cells are next to each other.) PC: On your Home menu, click on Format > Format cells . Mac: Right click while in the highlighted cell block, click Format cells , and then select Number Format. In the Format Cells dialog box, click Number and set Decimal to “0”. For your continuous variables you should make sure there is only one decimal point. First, select the first set of cells you want to format by selecting cells B78 through D81. (The CTRL/Shift keys do not work in Web Excel Right click while in that cell block, and select Number Format. In the Number Format dialog box, click Number and set Decimal to “0”. For your continuous variables you should make sure there is only one decimal point. Click the ‘Show Formulas’ again to see the numbers (instead of the formulas). Select the second set of cells you want to format by selecting cells F78 through G80. Right click, Select Number Format. In the Number Format dialog box, click Number and set Decimal to “0”. Analyze the frequencies of your categorical-nominal demographic data (e.g., age, sex, race, practice setting, and educational level). After completing your analysis of the categorical-nominal demographic variables, click on the Summary_Demographics worksheet and write a summary description of the demographics of this sample population. (Hint: Select the meta-data worksheet to be reminded of how the data is coded. E.g., Age_Grp is coded as 1=19-39 yrs, 2=40-59 yrs; 3=60 and older). Great Job! This completes the next piece of evidence for this CPE. Now you need to capture a screenshot of this worksheet, name the file to be Summary_Demographics and save the screenshot for uploading to your e-portfolio. WGU CEM1 TASK 1: CLINICAL PRACTICE EXPERIENCE ASSIGNMENT Categorical-Ordinal Variable Analysis When analyzing Categorical-Ordinal data, the MODE is the best choice, as it indicates the value that was reported most often for each of the Barriers Survey questions. To do this, click on the Desc_Stats worksheet, then in cell H78 enter this formula =MODE(H2:H77) and hit Enter. Click back in cell H78 and Autofill this formula across all “Q” questions ending in cell AJ78 . Your formulas should look like the ones below: After you have determined the Mode for each question on the survey, write a summary interpretation of the questions that scored high (4) and those that scored low (1) on the Summary_Responses worksheet. High scores indicate that the items are barriers to research utilization to a great extent and low scores indicate that to no extent is the item a barrier. For example, if the mode is 4 for Q1, you would conclude that the majority of respondents determined that nurses did not utilize research To great extent due to, “Research reports/articles are not readily available”. Great Job! This completes the next piece of evidence for this CPE. Now you need to capture a screenshot of this worksheet, name the file to be Summary_Responses and save the screenshot for uploading to your e-portfolio. Pivot Tables Your next analysis involves creating a matrix with counts of respondents using the Pivot Table function. For this activity you will look at the educational level of nurses by work setting and the age of participants by race category. You will use your Data_Raw worksheet for your Pivot Tables, so the correct labels will appear as column and row headings. Select the part of your worksheet that you will pull your fields from, which can be done quickly by clicking in cell A1 , pressing your shift-key and clicking on G77 . Next, select Insert > PivotTable . Under Choose the data that you want to analyze , confirm that the correct worksheet and range is showing in the Select a table or range box and that the New Worksheet radio button is checked, which will place your pivot table on a new worksheet. Select OK . This is similar to how your new Worksheet will look: In the Pivot Tables Field box on the right, click on the field name and drag these to the boxes at the bottom. If you check the box next to the field, instead of dragging and dropping the fields, it will automatically place it, which is not always correct. Once you drag and drop, a mark will occur in the checkbox next to the field. Drag Rec_ID to the Values box, Age_Grp to the Columns box, and Race to the Rows box. You will have to change the function in the values box, as you need to Count the number of participants in each group, not Sum. PC: Click on the small arrow next to Sum of Rec ID and select Value Field Settings. From the Value Field Settings box, select Count from the Summarize value field by box . Click OK. Mac: To do this, click on the small i next to Sum of Rec ID and select Summarize by and Count, then click OK. Pivot_Age The output for Age by Race is shown below. Right-click and Rename your worksheet Pivot_Age-Race. Right-click again, choose Tab Color, and choose a different color than red (red is a reminder to not use these worksheets). Below the table, create a box by selecting several cells and then clicking on Merge and Center on your Home tab. In this box you created, include a Summary Interpretation of the findings from your pivot table. When complete, capture a screenshot of this pivot table, name the file to be Pivot Table Age Group by Race and save the screenshot for uploading to your e-portfolio. Terrific! You have one more Pivot Table to go! Follow the same steps to create a Pivot Table and Summary Interpretation for Education Level by Work Setting. Choose the appropriate fields and have the Pivot Table count the number of records (Rec_ID) to determine how many are in each category. WGU CEM1 TASK 1: CLINICAL PRACTICE EXPERIENCE ASSIGNMENT If you put Ed_Level as the rows and Setting as columns, your Pivot Table should look like this: If you put Settings as the rows and Ed_Level as columns, your Pivot Table would look like this: Below the table, create a box by selecting several cells and then clicking on Merge and Center on your Home tab. In this box, include a Summary Interpretation of the findings from your pivot table. Rename your worksheet Pivot_EdxWrk. Right-click again, choose Tab Color, and choose a different color than red (red is a reminder to not use these worksheets). When complete, capture a screenshot of this pivot table and interpretation, name the file to be Pivot Table Education Level by Work Setting and save the screenshot for uploading to your e-portfolio. Conclusion Congratulations! Using these instructions, you have just analyzed a dataset! You saw the raw data, saw how it was coded into numbers for analysis, then you conducted the analysis yourself by using descriptive statistics and pivot tables. This activity used hypothetical data from a Barriers to Research Utilization by Nurses survey, but we hope that you can see how this same technique can be used for any kind of survey that you conduct in the future. Save these instructions for later use in your professional career. Follow the instructions in your CPE record to upload the screenshots you saved during this activity, and then continue to Phase 3: Data Visualization. Instructions for Presenting Data Using Data Visualization GETTING STARTED For this activity, you are going to continue to use the hypothetical data from a Barriers to Research Utilization by Nurses survey. Open the data file you used in Phase 2, and follow the step-by-step instructions below to visually represent the survey data. BACKGROUND Data visualization refers to techniques used to communicate data or information using visual techniques such as charts, graphs, maps, dashboards and other types of graphical representations. It is a type of data analysis that communicates information clearly and efficiently and provides an accessible way to see and understand trends, outliers, and patterns in data. Just as you learned in your data analysis activity, you must have numerical data to create various types of data visualizations. Also, the data must be in a format that supports the visualization technique you are using. For example, if you want to create a chart with a trendline to predict future values, you must have date information for each data point. Each type of data visualization has a different purpose, and several commonly used charts that can be created in excel are described below: Bar Charts – presents the frequency distribution of categorical (Nominal, Ordinal) data using horizontal rectangular bars. When it is vertical, it is referred to as a column chart. Bar charts are better to use when your labels are long. The bars can be reordered to help present increasing or decreasing frequencies. For example, use to display the number of survey participants and their highest degree earned (Associates, BSN, MSN, DNP/PhD). Stacked Bar Charts – used to compare the frequency within each category. For example, use to compare the number of survey participants and their highest degree earned (Associates, BSN, MSN, DNP/PhD) by each setting they work in. Column Charts (Columns, Cones, Cylinders, and Pyramids) – presents the frequency distribution of categorical (Nominal, Ordinal) data using vertical columns, cones, cylinders, or pyramids. Histograms – presents the frequency distribution of continuous data (interval, ratio, some ordinal data) in bar chart format, with the bars next to each other with no gaps. These bars cannot be reordered. For example, used to present the frequency of the three age groups in the survey (19-39, 40-59, >60). Line Charts – used to display continuous data over time. Pie Charts – Displays proportional segments of a whole (100%). Use when you have five or fewer segments (or slices) such as type of education for those working in academia (Associates, BSN, MSN, DNP/PhD) or the proportion of survey participants in the three different age groups. Donut Charts – Like a pie chart, a doughnut chart shows the relationship of parts to a whole, but it can contain more than one data series. The donut chart has a cut out center, which is often used to present a trend arrow or a total #. Area Charts – Area charts emphasize the magnitude of change over time and can be used to draw attention to the total value across a trend. For example, use an area chart if wanting to quantify and show the change in highest degree earned over time by participants responding from an academic setting. X-Y (Scatter) Charts – Scatter charts show the relationships among numeric values in several data series, or plots two groups of numbers as one series of x-y coordinates. Great examples include growth charts, showing a child’s height and weight over time. WGU CEM1 TASK 1: CLINICAL PRACTICE EXPERIENCE ASSIGNMENT Bubble Charts – Similar to a scatter chart representing the x-y relationship, the bubble (or circle) represents an additional dimension of data represented by the bubble’s size (z). For example, comparing life expectancy (x) by country (y) by healthcare spending (z) OR number of comorbidities (x) by healthcare spending (y) by number of patients (z). Funnel Charts – Used to show the progression of data. Sunburst Charts – Similar to a donut chart, but adds in a hierarchy for each ring. Treemap Charts – Used to present the relative size of two or more items and is organized hierarchically. An example is a chart displaying participants work settings.

