Assignment 1

  

Assignment 

Must be in 12 point, Times New Roman with 1” margins. Length should be approximately 3 pages double spaced (excluding Title Page, Abstract page and References page) including your summary paper of research and your QAPI worksheet. Must follow all APA format requirements.

All questions must be responded to.

Reading:

Go to the Centers for Medicare and Medicaid Services (CMS) website and read about QAPI (Quality Assurance Process Improvement)

http://www.medicare.gov/NursingHomeCompare/About/What-Is-NHC.html

and the 5 elements of QAPI. These elements can also be found on the Joint Commission for Accreditation website at http://www.jointcommission.org/assets/1/6/Crosswalk_TJC_QAPI_ncc

Assignment 1 Directions:

Use the same nursing facility you selected for Discussion Board 1 on the CMS Nursing Home Compare website (

http://www.medicare.gov/nursinghomecompare/search.html

).

For your chosen facility, select either 

A.) an inspection result health deficiency OR 

B.) a quality measure that is rated below the quality average for Kentucky or National. 

*Note: I have provided an example of both Option A and Option B at the end of this document to help you understand what I am asking you to do.

1. Provide the name and location of the facility you selected.

2. Provide detail on what quality measure you have selected.

3. Provide a weblink to the quality measure you have selected. 

4. Research: find at minimum of 2 full article references on Google Scholar that provide history or recommendations relative to the quality measure you selected. For example, you might choose residents that experienced pain as your quality measure to improve upon because your nursing home has a higher than average rating for that quality measure

You can find articles that talk about pain levels of residents, how to determine pain for non-communicating residents, alternative methods to pain reduction, etc. Summarize and cite these sources in 1-2 pages and how that information was utilized and beneficial to development of your QAPI Goal Setting Worksheet.

5. Utilizing the measure that you selected, complete a QAPI Goal Setting Worksheet for quality improvement. Your Goal Sheet should result in either no deficiencies on the next inspection process or improved quality rating percentage for the facility. 

*Your goals/action plans must be REALISTIC!!!! Do not put that you will do a daily audit every shift of with every staff member because you cannot possibly do that unless within your document you state staff that will assist you in that process. Again, think about if what you have put is REALISTIC or not.

Disclaimer: Use of this tool is not mandated by CMS for regulatory compliance nor

does its completion ensure regulatory compliance.

QAPI Goal Setting Worksheet

Directions:

Goal setting is important for any measurement related to performance improvement. This worksheet is intended to help QAPI teams establish appropriate goals for individual measures and also for performance improvement projects. Goals should be clearly stated and describe what the organization or team intends to accomplish. Use this worksheet to establish a goal by following the SMART formula outlined below. Note that setting a goal does not involve describing what steps will be taken to achieve the goal.

[Example: We will increase the number of long-term residents with a vaccination against both influenza and pneumococcal disease documented in their medical record from 61 percent to 90 percent by December 31, 2017.]

1. Describe the business problem to be solved (Use the SMART formula below to develop a goal)

A. SPECIFIC

Describe the goal in terms of 3 ‘W’ questions:

· What do we want to accomplish?

· Who will be involved/affected (what staff, what residents, others)?

· Where will it take place?

B. MEASURABLE

Describe how you will know if the goal is reached:

· What is the measure you will use?

· What is the current data figure (i.e., count, percent, rate) for that measure?

· What do you want to increase/decrease that number to?

C. ATTAINABLE

Defend the rationale for setting the goal measure above:

· Did you base the measure or figure you want to attain on a particular best practice/average score/ benchmark?

· Is the goal measure set too low that it is not challenging enough?

· Does the goal measure require a stretch without being too unreasonable?

D. RELEVANT

Briefly describe how the goal will address the business problem stated above.

E. TIME-BOUND

Define the timeline for achieving the goal:

· What is the target date for achieving this goal?

· Write a goal statement, based on the SMART elements above. The goal should be descriptive, yet concise enough that it can be easily communicated and remembered. Use the example at the beginning for a reference on statement format and information.

Goal Statement:

Tip: It’s a good idea to post the written goal somewhere visible and regularly communicate the goal during meetings in order to stay focused and remind caregivers that everyone is working toward the same aim.

