Adopting Innovative Approaches to Care: Facilitators & Barriers of School Nursing Practice in an Urban School District
AdvisorJordan, Will J.
Committee memberCucchiara, Maia Bloomfield
Hindman, Annemarie H.
Ruggieri, Dominique G.
School Nursing Practice
Permanent link to this recordhttp://hdl.handle.net/20.500.12613/2740
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AbstractAs new approaches to practice become available for school nurses, urban school districts must address the need to provide facilitators for the dissemination and adoption of new evidenced based practice models. With instructional capacity, curriculum challenges, and school climate at the center of the decision making of educational leaders, the needs of school health become neglected. As new innovations become available, school nurses working in urban school districts often rely on individual continuing education to access new ideas due to barriers that exist in urban schools with limited funding and resources. This dissertation research had two primary aims: (1) expand current research regarding specific barriers and facilitators to practice, and (2) to better understand the school nurses’ adoption of the Framework for the 21st Century School Practicing Nurse in an urban school district. This framework addresses the specific needs of the school nurse working in an evolving educational health setting. Using a descriptive and inferential quantitative design with a convenience sample of school nurses in the School District of Philadelphia (SDP), participants completed an online survey designed to examine awareness, agreement, and alignment with the framework, as well as barriers and facilitators of adoption. The results revealed differences in level of awareness of the framework across various demographic groups within the SDP. After presenting the framework to participants, school nurses agreed with the importance of fully aligning practice. Further, there were variations in level of importance regarding specific practice components of the framework. Participants identified facilitators and barriers that impacted their ability to fully align school nursing practice with the framework.
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The effects of school uniforms on school climate in elementary schoolIkpa, Vivian W.; Davis, James Earl, 1960-; DuCette, Joseph P.; Sanford-DeShields, Jayminn (Temple University. Libraries, 2009)This research sought to explore the link between mandatory school uniforms and a positive school climate. Beginning in the late 1980's public schools implemented mandatory school uniforms policies in urban school districts. The trend gained momentum when President Clinton included school uniforms in his 1996 State of the Union Address. Directly following the speech was a publication by the United States Department of Education on school uniforms that was distributed to all school districts in the country. Often the primary reason for implementing school uniforms was gang violence. Other reason included increased school safety and decreases in violence. Further, proponents believed uniforms would increase academic achievement and improve school climate. Research on the effects of school uniforms is limited and conflicting. Most studies available to date were conducted in urban settings. However, school uniforms have infiltrated rural and suburban schools districts as well. Two school districts in suburban Eastern Pennsylvania participated in this study. One school district had a mandatory school uniform policy. The other did not. Using a school climate survey and school uniform questionnaire, students in grades 4-6 and elementary school teachers rated the school climate in their respective schools. School climate was rated on seven subscales on the student school climate survey and 10 subscales on the faculty school climate survey. A t-test was performed on the data set to determine the difference between sample means and a factor analysis was conducted on the student school climate survey. Further, three themes emerged from the short answer questions on the student uniform questionnaire. The results of the research found that there was not a statistically significant relationship between a mandatory school uniform policy and elementary school students' perceptions of school climate. Of the seven subscales, students who wore school uniforms rated their peer relationships higher than students without school uniforms. Additionally, they rated the required rigor higher. Students that did not wear school uniforms rated the teacher-student relationship higher. When responding to the open ended questions, three themes emerged. They were expression, atmosphere and family. In essence, students were not in favor of wearing uniforms and believed uniforms suppressed their freedom of expression. Teachers responded similarly. The results showed no statistically significant relationship between a mandatory school uniform policy and teacher perceptions of school climate. Only two subscales showed any significant difference between the two groups of teachers. They were teacher-administrator relationship and student achievement. In both respects, teachers in the district without uniforms responded more positively. The results of this study should be used when reviewing current policy or considering new policy on school uniforms.