Nursing

Nursing

Discussion: Nursing Research Phase 5 Paper ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Discussion: Nursing Research Phase 5 Paper Please create an abstract for phase 5 of the nursing research project (phase 5 is a combination of 1-4). Discussion: Nursing Research Phase 5 Paper I already combined the papers together (phase 1-4) please review the paper and make sure is all in past tense (I already reviewed most of the paper It should be a minor fix) I also had some points deducted for tittle and subtitles not being in proper APA format Can you please make sure The paper has the corrects APA format Disregard Masters Essentials after the references phase_5.docx Patients 65 Years And Older Living In Miami Florida Struggling To Transition From Hospital To Home Or Long Term Care Setting Nayvi Brennan Florida National University Professor: Jorge Hirigoyen 11/16/2019 Introduction The paper explores the continuity of care provided to older Hispanic adults 65 to 80 years old with a chronic condition who faces other risks factors such as social barriers, difficulties in managing their healthcare needs, as well as challenges in carrying out daily activities, especially during acute illness. The need to recognize and determine the efficient strategies to improve continuity of care provided to older adults and the outcomes to the health and care for older adults is critical and essential. Discussion: Nursing Research Phase 5 Paper Clinical research was conducted with the ultimate aim of improving treatment options for patients, develop alternative options, and reduce hospital readmissions. The objective of this nursing research was to find out why older Hispanic adults are struggling to transition from hospital to home or other health care settings. The article provides a detailed analysis of the problem and continuity of care. The results of the study will also help the different stakeholders and policymakers on the best approaches to adopt in a bid to improve the welfare of the patients. Treatment options or plans must be subjected to questioning to make sure that they are acceptable within the set standards (Colorafi & Evans, 2016). Further, it is key to ensure that all results from clinical and nursing researches are validated. It will, therefore, be vital to ensure that the findings in this study reduce instances of duplication or replication of research efforts, while at the same time, uphold the transparency of the study (Tappen, 2016). These will, therefore, ensure that no single decision is made without enough reasoning and conclusion. Discussion: Nursing Research Phase 5 Paper Identifying the Problem Among over 20 million Medicare beneficial, more than 40% have a chronic condition (Verhaegh, et al., 2014). Older adults who suffer from a chronic condition, other risks such as social barriers or functioning deficits add to the difficulty in providing their health care needs. Besides of the frequent episodes of the illness, the older adults compared to other chronic condition patients, these patients experience a higher rate of healthcare services such as emergency department visits, hospitalizations, and physicians which adds to their health care costs. Research from various studies has proven that poor healthcare provided to older adults often results in too devastating economic and human problems. Such problem associated with the poorly managed health care provided among the older adults including; inadequate communication, poor continuity of care, poor patients’ engagement, poor follow up, inadequate collaboration among patients and the health care providers, and gaps that exist as patients move between hospitalizations as well as care settings (Verhaegh, et al., 2014). Limited hospitalization and poor follows up are among the most troublesome consequences. Though some re-hospitalizations are necessary and cannot be avoided, 20% of those faced by older patients are estimated to be preventable if well care and managed (Hirshman, Toles, Huang & Naylor, 2019). Moreover, to the human burden, the societal costs related to older adults’ health care services are significant. Studies indicate that health care services provided for medical beneficiaries with five or more chronic conditions make up of about 74% of the total health care cost spent. The majority of these costs are as a result of high rates of avoidable hospitalizations (Allen, Hutchinson, Brown, & Livingston, 2017). Healthcare providers, who focus on continuity of care such as transitional nursing aims at enhancing patient’s experience, reduce health care cost, increase population health. Particularly, transitional nursing which is set of limited services that are provided during an acute illness episode across healthcare settings has been recognized as an efficient approach to improve and manage health care services provided to older adults. Evidence-based show that the transitional care model has consistently proven to be efficient in enhancing economic and health outcomes for older patients. (Verhaegh, et al., 2014) Significance of the Problem In recent years there have been increased issues of poor health care provided to older adults with chronic illness. Due to this, there have been numerous models that target to resolve the issues such as the transitional care model which is a nurse based model that targets to provide efficient health care service to older adults with chronic illness. The issues are significant to nursing as it threatens the ability of healthcare nurses to meet the ethical requirement and role for providing basic health care (Verhaegh, et al., 2014). The increased number of older patients with chronic illness who are at a high risk of facing other risks factors pose a significant threat to health care services systems. Managing healthcare service provided to older adults, improves health outcomes, patients’ experiences and enhances better use of the available resources. Health care service provided to older adults includes a range of services aimed to ensure the continuity of care for older adults across multiple healthcare teams and healthcare settings like homes to hospitals. Nursing as a professional should present policy, practice, and research that can address the issues. (Allen, Hutchinson, Brown, & Livingston, 2017) Most older adults with a chronic condition who require to transit from one health care setting to another normally experiences risks of poor outcomes as they move between various settings to health care providers. In the recent years, there have been increased cases of older adults too with a chronic condition to transit to various settings because of other risks such as a frequent episode of acute illness, for nursing, rehabilitative and medical before they transit again to home (Hirshman, Toles, Huang & Naylor, 2019). Properly and efficient health care during the older adults transition from one health care settings to another to enhances their health outcomes. Purpose The purpose of the study was to identify the reason for poor health care outcomes: studies indicate that most older adults who move between health care settings for medical and other health care services experience poor health outcomes during their transit. Dependence on others, low socioeconomic status, and advances ages play a significant role in the vulnerability for the poor outcomes. Patient and their caregivers often have a burden to self- manage health tasks, such as taking the correct medications, monitoring changes, medical treatments and managing follows ups. Besides, the paper aims to identify ways in which poor health care outcomes can be enhanced and improved to ensure that older adults receive better health care outcomes. Properly and efficient health care during the older adults transition from one health care settings to another to enhances their health outcomes. Research Questions What are the main factors affecting transition from hospital to home or other health care setting of older Hispanic adults living in Miami, Fl? Are health care providers prepared and ready to provide sufficient service to the older adult with a chronic condition? Within the selected population, which patients have the highest readmission rate? What are the major factors that lead to poor health care outcomes? What are the best ways in which health care providers can deal with poor outcomes? How could the transitional nursing be allied with transitional care model to ensure enhanced health outcome? How can we help this population transition without difficulty and reduce readmission rate. Literature Review Now days older adults are facing many challenges in healthcare. Literature review was conducted in order to identify why this is happening. In a study conducted by Dyrsad, Laugaland & Storm in 2015, it points out that older patient have minimal participation in the hospital from the admission up to the time they are discharged. In improving the quality of healthcare provided in hospitals, there is certain information that needs to be available to the healthcare providers. This is based on the fact the level of participation for different groups during admission up to discharge in the hospitals vary. The article focuses on the level of participation for older people in the hospital (Dyrstad, Laugaland & Storm, 2015). As indicated by Dyrstad, Laugaland and Storm, among the facts that limit the participation of the older people in the hospital are the time constraints for the healthcare professionals and the high number of patients. It is noted that improving the involvement of the patients is one of the ways of improving the quality of health care (Dyrstad, Laugaland & Storm, 2015). Therefore, there is the need to create awareness among the healthcare professionals on the factors that affect the participation of older patients in health care. This is based on the fact that improving the patient of the older patients in the hospital is critical to improving the quality of patient care. A study published by the Journal of Clinical Nursing was able to identify that patients with low socioeconomic have poor results during a post-hospital transition. This article explores the problems which this group of patients encounters during the period. The report focuses on the experience of these patients during hospitalization period, alignment of the team care goals, health behaviors, socioeconomic constraints, and self-efficacy (Kangovi et al…, 2014). According to the article, patients feel powerless when they are hospitalized; hence, they are not able to participate from hospitalization to discharge. There is also a lack of alignment of the patients and health professional goals. This result in scenarios where health care professionals suggested what patients cannot afford after hospitalization. Further, Kangovi and his colleagues in the article argue that there is a lack of saliency behaviors because instead of focusing on the discharge instructions after hospitalization, patients concentrate on the pressing socio-economic challenges (Kangovi et al…, 2014). The financial difficulties cause the patients not to follow discharge instructions. Therefore, the authors propose for the designing of policies to improve the post host outcomes with a particular focus for the collaboration of the hospitals and other social support groups. A study conducted by Allen, Hutchinson, Brown & Livingston, (2018), other major challenges are identified. There is a significant need for nurses and health care providers to focus on continuing to provide quality care to older Hispanic adults with chronic conditions, even getting discharged. According to Allen, Hutchinson, Brown & Livingston (2018), the patients also face other risk factors like challenges in managing their health needs, carrying out basic daily activities, and social barriers, among others. The realization on these challenges is an indication that with coordinated and dedicated care provision, nurses and healthcare providers can be able to continue offering quality care to patients, as observed by Allen et al., (2018). The study conducted by Allen, Hutchinson, Brown & Livingston, (2017), has insisted on the need of quality care by arguing that transition for health care services from the hospital to home should include effective communication between the practitioners involved, a framework for assessment, preparation, and planning. The understanding in this context is that medication reconciliation supported by follow?up care and self?management education will help older Hispanic patients avoid readmission or help them in the recovery process (Allen et al., 2017). Further, Allen et al. (2017), through their study, have also revealed that it is important to consider four thematic areas in the provision of care. These areas include; who will be the caretaker, what standards must we adhere to, what involves a proper discharge, and finally, how to adjust to provide quality care, since these are key to the quality transition. Brown (2018), in Transitions of care; In Chronic Illness Care , also notes that the world’s population is aging, but despite this happening, advanced medical procedures and medical science has made it increasingly possible for people with advanced diseases to stay longer. Brown (2018) has also observed chronic care has dominated the American healthcare system over the last ten years, and therefore there is the need to onboard and practice the effective management of treatment options for Hispanic adults aged 65 and above and with chronic diseases. Finally, the study by Brown (2018), also found out that the process of discharging patients and taking them to home care is seen as a social process as it involves aspects of negotiation and navigation of dependence and independence between the health care providers and the recipients of care. Hirschman, Shaid, McCauley, Pauly, and