Page 1 of 3

Assignment/Case Study Grading Guide:

Total available points is

*IMPORTANT NOTE:
any sources cited in assignments must be reputable websites (.org, .gov, etc) or available in full article/pdf on Google Scholar or WKU libraries. No blogs or random internet resources will be allowed and paper will be rejected.

points:
follows APA formatting to include items such as Running Header, page numbers, Title page, Abstract page, Times New Roman 12 point font, double spacing and References page with references and in text citing of sources in proper APA format.

points:
document has minimal grammar and spelling mistakes. All assignments are expected to be presented in a well presented and scholarly manner, attached Word document.

points: paper follows general guidelines and expectations. Student thoroughly and adequately addresses topics and questions in a scholarly manner, utilizing cited sources in a manner that further enhances the product submitted.

*Note: late submissions not accepted. Grade of zero (0) is given but assignment can be submitted as one allowed makeup/redo submission for this course.

Varying Definitions of Online Communication and

Their Effects on Relationship Research

Elizabeth L. Angeli

State University

Author Note

Elizabeth L. Angeli, Department of Psychology, State University.

Elizabeth Angeli is now at Department of English, Purdue University.

This research was supported in part by a grant from the Sample Grant

Program.

Correspondence concerning this article should be addressed to Elizabeth

Angeli, Department of English, Purdue University, West Lafayette, IN 55555.

Contact: author@boiler.edu

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Running head: VARYING DEFINITIONS OF ONLINE COMMUNICATION 1

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VARYING DEFINITIONS OF ONLINE COMMUNICATION

2

Abstract

This paper explores four published articles that report on results from research conducted

on online (Internet) and offline (non-Internet) relationships and their relationship to

computer-mediated communication (CMC). The articles, however, vary in their

definitions and uses of CMC. Butler and Kraut (2002) suggest that face-to-face (FtF)

interactions are more effective than CMC, defined and used as “email,” in creating

feelings of closeness or intimacy. Other articles define CMC differently and, therefore,

offer different results. This paper examines Cummings, Butler, and Kraut’s (2002)

research in relation to three other research articles to suggest that all forms of CMC

should be studied in order to fully understand how CMC influences online and offline

relationships.

Keywords: computer-mediated communication, face-to-face communication

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VARYING DEFINITIONS OF ONLINE COMMUNICATION

3

Varying Definitions of Online Communication and

Their Effects on Relationship Research

Numerous studies have been conducted on various facets of Internet relationships,

focusing on the levels of intimacy, closeness, different communication modalities, and

the frequency of use of computer-mediated communication (CMC). However,

contradictory results are suggested within this research because only certain aspects of

CMC are investigated, for example, email only. Cummings, Butler, and Kraut (2002)

suggest that face-to-face (FtF) interactions are more effective than CMC (read: email) in

creating feelings of closeness or intimacy, while other studies suggest the opposite. To

understand how both online (Internet) and offline (non-Internet) relationships are affected

by CMC, all forms of CMC should be studied. This paper examines Cummings et al.’s

research against other CMC research to propose that additional research be conducted to

better understand how online communication affects relationships.

Literature Review

In Cummings et al.’s (2002) summary article reviewing three empirical studies on

online social relationships, it was found that CMC, especially email, was less effective

than FtF contact in creating and maintaining close social relationships. Two of the three

reviewed studies focusing on communication in non-Internet and Internet relationships

mediated by FtF, phone, or email modalities found that the frequency of each modality’s

use was significantly linked to the strength of the particular relationship (Cummings et

al., 2002). The strength of the relationship was predicted best by FtF and phone

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VARYING DEFINITIONS OF ONLINE COMMUNICATION

4

communication, as participants rated email as an inferior means of maintaining personal

relationships as compared to FtF and phone contacts (Cummings et al., 2002).