SCHOOL PERSONNEL ESTABLISHING FUNCTIONAL COMMUNICATION TRAINING BASED ON A FUNCTIONAL ANALYSIS WITH AUTISTIC STUDENTS IN A PUBLIC SCHOOL SETTING TO REDUCE PROBLEM BEHAVIORSAxelrod, Saul; Fiorello, Catherine A.; Rosenfeld, Joseph G.; Connell, James; Farley, Frank (Temple University. Libraries, 2008)Autism is subset of the special education population that seems to be growing at an alarming rate. According to the American Psychiatric Association (2000), one of the three main deficits found in someone diagnosed with autism is a "qualitative impairment in communication". However, language skills are very difficult for autistic children to learn and are often associated with disruptive behaviors. Research has shown a strong correlation between problem behaviors and difficulties with communication. This study uses techniques (i.e. functional analysis and functional assessment) to determine the function of these problem behaviors and their communicative intent. This study also demonstrates that an experimental approach such as a functional analysis can be done in a public school setting by public school personnel. Once the function is determined, treatments incorporating Functional Communication Training (FCT) can be applied to reduce these problem behaviors while increasing communication. Research has shown that FCT that replaces each function of a problem behavior will reduce problem behaviors in autistic children. Therefore, functional analysis results allow for the reduction of problem behaviors while identifying optimal situations/settings to teach language. Three male autistic students, attending a public school, were involved in the study. All subjects exhibited one or more problem behaviors that interfered with their everyday functioning at school. Initially, functional assessment data were collected via a descriptive analysis using Antecedent-Behavior-Consequence (A-B-C) data. The A-B-C data were taken throughout each subject's school day in various environments. The data for each subject were graphed and analyzed by a school psychologist. Based on the results, the school psychologist developed a hypothesis for each subject regarding the function of his problem behavior. Subjects were exposed to various functional analysis conditions using a single subject multielement manipulation design based on the A-B-C data. These functional analysis sessions were conducted in each student's current public school placement. Functional analysis conditions were implemented until stable levels of problem behaviors were obtained or a clear pattern provided evidence as to the function of the problem behavior. Data from all sessions were graphed in a multiple baseline across subjects and visually assessed. Based on the data from the functional analysis, the function of the student's problem behavior was hypothesized. The experimenter, who was also a school psychologist, designed and implemented a function based treatment package to successfully reduce each student's problem behaviors. The treatment for each subject was individually designed based on that subject's functional analysis. Each treatment also incorporated a FCT component. As a result, problem behaviors were successfully reduced for each subject using functional assessment methodology by a school psychologist in a public school setting.
School Choice and Segregation: How Race Influences Choices and the Consequences for Neighborhood Public SchoolsGoyette, Kimberly A.; Elesh, David; Saporito, Salvatore; Horvat, Erin McNamara, 1964- (Temple University. Libraries, 2008)This dissertation examines the relationship between school choice and race. I examine whether the racial composition of schools influences choices and whether choices of private and public choice schools lead to greater segregation and stratification in neighborhood schools. I improve on existing research by adopting the theoretical framework used in neighborhood preferences literature to distinguish between race and race-associated reasons as motivations for avoiding racially integrating schools. This study utilizes geocoded data from the Philadelphia Area Study (PAS) and elementary school catchment maps to examine families' preferences and behaviors in the context of the actual conditions of their assigned schools. Catchment maps are integrated with Census data to determine whether choice schools have a role in white flight and segregation and stratification in neighborhood schools. The findings suggest that families are most likely to avoid neighborhood schools with high proportions of racial minorities. However, attitudes regarding racial climates are more consistent predictors of preferences than the actual racial composition of local schools. Highly segregated neighborhood schools satisfy families who desire racially homogeneous school climates, as do private schools. Families who seek diverse environments are more likely to look to charter and magnet schools. The white flight analysis shows that whites are more likely to leave schools that have modest proportions of black students, and less likely to leave schools that are already integrated. These results suggest that whites react especially strongly to schools with low levels of integration, and those who remain in the few racially balanced schools do so out of a preference for diversity or because they do not have the resources to leave. Public choice schools spur white flight in urban areas, but actually reduce flight in suburban schools. Finally, I find that choice schools do not uniformly affect the degree to which racial groups are spatially segregated from whites, and they also do not uniformly affect the degree to which racial groups attend more or less disadvantaged schools than whites. This suggests that segregation and stratification are two distinct aspects of racial inequality and should be considered separately when evaluating the effectiveness of choice programs.