Naylor, (2015), have in their studies on continuity of care noted that the transitional care model is all about providing intervention to older adults who have high risks of deprived healthcare. The argument put forward in their study is on ensuring that there need to recognize, develop, and determine the effective and efficient strategies that can be used to improve the continuity of care without interruptions. Bookey?Bassett, Markle?Reid, Mckey & Akhtar?Danesh, (2017) have also revealed that transitional care should be able to facilitate the safe and timely transfer of patients across the two settings without compromising quality care. This would, in a significant way to reduce the cases of hospital readmissions and also strengthen community health programs related to the management of chronic diseases among the older Hispanic population. Bookey?Bassett et al., (2017), have also revealed that there is also the challenge that arises as a result of a limited understanding of how to actively and successfully involve care providers and care recipients in transitional care. This has made provision of care for an older Hispanic population a challenge. My study will focus on Hispanic patients 65 year old and older in Miami, FL struggling to transition from hospital to home or long term care setting as a target population. The purpose will be to identify specific issues affecting the transition. Studies mentioned above focus on other populations and issues affecting healthcare. The purpose of this study is to help facilitate transition from hospital to home or long term care setting. Methodology and Design of the Study This research aimed to find out a concept or rather approaches that can be used to promote a positive, successful, and working inter-professional relationship and collaboration for health care providers, health facilities, and other professionals in the provision of care. The research focused on the older Hispanic adults, an aspect that will make it different from the rest and dependable in providing important data sets and patterns about challenges they face while transitioning from hospital care to home care. Specifically, Hispanic adults aged 65 years and older living in Miami, Florida were targeted. Finding data on the nature of chronic diseases, their prognosis, and other factors will involve collaborating with agencies like the Center for Diseases Control, among others. The study involved patients’ assessments and interviews as well as the use of secondary data that relates to the management of chronic diseases for older adults. The study mainly depended on qualitative research designs and methodologies since they are highly preferred in the fields of nursing and other associated fields. The research designs and methodologies involved phenomenology, narrative inquiry, grounded theory, and ethnography (Tappen, 2016). The purpose of phenomenology in this study was help the researchers in finding and describing the areas of interest which individuals live in and interact with. Phenomenological studies are important in helping capture the experience of individuals about a subject of study. Using phenomenology ensured that the study is developed only through reliable and information that can be validated. Inclusion and exclusion criteria was used ensure that only those who have had an experience with a chronic disease will be interviewed. Discussion: Nursing Research Phase 5 Paper In a bid to understand what social or family-related traits or factors have on chronic disease, the study used ethnography. Ethnography aims to seek a deeper understanding of the community, group, or even a specific family. The final methodology used narrative inquiry, especially from the patient, family members, or caregivers. The narrative inquiry helped in capturing the experiences of individuals and probably find a connection between their narratives and chronic diseases (Wang & Geale, 2015). Sampling Methodology The sampling method is simply a way to select the members of a population who are qualified for this study. The Study was conducted with the support of two local hospitals, West Gables Hospital and Hialeah Hospital using random sampling. The study aimed to achieve results and data that can be used in decision and policy-making and towards making permanent interventions on how to assist caregiver’s transition caregiving from a hospital setting to a home setting without compromising the quality of care given (Tappen, 2016). In achieving this; simple random sampling was used since it will help in selecting a fairly representative. The study avoided using convenience sampling and voluntary response sampling as they might give biased results, which could, in turn, affect the outcomes. In essence, sampling methodology was used because it provided a fair and unbiased representation, which guaranteed that all population groups are represented. Necessary Tools The study was highly organized, rigorous, and comprehensive to ensure that the results obtained can be used in the decision and planning processes of the management and treatment of chronic diseases among older adults. Several organizational and project management tools were used especially in carrying out the interviews, collecting data, recording data, and finally, to ease the access of the obtained data sets and results. The tools included; event calendars, screening and enrollment logs, data summary sheets, instrument scoring tables, and protocol & eligibility checklists. These tools created efficiency, promote a professional outlook and a positive image, provide a sense of control during the study, maintain the integrity of the collected data and minimize errors (Tappen, 2016). Algorithms and Flow Maps Based on the design and an analysis of the entire research study process, flow maps and data table were used in order to present the collected data. Algorithms and flow maps are usually preferred in instances where the flow or process is uniform and not random. The methodologies and designs used in the research study are popular and widely used in nursing and healthcare, making it easy for researchers to implement without the flow maps (Tappen, 2016). The objectives, goals, and constraints of the research study are also well laid down, thus removing any aspect of ambiguity that might confuse the researchers. Finally, the scope of the study is narrow and does not involve aspects like medical test selection, therapy & prognosis, and diagnosis. The study was implemented in stages to ensure that we fully onboard our partners and sponsors. We are going to involve Agency for Healthcare Research and Quality, Health Resources and Services Administration, Centre for Diseases Control and Prevention, the Centers for Medicare and Medicaid Services (CMS), and other agencies as the study might require. Our study adheres to Good Clinical Practice guidelines (GCPs) as set out by the Federal Government and other regulators. Implementation Phase The project focused on finding concepts and approaches that will be used to promote a positive and successful working relationship for health care transition for older Hispanics with chronic diseases. We implemented this project in phases to ensure continuity and completion of each phase and stage. According to Kadu & Stolee (2015), transitioning care is a systematic approach that is used to study, identify challenges facing patients who transition from hospital care to home-based care, and at the same time, prevent hospital readmissions from occurring. The implementation involved assessment, diagnosis, planning, and evaluation. The implementation of the study was also included the study design, identification of the site, development, monitoring of sites, and their management. In a bid to ensure that implementation was not affected by issues to do with data, the project focused on data management, quality, and integrity (Kadu & Stolee, 2015). Furthermore, the study team was also focus on biostatistics and statistical analysis while at the same time, protocol development was used while working with our partners and stakeholders. The communities were involved in the studies, and therefore, it was important to assess their preparedness. Research operations and logistical support also played a key role in strengthening the study. The implementation skills needed from nurses and caretakers are cognitive, interpersonal, and technical skills. Cognitive skills will be vital in problem-solving, critical thinking, and creativity. Interpersonal skills focused on helping to address issues to do with communication (Kadu & Stolee, 2015). Technical skills were required in the implementation process. According to Friesen?Storms et al,. (2015) ; Leff, Soones & DeCherrie, (2016), the process of implementing nursing projects involves reassessing the client, determining the nurses’ needs for assistance, implementing nursing interventions, supervising delegated care, and documentation. Discussion: Nursing Research Phase 5 Paper Project management tools were used to ensure that it is consistent in implementation, coordination, and deliverables. We monitored the project and make adjustments based on the milestones and goals set. The nursing team also recorded any variances that might be experienced during the implementation process. The project reviewed weekly to ensure that any challenges and discrepancies from the main goals are noted and corrected. We updated sponsors and other critical stakeholders on the status of our clinical study and adopt recommendations. Status reports generated during the implementation phase showed the anticipated endpoint, cost of study, the schedule, as well as the quality of deliverables. West Gables and Hialeah Hospital worked with the team to ensure that the project goes full scale. Before the implementation, there was a need to ensure that the central clinical site monitoring is done. The monitoring was important in ensuring compliance with the set standards and protocols, follow the Good Clinical Practices, the Federal government regulations, as well as other institutions concerned with the subject of study (Smith & Johnson, 2019). The implementation fallowed the clearly set guidelines as it relates to clinical research studies. The implementation plan was bolstered by a Clinical Monitoring Plan that has set guidelines on issues of complexity of the study, human subject risk, and nature of the study. The project management team understanded that the implementation of the project depended on the quality of communication with the involved stakeholders. According to Kadu & Stolee (2015), communication involved debriefing, follow-ups, visit reports, and Action Item Tracking. In finality, the preparation for the implementation of the study also focused on on-site assessment review, protocol compliance, the integrity of data and samples, human subjects protection, staff training, protocol compliance, and laboratory SOPs and compliance. Time Frame of the Project The success of the study was purely be driven by the use of quality approaches towards the project. The study involved many activities ranging from assessment to evaluation. Additionally, since the project involved different stakeholders, there was the need to onboard them for ease of implementation of the project. The communities to be involved was trained on the importance of this study. These steps further made the project a reality. The entire project was achieved in milestones, thereby narrowing the chances of failure. Working in different phases also reduce the pressure on available resources committed in the study. Activity Duration Cost Assessment 2 months $8,000 Data Collection 3 months $14,010 Data Organization and Analysis 1 month $3,200 Nursing Diagnosis 3.5 months $36,175 Planning 6 months $84,014 Implementation 9 months $112,068 Evaluation 3 months $8,953 The entire project from the assessment phase to the evaluation phase required 27.5 months and a financial commitment of $266,420. The budget was broken down into units that were seen the different stakeholders investing to make the study a reality. Resources and Statistical Tools Patient assessment after transitioning from hospital to home-based care and clinical data collection required a dedicated approach (Leff, Soones & DeCherrie, 2016). Our study was implemented in a way that enhances data collection through clinical observations, specimen collection, clinical measurements, data and information documentation, and in some instances, the manipulation of the collected outcomes. Interventions and study procedures for older Hispanics with chronic illnesses involved the administration of investigational drugs, other treatment options, and detailed evaluation to reveal the implications of the treatment options on the health of the patients. The resources used in the clinical study were also used in phenotyping to find out the natural history of chronic illnesses. According to Friesen?Storms et al,. (2015), the study team should also focus on training caregivers and caretakers on the best way to physiologically monitor patients and help them in the recovery process. The study carried out with the input of the partner hospital and other agencies in Florida and from the Federal government and, therefore, required comprehensive tools and resources. There was a team of dedicated health practitioners and professionals whose expertise were required in guiding the clinical nursing officers from carrying out the study successfully. The study was engaging, rigorous, and comprehensive to ensure that it makes important inferences that are supported by facts and can be used in minimizing cases of readmission into hospitals after they are discharged. Discussion: Nursing Research Phase 5 Paper Significant activities in the study involved interviews, data collection, data recording, and storage of the data for use in the future. Tools that were used in this case included data sheets and screening tools (Ali & Bhaskar, 2016). The team consisted of Registered Nurses who trained and educated patients during the period of the study. This will be instrumental in reducing cases of hospital readmissions. Clinical Nurse Specialists, Nursing Educators, and Public Health Nurses also required to strengthen the human resources team and further to guide the team on the ground. All these efforts invested in helping generate consistent and valuable data that can be used in decision making. Data collected in the study was manipulated by the use of the Bradford Hill criteria, while the Statistical Package for the Social Sciences (SPSS). The project team also made use of Microsoft Excel and the Statistical Analysis Software (SAS) (Ali & Bhaskar, 2016; Chen, Carlin, & Hobbs, 2018). Instant Data Entry Application (IDEA) was used in capturing data during the period of the project. This application reduced instances of losing data and at the same time, help to develop a relationship of data sets. Google Forms and Zoho Survey tools were used in administering surveys to the different target populations (Chen, Carlin, & Hobbs, 2018). OpenRefine was also important in linking data sets. Airtable, a cloud-based database, was used in the study because it has capabilities for capturing data and displaying information. Data integration was done by using the Talendi tool (Ali & Bhaskar, 2016). According to Smith & Johnson, (2019), such projects involved a lot of activities, especially in assessment, planning, and implementation. Creating quality results was instrumental in the study because the data collected and the results will be shared with our partners and other stakeholders like the Centre for Diseases Control, and other agencies working to improve public health (Kadu & Stolee, 2015). Scoro was the best software to use in project management since combines all aspects of project management and made it easy to improve the project as needed. Since the study involved finding ways by which nurses can continue offering quality care to older Hispanic adults with chronic conditions, it was important to consider comparing data with other countries. Discussion: Nursing Research Phase 5 Paper Baseline Data The baseline data was collected before the research study started. These data include demographics, the characteristics of the patients, and other characteristics that are key in the assessment of patients with chronic illnesses. All participants selected were Hispanic male or females living in the Miami, Florida area with admission diagnosis of exacerbation of current chronic illness. Chronic illnesses included Congestive Heart Failure, Chronic Pulmonary Obstructive diseases and Diabetes. The age rage of the participants was taken to be between 65 to 80 years old. The average weight of the participants was at a mean age of 81.5 kilograms, while the Body Mass Index (kg/m2) was at 31.8. These data sets were important in setting the basis for the research study. Participants Age Range 65-70 years old 134 patients 71-75 years old 131 patients 76-80 years old 85 patients Average age 72.3 years old Total participants 350 patients Chronic Illness exacerbation as admitting diagnosis COPD Exacerbation 94 patients CHF Exacerbation 122 patients Complications related to poor management of diabetes 134 patients Total participants 350 patients Gaussian Distribution The research study can be termed as a biological study because, on the one hand, it was about chronic illnesses, aging, and the recovery process of patients while, on the other hand, it was trying to find ways of reducing readmissions in the hospital. These aspects make most biological variables to cluster around a central value. This, too, can be explained by the statistical tools used in interpreting the data sets. The variables, despite this clustering, have symmetrically positive and negative attributes (Leung, 2015; Polit, 2017). The research study indicated that out of the 500 participants, only a mere half were focusing on improving their wellbeing by being at home. The rest were not aware as to whether taking treatment at home would be of any help in their recovery process. These behaviors are attributed to normal or Gaussian distribution. Adverse Events Experienced by the Study Participants The research study was not without several adverse events, as some aspects did not work as planned. There were several unanticipated adverse events, especially when participants cited as the new setting as to ha

Assistance with Marketing Assignment ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Assistance with Marketing Assignment I’m trying to learn for my Health & Medical class and I’m stuck. Can you help? Assistance with Marketing Assignment Please assist with two page writing assignment. Please see attached word document with instructions database_marketing__houston_methodist.docx chapter_10_organization_growth.docx swot_analysis___houston_methodist.docx houston_methodist.docx Database Marketing This week you will obtain information on database marketing to support the Marketing Mix section of your Final Project. As discussed in Chapter 10 of the course text, database marketing centers on gathering customer-based information such as gender, age, occupation, and lifestyles. As an example, to better understand the wants and needs of patients and their families, the Happy Valley marketing director monitors activities on the long-term care center’s web page. Data is collected regarding specific links viewed such as activities, skilled care services offered, and physical therapy. If a certain link is viewed more than other links, this could indicate to the marketing director that potential patients and their family members prefer specific amenities or services. Those amenities or services would then be marketed as a priority for the organization. Considering the marketing plan for your chosen healthcare organization, construct a three- to four-page paper in which you: Assistance with Marketing Assignment Describe your understanding of database marketing and how it could potentially be applied to your marketing plan for the Final Project. Discuss the benefits and drawbacks of using database marketing. State the ethical, legal, and HIPAA issues that need to be considered. Articulate reasons why you would implement or exclude the use of database marketing in your marketing plan for the Final Project. The paper Must be two double-spaced pages in length (not including the title page and references page) and formatted according to APA style as outlined in the Ashford Writing Center(Links to an external site.)Links to an external site. . Must include a separate title page with the following: Title of paper Student’s name Course name and number Instructor’s name Date submitted Must use at least three scholarly sources in addition to the course text. Must document all sources in APA style as outlined in the Ashford Writing Center. Must include a separate references page that is formatted according to APA style as outlined in the Ashford Writing Center. 10.1 Organizational Growth Most organizations have growth as a basic goal. Growth means an increase in revenue and a greater impact on the communities served.Growth also creates opportunities for staff to advance and take on new responsibilities. While many activities can help an HCO grow, the mostimportant is the development of an effective marketing plan to provide a consistent platform for the organization’s visibility and to brand theHCO as an attractive option for medical services. The development of an effective marketing plan was stressed in Chapter 8 as a basicmarketing need for an HCO: that is, to inform new and existing customers of the organization’s services and to persuade them to continueusing or to try using these services. Product/Service Life Cycles Like people, products and services have a life cycle. The term product life cycle refers to the stages that a product or service goes throughfrom the time it is introduced until it is taken off the market or “dies.” The stages of the product life cycle, illustrated in Figure 10.1, usuallyinclude the following descriptions: Introduction—The stage of researching, developing, and launching the product or service. Growth—The stage when revenues are increasing at a fast rate. Maturity—The stage when revenues peak, and the rate of growth slows down. Decline—The final stage of the life cycle, when revenues start to decline. Assistance with Marketing Assignment For example, a pharmaceutical manufacturer introduces a new cholesterol drug, and it is promoted by sales reps and possibly promoteddirectly to consumers during the product’s introduction stage. As more and more physicians prescribe the drug, sales grow at a fast pace, andthe drug enters the growth stage. As time passes, sales begin to slow as the drug reaches the maturity stage. Then, newer drugs areintroduced, and sales of the older drug start to decline. In an attempt to maintain sales of the older product, the manufacturer may decide tosell the older product as an OTC drug, but at a much lower price than when it was a prescription drug. Of course, not all products reach the final stage and may instead continue to stay at the maturity stage for a long period of time. Regardless,attracting and keeping new customers is critical because of the nature of how products evolve from their conception to extinction. When therevenues produced by the product or service begin to decline, so do profits. To boost or maintain revenues requires keeping existingcustomers, but also attracting new ones. Figure 10.1: Product/service life cycle Some products stay in the maturity phase for a long time. Other products movequickly through the cycle. Source: Adapted from Product Life Cycle Stages at http://productlifecyclestages.com/ Individual Adoption Stages A critical element in attracting new customers is to understand the stages that individual consumers move through when adopting a newproduct as it moves through the product life cycle. These stages, shown in Table 10.1, are referred to as the individual adoption stages . Ofcourse, promotional messages must be aligned with these stages to carry the consumer through them. In the introductory stage, promotionalmessages must inform potential customers of the offering. In the growth stage, promotional messages must encourage potential customers touse that specific offering, or product, rather than competing products. At the maturity stage of the product, customers are reminded of theproduct to build repeat usage and referrals. Thus, messages stressing the firm’s competitive advantage must be developed to answerconsumers’ questions at a given stage in the individual adoption process and to reflect the nature of the product at a given time during its lifecycle. Table 10.1: Individual adoption stages and information needs Stage in Individual Adoption Process Questions Consumers Want Answered 1. Awareness: Consumer first learns of the product,service, or organization. Who are you? What are you all about? What do you do? 2. Interest: Consumer is stimulated to get moreinformation about the product or service. Why would anyone use your services? What benefits would they get? 3. Evaluation: Consumer considers whether to trythe product or service. Assistance with Marketing Assignment Why should I buy your organization’sservices? 4. Trial: Consumer tries the product or service. Will it really deliver those claimed benefits? Can I risk trying the service? 5. Adoption: Consumer decides to use the product orservice, becoming “your” customer or patient. Did I make the right decision? 6. Repeat: Consumer may reevaluate his or herdecision to continue using the product or service. Should I continue to use the same serviceprovider or are there better alternatives? Consumers will be at various stages in their individual adoption process of a product and will have varying levels of knowledge andexperience. Therefore, a variety of promotional messages, conveying different types of information about the product, service, ororganization, is usually necessary to communicate effectively to them. While most consumers are concerned about the benefits received froma product, some are interested in the detailed information that produces those benefits. Such detailed information should be available toconsumers who request it. Information from the marketing plan’s consumer analysis is vital in making communications decisions on promotional message content. Theneeds and motives of consumers become the center of such content decisions. If time and money permit, promotional messages should betested before use, and measures indicative of consumer responses to those promotional messages should be evaluated in the decision-makingprocess to finalize the message content. 10.2 Attracting New Customers New customers, or patients, can be attracted to an HCO in several different ways, some at a relatively low cost. One source has identified fourlow-cost approaches (Guerrero, 2013), which follow: Create an online presence with a website because people search for information, and sometimes ratings, online. Use social media to create a profile of your business and to get feedback. Using social media increases visibility and presence, and showspotential patients you are up-to-date. Increase community involvement, which is an age-old technique, but it works. Clubs, churches, speaking engagements, and so forth allincrease name recognition and awareness. Make it easy for patients to contact you. This can be done by creating a link on your website for customer contact or by using text,tweets, and email. Some hospitals have started using animated videos to attract new patients. These videos can be linked from your website, or emails can besent to provide links to videos on YouTube. This allows potential and existing patients to view the videos at their leisure and provides aninteresting interface, which can serve to present useful information (PRWeb, 2012). Another approach for increasing patients/revenues is to offer additional services. Dr. Clint Long of Long Eye Clinic in Sherman, Texas is aboard-certified ophthalmologist who has added new services to his practice to attract new patients and increase revenues from existingpatients. The clinic offers BOTOX ® Cosmetic, a proven prescription medicine that is injected into muscles to temporarily improve the look ofmoderate-to-severe frown lines between the eyebrows in patients from age 18 to 65. The clinic also offers CO2 laser treatment for skinrejuvenation. This treatment can help diminish brown spots and wrinkles while firming and toning facial skin. LONG VISION CENTER: DR. CLINT LONG Long Vision Center in Sherman, Texas cares about your vision. In fact we believe that it is very precious, and Dr. Long ishere to make sure you have superior quality eye care. Here at Long Vision Center, we provide general eye care, medical eyecare, surgical eye care, laser eye care, as well as Botox Cosmetic, Laser Skin Re-surfacing, and Lasik to patients in Sherman,Texas and the surrounding North Texas area. Dr. Clint Long, a State of Texas Board Certified Licensed Ophthalmologist, performs general eye examinations foreyeglasses and contact lenses, examinations for cataract and cataract surgery, lens implants, corneal surgery andtransplants, diagnosis and treatment of dry eyes, laser vision correction & surgery such as LASIK, diagnosis, medical, laserand surgical treatment of glaucoma and provide eye examinations and laser treatment for diabetic retinopathy andtreatment for age related macular degeneration. Source: http://www.longvisioncenter.com/ Retrieved November 13, 2013 (continued) While Dr. Long’s initial interest was in helping patients with skin issues around the eyes, he soon learned that patients also wanted thetreatments for other areas of their face. His investment in additional training and certification in those procedures has paid off through anexpanded customer base and increased revenues (Long Vision Center, 2013). Patient referrals are a cost-effective way of getting new patients. However, patient referrals, like other aspects of a marketing plan, must bemanaged. This means evaluating the process of new-patient referrals; that is, who is referring new patients, how is this information beingobtained and kept, and how are new patients treated by staff and made to feel welcome and valued. Many doctors will actually set up an appointment for a patient with another doctor and have the referred doctor’s office confirm theappointment. A record of each of these referrals should be maintained and the referring doctor thanked for the referral. A short note or callcan show appreciation and lead to more referrals. The cross-selling of services within a clinic is a valuable tool for referrals. Cross-selling means referring patients to other doctors or servicesoffered by the clinic. It is important that each doctor be aware of the services and qualifications of other medical staff at the clinic andcontinually reminded of the need to cross-sell, because it works both ways: I refer someone to you, and you refer someone to me. Assistance with Marketing Assignment In addition to attracting new patients, HCOs must effectively manage their existing customers to support long-term profitability. Customerrelationship management (CRM) further analyzes a targeted segment by addressing each customer’s potential for profitability. CRM isbased on the following four premises: Customers are a key asset of the organization. Customers vary in their preferences and behaviors and their value to the organization. Understanding customer needs, preferences, and behavior can improve a customer’s value. Relationships with customers must be managed. While many companies have operated on the premise that the best customers are loyal ones and have focused on segmentation by frequencyof purchase, traditional loyalty programs have neglected to analyze their profitability (Mason & Young, 2003). Instead of focusing on loyaltyalone, CRM goes one step further in finding ways to measure the company’s “cost” to maintain that customer relationship. Many companiesnow offer software for CRM programs, which, if implemented appropriately, can provide a competitive edge for an organization (Kotler,2003). These software programs involve the use of database marketing, which will be discussed in the next section. The All About Smiles dental practice in Durant, Oklahoma has learned to use several approaches to CRM. At All About Smiles, CRM beginswith new patients at the front desk, where they are greeted by office staff and made to feel welcome and appreciated. Everyone else’s job is toensure that customer appreciation continues throughout the whole treatment and payment process. The office layout is unusual for dentalpractices. For example, the Egypt room has murals of pyramids; the Jamaica room has scenes of beaches and palm trees; and a game roomcomplete with PAC-MAN ® entertains the younger patients. New patients are asked for their email addresses and mobile phone numbers so they can be sent reminders of their next appointment andalso have an opportunity to evaluate the services through an online survey, which is sent to patients a few days after their dental visit. Emailreminders are sent the day before the upcoming appointment, and text messages are sent the day of the appointment and two hours beforethe appointment time. Patients can opt out of both of these contact methods and request phone calls instead, if they prefer that type ofreminder. The office manager reports that the texts sent on the day of the appointment have significantly reduced the number of no-shows. ALL ABOUT SMILES DENTISTRY, DURANT, OKLAHOMA At All About Smiles Dentistry, we value our patient relationships, making it our priority to deliver gentle compassionatecare that you deserve from a dentist in Durant. We work hard to make you feel at ease by providing exceptional patientcare in a relaxed, convenient atmosphere. We strive to develop lifelong relationships with our patients by combining thelatest dental technology with a professional and compassionate staff. The result is a beau-tiful, healthy smile that lasts alifetime. We also believe that patients should have sufficient information to make educated deci-sions about their oral health,treatment options and choice of dentist in Durant. You’ll find all of this important information on our website, includingdirections to our Durant office, service descriptions, patient forms, patient education resources and more. Not only are we a leading dentist in Durant, we are a full-service practice providing for all of your dental needs. Ourservices include: General Dentistry Teeth Whitening Crowns Preventive Care Periodontal Exams View a Complete List of our Dental Services Should you ever need additional information about our practice, we are always available to answer your questions. Let uscare for your entire family! We look forward to meeting you. Source: http://www.durantsmiles.com/ Retrieved November 13, 2013 10.4 Database Marketing True database marketing creates customer intelligence that contributes to the development of profitable customer relationships. Databasemarketing is an organizational process that is customer research driven. The information base is dynamic and evolving, preferably with two-way dialog with the customer (Berry & Linoff, 2000). It is a measure of the importance of creating and maintaining a good database of marketinformation that Business Week devoted the cover story of its September 5, 1994 issue to the subject of database marketing, calling it “one ofthe biggest changes in marketing since ‘new and improved’” (Bloomberg Businessweek, 1994, para 5). Since that time, the concept ofdatabase marketing, coupled with new technologies, has grown to the point that a new generation of marketing professionals has beencreated. Basic information on age, gender, lifestyle, occupation, and so forth can easily be captured by HCOs through additions to the regularpatient forms filled out annually or by new patients. This information must then be entered into a software program by staff or an outsidemarketing agency. The data can then be analyzed for commonalities and trends. Assistance with Marketing Assignment Advantages of Database Marketing The new generation of database marketing professionals offer skills in four primary areas: (a) secondary data acquisition, including analysisof the value of lists; (b) database-building, including the understanding of computer hardware and software; (c) target marketing, includingmaximizing database record use; and (d) one-to-one marketing, which involves managing and refining the targeting process to customizecontacts for every customer (Kotler, 2003). The popularity of database marketing is grounded in the belief that marketing planning begins byunderstanding the customer—his or her buying and consumption patterns, location, interest, and other aspects of buying behaviordiscernible from databases—and then formulating plans that attempt to weave the firm’s product or service into the consumer’s pattern ofbehavior. The basic idea behind the use of databases is this: If that is what the consumer is doing, how can we make consumers want to dothat more often and with our product? This approach to satisfying customers adheres to the belief that the best indicator of future behavior ispast behavior. Thus, if American Express ® sees its card frequently used by a cardholder to purchase works of art, then it assumes anadvertisement for artworks in that cardholder’s monthly bill will generate a better response than it would with a cardholder who uses thecard for travel in the Caribbean (and receives advertisements for travel specials to that region). In fact, by monitoring card members’shopping, travel, and eating patterns, plus the economic and weather patterns in which they live, the database may trigger an ad to be sent tosomeone who has traveled in the past to warmer climates during a particularly inclement winter month, in a calculated effort to strike whilethe iron is hot. If an HCO learns that more and more patients are accessing its website before a visit, then ensuring that the website is up-to-date, and thatlinks to departments and services are all working, is an essential part of the use of data mining, which is discussed in the next subsection.Patient forms can simply ask about visiting the website and any additional information patients would like to be able to access on the website.Patients can also be asked whether they want to receive email or text updates of changes to the website. Data Collection and Manipulation The process of data collection and manipulation, which allows such powerful tactical marketing actions to occur, consists of several steps: Consumer action. The process begins with the consumer taking some form of action—they use a coupon, fill out a warranty card, make apurchase, enter a sweepstakes, place a toll-free call to request information, fill out a business reply card, order from a catalog, and soforth. This behavior is combined with other information in public records to identify a broad profile of each consumer in the database. Digesting the data. Sophisticated statistical techniques are used to merge data on the consumer into a coherent, consolidated database.Other software allows the marketer to “drill down” into the data to reveal patterns of behavior for classes of customers. Profiling the ideal customer. Neural networks that “learn” from the data are used to identify a model consumer, that is, the commoncharacteristics held by the high-volume customer. This allows the marketer to find customers or potential customers who share thosecharacteristics in common with the high-volume customer. Using the knowledge. This data can be used in many ways: to determine who gets which sales promotions, to develop attributes for newproducts or services with a targeted list of customers for new-product introduction announcements, to tailor ad messages and targetthem by customer groups, and so forth. Sharing data with channel members. For consumer package-goods marketers, it is possible to merge the manufacturer’s database(described in item 2 of this numbered list) with an individual store’s scanner data to help plan local promotional mailings, fine-tuneshelf displays, and design store layouts (Berry, 1994). Assistance with Marketing Assignment Modern technology has made it possible for marketers to do extensive searches through a large database, essentially mining the data. Datamining is the process of sorting through the data to find hidden patterns, potential trends, and correlations between customers or within asingle customer’s data. Data mining is predominantly accomplished through mathematical and statistical processes and is typically doneusing software developed for this purpose (Mason & Young, 2003). However, great care must be used in healthcare-related data miningbecause of the privacy concerns of patients and the need to safeguard access to patients’ medical information. While modern technology, including neural network software and parallel processor hardware, makes the use of such database marketingpossible, it is old-fashioned objectives that drive the interest in databases. Marketers seek to know their customers so well that they cananticipate their needs and provide them with desired products and services before the customers themselves know what they want. This isrelationship marketing, which is now at its most efficient evolutionary stage. Computer technology allows the marketer to acquire knowledgeof the purchasing habits of millions of individual customers and to weave relationships with them by anticipating their needs and informingthem of need-satisfying products specifically suited to their situation. By successfully weaving these relationships, the marketer makes itinconvenient or costly for the customer to switch to a competitor. Using the Data To some degree, the marketing plans of companies actively engaged in database marketing are driven by the desire to maximize the use oftheir databases and the technology that allows the manipulation of those databases. In other words, the ability to use the database in certainways means that those uses will become the implementation of the marketing plan (that is, the marketing plan conforms to fit the technologyavailable). This is not necessarily an inappropriate or backward approach to marketing, as long as marketers do not lose sight of this fact: Theultimate goal of any technology usage or marketing plan objective is to identify how an organization can gain a competitive advantage insatisfying customer needs and wants. Jackson and Wang (1994) have identified 15 ways to use a marketing database. These uses of a marketing database are described in depth intheir book and are listed as follows to illustrate the spectrum of possibilities for the use of databases in data-based marketing planning: Identify your best customers. Develop new customers. Deliver a message consistent with product usage. Reinforce consumer purchase decisions. Cross-sell and complementary sell products. Apply three-tiered communications. Improve delivery of sales promotion. Refine the marketing process. Increase the effectiveness of distribution channel marketing. Maintain equity. Establish a management resource. Take advantage of stealth communications. Conduct customer, product, and marketing research. Personalize customer service. Provide program synergy and integration. 10.5 Managing Real and Virtual Customer Interactions Patients develop a service script in each healthcare setting. A service script is the expected sequence of events and outcomes for thatparticular setting. When the actual experience departs from the script, the patient may be uncomfortable (Solomon, 2013). For example, adental patient may expect a visit to the dentist to include reading out-of- Assistance with Marketing Assignmentdate magazines in the waiting room, experiencing pain while a cavityis filled, and hearing the high-pitched sound of the drill. This may not be perceived as a pleasant experience, but it is, traditionally, thepatient’s expectation. A problem now faced by many HCOs is that patients gather information from social media outlets before contacting a healthcare provider(Kane, Fichman, Gallaugher, & Glaser, 2009). The information gleaned from the Internet and social media sites determines, at least in part, thepatient’s service script. A new dental patient can search the Internet or interact with friends on a site such as Facebook to find a dentist whohas a big-screen TV in the waiting room, guarantees little or no pain, and uses a quieter laser drill. This information dramatically alters thepatient’s expectations of the dental appointment. Several popular healthcare social media sites are listed in Table 10.2. Table 10.2: Healthcare social media sites Website Purpose PatientsLikeMe.com DailyStrength.org Allows patients to share real-world health experiences tohelp themselves and other patients. angieslist.com healthgrades.com RateMDs.com All of these allow patients to rate healthcare providers. CaringBridge.org Helps people who have significant health problems connectwith friends and family, making the experience easier. Sermo.com Exclusively for MDs and DOs to post observations andquestions about puzzling cases. The following subsections will discuss the use of social media by patients, the management of online community relations, gaps in expectedand delivered service, and service recovery. Social Media in Healthcare Sixty million people in the United States read or contribute to blogs, wikis, and/or social networks about healthcare (Kane et al., 2009). Often,social media is the first place patients search for information concerning specific illnesses or recommended healthcare providers. This use ofsocial media provides opportunities as well as possible pitfalls for HCOs and individual healthcare providers. The opportunities offered by social media include the ability for the HCO to communicate its mission, vision, and products or services as wellas health education. HCOs also can use social media to advertise and post patient testimonials. Finally, social media can be used to managecustomer experiences by helping to create realistic service scripts. The biggest challenge for any organization involved in social media is the ability to control the conversation ( Forbes Insights, 2013). Threatsto a firm’s reputation may be internal or external. Internally, a disgruntled employee may post information damaging to an organization, suchas protected health information about a patient. Even an act of kindness may be damaging to an organization. For example, a nurse may post arequest on Facebook for her friends and family to keep a particular hospitalized patient in their thoughts and prayers. Depending on theamount of information revealed by the post, patient confidentiality may have been breached. Assistance with Marketing Assignment Controlling the external conversation is more difficult. Online communities spontaneously appear, often with different contributors taking thelead. Further, as patients, the participants are free to discuss personal medical information without violating privacy law (Kane et al., 2009).This allows the participants to be very specific about their experiences with an HCO or a healthcare practitioner. Often, the HCO cannotrespond to such posts without violating patient confidentiality. Nonetheless, it is imperative that HCOs have personnel who constantlymonitor and respond to social media conversations—both positive and negative. Elements of a social media policy are outlined in Table10.3. Table 10.3: Social media policy ?Develop a Formal Social Media Policy · Activate network settings so only designated staff can access social media. · Define inappropriate use of social media and ramifications for policy violations. · Encourage employees to report the inappropriate use of social media by others. ?Monitor External and Internal Online Communication · Use Google Alerts, Twitter Keyword Tool, and other tools to monitor online communications. · Deputize employees to augment the team’s efforts for internal communication. Assistance with Marketing Assignment ?Engage Online Communities Create compelling social media. Use online community leaders, such as well-known bloggers and journalists, to ensure that yourmessage is understood. Communicate internally—marketing to employees unifies the organization’s message. ?Act as First Responders React quickly to negative comments, but use a team trained in public relations triage. Acknowledge legitimate criticism and mistakes. Respond forcefully to unfounded rumors. Do not engage every online community—pick and choose those with which you want to beassociated. Managing Customer Service In a recent survey, more than 300 chief marketing officers (CMOs) from a broad array of industries, including healthcare, reported thatcustomer experience was their most important priority. Customer experience was viewed as more important than new products or services,branding, or need identification. Interestingly, pricing, as a concern, came in last. To achieve an outcome of excellent customer experience,CMOs believe that marketing, strategy, finance, information technology, and social medial need to all collaborate. As the CMO of onepharmaceutical company stated, “We don’t have a silo-driven culture at all. We are highly integrated across sales, marketing, R&D, andfinance” ( Forbes Insights, 2013, p. 8). As noted earlier in this section, social media now drives the service script, or customer expectations, of the healthcare experience. Thedifference between the service expected and the customer’s perceived service quality is known as the service gap , and the management ofthis difference is known as gap analysis (Loudon, Stevens, & Wrenn, 2005). Management needs to constantly monitor customer serviceexpectations and the customer’s perceived service quality. Actual gaps in service need to be addressed by the appropriate personnel. Forexample, a stand-alone urgent care center may advertise a no-waiting policy. However, patients actually experience a 15- to 20-minute wait,and they perceive that wait to be much longer. In this case, the person in charge of the promotional message can close the service gap byadvertising “short wait times.” Frontline employees , such as admissions clerks, receptionists, and triage nurses, are also in a position to manage service gaps. Frontlineemployees, as well as other personnel who initially interact with the patient, are the first experience the patient has with the H

EDUC 6156 Walden University Cognitive Development Discussion EDUC 6156 Walden University Cognitive Development Discussion ORDER NOW FOR CUSTOMIZED AND ORIGINAL NURSING PAPERS Can you fix this prospectus so it can be approved by the committee? Prospectus Is there a relationship between students’ level of motivation to perform academically and students’ level of academic performance in a language arts classroom? Shenita Russell EdD Doctoral Study– Educational Leadership A0004900 Prospectus: Is there a relationship between students’ level of motivation to perform academically and students’ level of academic performance in a language arts classroom? Problem Statement A lack of student motivation is a concern within public school districts in the elementary, middle and high school classroom setting (Hossainy, 2012). While a lack of student motivation is not easy to define, it is easy to observe (Thoman, 2013). Recent reports from educational researchers within the US Department of Education recognize the unmotivated student as one whose attitude toward school is a lack of interest or concern (NCES, 2010). The lack of interest or concern is demonstrated in the avoidance of school work and a level of disinterest in the educational environment (Terry, 2010). The national concern for a lack of student motivation within the educational environment prompted an action plan for the development of a model of learning. In 2010, educational researchers within the US Department of Education developed an action plan known as The National Education Technology Plan 2010 (NETP). The model of learning described in the action plan necessitates the need for engaging and empowering learning experiences for all learners. The model suggests that educators focus what and how they teach to match what students need to know, how they learn, where and when they will learn, and who needs to learn. The model was designed to incorporate state-of-the art technology into the learning environment to enable, motivate, and inspire all students, regardless of background, languages, or disabilities, to achieve, thus fostering continuous and lifelong learning (NCES, 2010). The National Center for School Engagement (NCSE) partnered with school districts, law enforcements, the courts, and state and federal agencies to support youth and their families in improving student motivation and engagement within the learning environment. In an effort to improve student motivation and resolve the issues concerning low academic achievement, the purpose of the study was to examine how motivation is defined and how to measure student motivation. The study used twenty-one instruments and focused on the age ranges of the participants of the study. Through data collection analysis, researchers were able to identify a decline in student motivation at both the middle and high school level (NCSE, 2009). Even more recently, the reports from educational researchers from state’s Department of Education across the country has determined best practices in instructional delivery as one of the essential components to motivating and preparing students for college and career readiness. Results from the reports have acknowledged the significance of student motivation for aiding student academic success in these college and career readiness programs. From 2012-2014, educational researchers within state’s Department of Education worked to develop an educational plan referred to as Task Based Learning (TBL). The framework for TBL comprised of pre-task activities, a task cycle and language focus all designed to provide instruction that is engaging and motivating. EDUC 6156 Walden University Cognitive Development Discussion The framework requires a shift from student-based to task-based learning suggesting that educators create tasks that prompt students to use and apply learning to 21st century scenarios (The Bureau of Educational and Cultural Affairs, 2015). The U.S. Department of Education reported on a study conducted by researchers from the University of Western Sydney. The focus of the report was to bring awareness to the need to consider student motivation, especially as it relates to male students. The purpose of the project study performed by researchers from the University of Western Sydney was to inform educational best practices for teachers and to aid development of school curriculum designed to address the needs of male students in the elementary and middle grades. Research participants consisted of case studies from fifteen different schools. The conceptual framework of the study was developed by University of Western Sydney researchers, Dr. Andrew Martin and Dr. Geoff Munns (Munns, 2004; Munns & Martin, 2005) was the MeE Framework. The Motivation, engagement, Engagement Framework was used as part of the project analysis of student motivation and engagement. Through data collection and analysis, researchers were able to determine key psychological and sociological factors that contributed to motivation in male students. Some of the strategies identified included learning environments in which students were given whole-class tasks to complete and learning environments in which student motivation was a school-based initiative (Munns & Martin, 2005). Currently, questions concerning why students remain unmotivated in the classroom is a focus of recent educational research with the state of Georgia (McQuown, 2011). Educational research within the Georgia Department of Education suggests that a lack of student motivation may be associated with students’ intrinsic motivation to perform well in the classroom and on high stakes assessments. The reports from the educational research indicate that whether intrinsic motivation was high or low for a student, there was some bearing on student achievement being high or low for that student (Thoman, 2013). Under the premise of student motivation and accountability, the educational researchers within the Georgia Department of Education (GADOE) worked to create a rigorous college and career readiness curriculum (adapted from Common Core) along with a teacher effective measurement system (TEMS) designed to ensure that instructional delivery was engaging and motivating for all students. EDUC 6156 Walden University Cognitive Development Discussion Results from data collection of state mandated high stakes assessments centered on standards-based instructional delivery utilizing the rigorous curriculum and teacher evaluations determined student achievement is linked to student motivation and school accountability (Schraw, 2010). Data collection results also indicate the growing concern regarding a lack of student motivation in the middle grades (6th-8th) (GADOE, 2015). At the local level, the concern of a lack of student motivation focuses on the middle grades because the middles grades have proven to consist of being a pivotal academic time for students in which assessment scores in content areas such as language arts and classroom performance have a bearing on retention, classroom placement and college and career readiness indicators at the high school level (McQuown, 2011). Public school systems within the state of Georgia, such as, Atlanta Public Schools (APS), have worked to analyze instructional best practices designed to motivate and engage students in the content required for college and career readiness. Unfortunately, many educators are not aware of instructional strategies for measuring and fostering student motivation, especially within the middle school classroom (APS, 2014). Purpose The rationale for the correlational study is to determine if there is a relationship between student’s level of motivation and student’s level of academic achievement in middle grades language arts classroom. Significance The proposed research study is significant because it has the potential to contribute to existing theories on the correlation between levels of student motivation and levels of student academic success. Those who will benefit from the study are students, teachers, school administrators and school board officials. School board officials will benefit from the study by gaining an understanding into what motivates students and thus what them to make policy changes on curriculum mandates. If school officials make policy changes to curriculum design that takes student motivation into consideration, the potential exists for a lack of student motivation to decrease. Until changes in school policies such as No Child Left Behind (2001), Common Core (2009) and even more recently, Teacher Keys Effectiveness System (2012), school board officials did not focus on student performance (Gemberling, Smith, & Villani, 2009; Marzano & Waters, 2009). Student academic achievement and student performance was primarily under the guide of the state superintendent and staff. The paradigm shift in school accountability has moved toward localized control. School board officials now share in the responsibility of student learning and are held accountable for student academic performance, most commonly through the use of standardized testing (Gemberling et al, 2009; Marzano & Waters, 2009). Student performance results are often reported to state authorities to determine if changes to the curriculum and/or teacher training and evaluations are necessary. Additionally, performance results are shared with community members as a way of determining the effectiveness of school and board leadership. With changes to the curriculum design that take student motivation into consideration, teachers may be able to effectively implement strategies to motivate students to learn. EDUC 6156 Walden University Cognitive Development Discussion Teachers’ abilities to motivate students to learn has been termed teacher self-efficacy. Research studies on teacher self-efficacy have used the conceptual framework of Bandura’s (1994, 2002) notion of self-efficacy. Teacher self-efficacy has been defined as the level of competency and level of confidence a teacher has in his or her ability to promote students’ learning (Bandura, 1994). According to a research study conducted by Skaalvik & Skaalvik (2010), teachers with high self-efficacy will implement strategies to motivate students to learn such as providing opportunities for student communication by using a variety of learning strategies and tasks to meet the needs of all learners (working individually, in pairs, and in groups). Results from the study also indicate that teachers with high level of self-efficacy are more likely to divide the class into small groups rather than teaching the class as a whole, thereby allowing the opportunity for more individualized instruction (Tschannen-Moran, 2010) Additionally, students will benefit from a learning environment that fosters behaviors that contribute to motivating students resulting in academic success. According to Gardner’s motivation theory (1985) students are motivated to learn and achieve when they perceive their teachers care about them. Findings from the case study suggest the concept of teachers who care create learning environments that promote democratic interaction styles, developing expectations for student behavior in light of individual differences, modeling a “caring” attitude toward their own work, and providing constructive feedback. Researchers with Stanford University also conducted a research study of a learning environment that takes student motivation into consideration. Results from data collection of the case study of middle grades students showed students benefited learning environments that take student motivation into consideration. Students benefit because they are encouraged to understand the content. The learning environment and instructional strategies were designed to treat students’ misunderstandings in the subject and different visual aids were utilized in order to make the subject more enticing and meaningful. Additionally, within the learning environment, students were given opportunities to engage in conversations and were given purposeful feedback rather than non-descriptive scores on assignments (Stipek et. al., 2002). More recently, researchers for the National Education Association (NEA) conducted studies on 21st century learners with regards to student motivation (NEA, 2013). Research results indicate that a lack of student motivation is more prevalent in non-lab content areas such as language arts, thus, further research to gain knowledge of how to motivate students in the non-lab content areas is significant. Knowledge of factors contributing to student motivation in the classroom as it relates to academic success may prove useful in guiding decisions made pertaining to curriculum and instruction (NEA, 2013The proposed research study is significant in understanding the impact of student motivation on academic achievement and posing questions to guide further studies concerning student academic success. Certainly, there is a need to understand what motivates students to perform well in the classroom and on high stakes assessments. Understanding what motivates students, how they are motivated and ways educators can utilize motivational strategies within their instructional practice is valuable in the field of education (NEA, 2013). Background Literature Educational trends such as accountability, college and career readiness, along with motivating the 21st century learner have shaped the current focus of curriculum standards and instructional delivery (NEA, 2013). The U.S Department of Education along with state Departments of Education researchers work to develop curriculum standards with an emphasis on rigor and instructional strategies that move students toward self-efficacy. As part of the attempt to ensure that students move towards self-efficacy, educational systems at the state and local level also have a goal of ensuring that every child can learn (US DOE, 2011). While the educational system at the national level is aiming towards ensuring that students are successful, there is also a concern at the state and local level that student motivation to perform at proficiency is declining (GA DOE, 2013). EDUC 6156 Walden University Cognitive Development Discussion Research studies within state departments of education address the issues of moving toward self-efficacy, increasing rigor in the classroom and increasing student motivation. Student motivation defined The unmotivated student is one whose attitude toward school is a lack of interest or concern. The lack of interest or concern is demonstrated in the avoidance of school work and a level of disinterest in the educational environment (Terry, 2010). Recognizing the unmotivated student requires identifying the characteristics of a motivated student. The motivated student is one who is not afraid to try for fear of making mistakes. The motivated student will take risks and accept challenges versus viewing the sometimes routineness of learning tasks, this student will think outside of the box and produce work that is of quality. The motivated student is also one whose basic needs have been met thus equipping them to have a desire to learn and a willingness to complete the tasks at a level of proficiency. Conclusions from research suggest that student motivation can be defined on the basis of factors that contribute to motivation such as the students understanding that any amount of effort equates to a positive outcome on learning (McTigue, 2011). What causes a student to be self-motivated? A question often asked in the learning environment is how I can motivate this student to learn. The answer stems from the notion that the student must be self-motivated. Self-motivation means that the student enters the learning environment with a desire to be a part of the learning and willing to contribute to their own academic success. Research indicates that what motivates students to learn is a concept referred to as “voice and choice.” Another contributing factor to student motivation is engagement and learning tasks that pique the student’s curiosity. Research studies for varying grade levels concluded several key concepts that attribute to student motivation. The key concepts include student “voice and choice”, how relevant the learning is to the student’s interests, how involved the teacher is with the subject matter being taught, significance of feedback, varying instructional delivery and how often students are encouraged to complete tasks (Brophy, 2013) (Laskey, 2010). Intrinsic and extrinsic motivation Two schools of thought exist with regards to motivation. In other words, there are two types of motivated student. One type of motivated student is the one who is intrinsically motivated. The intrinsically motivated student is the one who wants to learn for the sake of learning. EDUC 6156 Walden University Cognitive Development Discussion Recognizing the intrinsically motivated student requires looking at the student who set goals for themselves, wants to be an integral part of the learning environment. The intrinsically motivated student comes prepared, seeks understanding and extends learning beyond the classroom. Conversely, the extrinsically motivated student is one who achieves for others. The extrinsically motivated student wants good grades to please parents or receive some reward or tangible gift. While the extrinsically motivated student will come to class prepared, the willingness to be a part of the learning environment is fostered by the desire to receive a reward for being in the learning environment versus contributing to the learning. One key concept states that when lessons appeal to a variety of learning styles and consist of varying modes of instructional delivery, students are engaged because they feel in control of their learning. Maurer, Allen, Gatch, Shankar, and Sturges (2013) examine intrinsic and extrinsic motivation in students. The participant group in the study consisted of undergraduates in three different courses. The data collection instrument was archival data final course grades along with results of the Academic Motivation Scale which included questions about study habits and efforts. The implications of the results of the study indicated that each factor had a significant impact on student motivation at varying degrees. McTigue and Liew (2011) examined student motivation in a language arts classroom. The hypothesis of the study was the use of research-based strategies that foster self-efficacy within the classroom could also motivate reluctant middle school readers to perform in a language arts classroom. Bembenutty (2012) interviewed Professor Allan Wigfield who serves as chair of the Department of Human Development at the University of Maryland. The interview focused on Wigfield’s research on children’s motivation. The conclusion of the interview indicated that Wigfield’s studies determined that children’s motivation was developed based on the expectancy-value model of motivation Keklik and Erdem-Keklik (2012) expressed an opposing view of intrinsic and extrinsic motivation. Their study examined motivation within the high school setting. A participant group of 318 high school volunteers completed motivational and learning strategies questionnaires. Results of the questionnaires along with demographical data analyzed through data collection instruments ANOVA and MANOVA indicated that student motivation factors were limited to grade level. EDUC 6156 Walden University Cognitive Development Discussion Additionally, Leaper and Brown (2012) examined student motivation when social and personal factors were present. A participant group of 579 ethnically diverse teenage girls were selected for the study. Participants completed a questionnaire about their academic achievement, beliefs about their academic ability in Math/Science based classes versus English (liberal arts) based classes and values and experiences concerning school. The hypothesis in the study indicated that student motivation would vary from a Math/Science based class in comparison to an English (liberal arts) based class. The implications of the results of the study indicated that social and personal factors can have a positive effect on student motivation. Learning environments that motivate Creating a learning environment that motivates requires establishing what is known as sustained motivation. Achieving sustained motivation requires a partnership between teacher and student. While the teacher cannot make a student self-motivate, an environment can be created that fosters natural self-motivation. The motivating environment would provide opportunities for students to feel a sense of autonomy, a sense of a connection to the classroom and school and a sense of being capable of to master the challenges of school. The research has determined that teacher-student relationships while establishing a motivating learning environment are a factor in student motivation to perform within the classroom and on high stakes assessments. Bintz (2011) inquired through the use of the exploratory research design method the question of whether or not the curriculum is the problem, solution or both to factors relating to student motivation. The purpose of the study was to examine whether or not “way-in” books are an effective means to supplement curriculum requirements to motivate students in the middle school language arts classroom. Little (2012) analyzed the curriculum framework compared to gifted student motivation. EDUC 6156 Walden University Cognitive Development Discussion The implications of the results of the study concludes with findings to answer the question of which strategies and learning environments best motivate students receiving advanced learning instruction. Thoman, Smith, Brown, Chase and Lee (2013) examined the correlation between student motivation and stereotyping. The study focuses on how stereotyping of underrepresented and over-stigmatized students effects their motivation in the classroom and beyond. The significance of the study expressed the connection between self-efficacy and feelings of a sense of belonging to the learning environment. Participants in the study were observed over long periods of time and it was determined that positive or negative experiences within the learning environment had a lasting effect on student motivation. McQuown (2011) examined factors that contributed to student academic success. The study participants included six fifth grade students who took part in pullout enrichment activities. Students selected for the study were ones who at the start of the experiment lacked motivation and focus. Data was collected in the form of teacher observations, student surveys, and tests. Results of the study were used to indicate whether or not being placed in an enrichment room was essential enough in increasing motivation and focus to yield student academic success. Hossainy, Zare, Hormozi, Shaghaghi and Kaveh (2012) conducted a study with a university undergraduate participant group of thirty-four randomly selected psychology majors. The purpose of the study was to test the hypothesis that situated learning would increase learning and student motivation. The data collection process consisted of archival data from school achievement tests and questionnaire. The implications of the results of the study indicated that situated learning did increase learning and motivation when compared to lecture-based learning. Inkaya, Boz, and Erdur-Baker (2012) investigated the use of case-based learning (CBL) versus traditional chemistry instruction as a means of increasing student motivation. The participant group of forty-five 10th grade high school chemistry students was randomly selected. 25 students were a part of the experimental group (case-based learning) and 20 were a part of the control group (traditional instruction). As part of the study, both groups were given pre and posttests along with classroom instruction. The data collection instrument used to determine the results was a one-way MANOVA and a motivation questionnaire. The implications of the results of the study indicated that the use of CBL students showed gains in test scores and the questionnaire indicated that those experimental group participants were more motivated to learn in the classroom. Kucuk and Sahin (2013) examined the concept of learning centers in the context of a learning community as a means of increasing student motivation. The conceptual framework examined in the study was the Community of Inquiry (CoI) Framework as both a face to face and a blended (online and face to face) learning model. The participant group consisted of 109 undergraduate students who took part in the face to face (control) or blended (experimental) learning model. As part of the data collection process, students were given pre and posttests and an analysis of the content being delivered was conducted. Based on the results of the study, data collected did not indicate a significant difference in control group versus experimental group academic success; however, there was some significant difference in student motivation. Shankar-Brown explained in a research study the impact of incorporating photo journals as part of learning tasks within all content areas. The study’s participant group consisted of randomly selected middle school students who were identified as being reluctant learners. The study results were used to indicate the implications of utilizing photo journals as a learning tool and the impact they had on students, teachers and researchers. Shumow, Schmidt, and Zaleski (2013) discussed in their research study the correlation between student motivation and academic success during lab activities versus other classroom activities. The participants in the study were high school students. Each student was observed and work for the learning task was analyzed. Results of the study showed a comparison between student engagement and motivation when completing a lab-based activity versus a lecture-based activity. The results were also used to determine the increase in student learning was more present during lab-based activities as compared to lecture-based activities. Velez and Cano (2012) described the correlation between verbal and nonverbal cues and student motivation. The purpose of the study was to examine the relationship between the importance of the task as related to students through verbal and nonverbal cues from the teacher compared to student motivation to complete the task. The significance of the study was to demonstrate to teachers that there was a positive relationship between verbal cues of the importance of the task and the increase in student motivation. The results of the study indicate the more teachers express the importance of a learning task; the more likely students were motivated to complete the task.EDUC 6156 Walden University Cognitive Development Discussion Ziegler and Moeller (2012) examined self-regulating learning. The purpose of the study was to determine if the incorporation of portfolio-based assessments would increase self-regulated learning. The participant group consisted of 168 undergraduate students in either a French or Spanish class. The research design was quasi-experimental and was conducted over one semester. Students were given pre and post questionnaires to determine whether or not the incorporation of portfolios motivated students to actively participate in the learning process. The data collection results were used to analyze student performance on the portfolio assessments versus student performance on unit tests. The implications of the study results promote the use of portfolios to aid in student self-regulated learning. According to the literary review, teacher-student relationships are also essential in providing instructional strategies that motivate students to achieve self-efficacy. The research provides insight into the use of instructional strategies. Instructional strategies are designed to provide learning experiences that include rigor to move students toward self-efficacy and performing at proficiency on high-stakes assessments. In terms of student motivation, the literature review describes studies that determine the need for instructional strategies that provide students with choice and a voice as to the learning experiences they take part in. Framework The theoretical framework for this study will be Maslow’s Motivation Theory (1954). Maslow’s theory addresses both extrinsic and intrinsic motivation based on a hierarchy of needs. Maslow’s theory is relevant in education due to the desired goal of wanting all students to learn. Based on the framework of Maslow’s theory, both extrinsic and intrinsic motivation would exist for students whose needs were being met. In a classroom setting, these needs may consist of a student feeling safe and accepted in the learning environment along with the sense that their voice will be heard, they have choices, they understand what they gain from what is being required and they sense that the teacher is also invested in their learning. The conceptual framework for this study will be the self-efficacy model (Bandura, 1977). Bandura’s theory is relevant in education based on the belief that individuals have the ability to exhibit behaviors that yield successful performance. The self-efficacy model is based on the belief in one’s own abilities to understand and complete a task aside from intrinsic or extrinsic motivation (McTigue, 2011). Both the theoretical and conceptual frameworks explanation of the need for student motivation in a middle grades classroom presents a validation that a lack of student motivation in a middle grades classroom is an educational concern. The concern stems from a rise in increasing school accountability and school improvement. Studies indicate that there is an impact that high stakes assessments has had on student achievement. Research also indicates the results of the effect of high stakes assessments on student achievement are linked to student motivation and school accountability. Research Question Research question (quantitative) Is there a relationship between students’ level of motivation and students’ level of academic success in middle grades classrooms? Null Hypothesis There is no relationship between students’ level of motivation and students’ level of academic success in middle grades classrooms. Alternative Hypothesis There is a positive correlation between students’ level of motivation and students’ level of academic success in the middle grades classrooms. Research Methodology and Design A correlational research design will be used for this study. Utilizing a quantitative research approach is beneficial for the purposes of this study. EDUC 6156 Walden University Cognitive Development Discussion Quantitative research tests and validates already existing theories about how and why a phenomenon occurs. In general, a correlational study is a quantitative method of research in which the researcher has two or more quantitative variables from the same group of subjects, and they are trying to determine if there is a relationship (or covariation) between the two variables (a similarity between them, not a difference between their means). In theory, any two quantitative variables can be correlated (for the purposes of this study, students’ level of motivation and students’ level of academic success) as long as the researcher has scores on these variables from the same participants. The researcher must take into consideration that it is not feasible to collect and analyze data when there is little reason to think these two variables would be related to each other. Another factor in increasing the validity of the research is to have at least thirty participants. In a correlational research design, the researcher’s hypothesis will be that there is a positive correlation (for the purposes of the proposed study, students’ level of motivation and students’ level of academic success), or a negative correlation (for the purposes of this study, students’ level of motivation and students’ performance on high stakes assessments). In a correlational research design, a positive correlation would be an r = +1.0 and a negative correlation would be an r= -1.0, while no correlation would be r = 0. In a correlational research design, perfect correlations would almost never occur with the exception of correlations much less than + or – 1.0. The researcher must take into consideration that correlation cannot prove

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