Cummings et al. (2002) reviewed an additional study conducted in 1999 by the

HomeNet project (see Appendix A for more information on the HomeNet project). In

this project, Kraut, Mukhopadhyay, Szczypula, Kiesler, and Scherlis (1999) compared

the value of using CMC and non-CMC to maintain relationships with partners. They

found that participants corresponded less frequently with their Internet partner (5.2 times

per month) than with their non-Internet partner (7.2 times per month) (as cited in

Cummings et al., 2002). This difference does not seem significant, as it is only two times

less per month. However, in additional self-report surveys, participants responded

feeling more distant, or less intimate, towards their Internet partner than their non-

Internet partner. This finding may be attributed to participants’ beliefs that email is an

inferior mode of personal relationship communication.

Intimacy is necessary in the creation and maintenance of relationships, as it is

defined as the sharing of a person’s innermost being with another person, i.e., self-

disclosure (Hu, Wood, Smith, & Westbrook, 2004). Relationships are facilitated by the

reciprocal self-disclosing between partners, regardless of non-CMC or CMC. Cummings

et al.’s (2002) reviewed results contradict other studies that research the connection

between intimacy and relationships through CMC.

Hu et al. (2004) studied the relationship between the frequency of Instant

Messenger (IM) use and the degree of perceived intimacy among friends. The use of IM

instead of email as a CMC modality was studied because IM supports a non-professional

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VARYING DEFINITIONS OF ONLINE COMMUNICATION

5

environment favoring intimate exchanges (Hu et al., 2004). Their results suggest that a

positive relationship exists between the frequency of IM use and intimacy, demonstrating

that participants feel closer to their Internet partner as time progresses through this CMC

modality.

Similarly, Underwood and Findlay (2004) studied the effect of Internet

relationships on primary, specifically non-Internet relationships and the perceived

intimacy of both. In this study, self-disclosure, or intimacy, was measured in terms of

shared secrets through the discussion of personal problems. Participants reported a

significantly higher level of self-disclosure in their Internet relationship as compared to

their primary relationship. In contrast, the participants’ primary relationships were

reported as highly self-disclosed in the past, but the current level of disclosure was

perceived to be lower (Underwood & Findlay, 2004). This result suggests participants

turned to the Internet in order to fulfill the need for intimacy in their lives.

In further support of this finding, Tidwell and Walther (2002) hypothesized CMC

participants employ deeper self-disclosures than FtF participants in order to overcome the

limitations of CMC, e.g., the reliance on nonverbal cues. It was found that CMC partners

engaged in more frequent intimate questions and disclosures than FtF partners in order to

overcome the barriers of CMC. In their 2002 study, Tidwell and Walther measured the

perception of a relationship’s intimacy by the partner of each participant in both the CMC

and FtF conditions. The researchers found that the participants’ partners stated their

CMC partner was more effective in employing more intimate exchanges than their FtF

VARYING DEFINITIONS OF ONLINE COMMUNICATION

6

partner, and both participants and their partners rated their CMC relationship as more

intimate than their FtF relationship.

Discussion

In 2002, Cummings et al. stated that the evidence from their research conflicted

with other data examining the effectiveness of online social relationships. This statement

is supported by the aforementioned discussion of other research. There may be a few

possible theoretical explanations for these discrepancies.

Limitations of These Studies

The discrepancies identified may result from a number of limitations found in the

materials reviewed by Cummings et al. These limitations can result from technological

constraints, demographic factors, or issues of modality. Each of these limitations will be

examined in further detail below.

Technological limitations. First, one reviewed study by Cummings et al. (2002)

examined only email correspondence for their CMC modality. Therefore, the study is

limited to only one mode of communication among other alternatives, e.g., IM as studied

by Hu et al. (2004). Because of its many personalized features, IM provides more

personal CMC. For example, it is in real time without delay, voice-chat and video

features are available for many IM programs, and text boxes can be personalized with the

user’s picture, favorite colors and text, and a wide variety of emoticons, e.g., :). These

options allow for both an increase in self-expression and the ability to overcompensate

for the barriers of CMC through customizable features, as stated in Tidwell and Walther

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under
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VARYING DEFINITIONS OF ONLINE COMMUNICATION

7

(2002). Self-disclosure and intimacy may result from IM’s individualized features,

which are not as personalized in email correspondence.

Demographic limitations. In addition to the limitations of email, Cummings et

al. (2002) reviewed studies that focused on international bank employees and college

students (see Appendix B for demographic information). It is possible the participants’

CMC through email was used primarily for business, professional, and school matters

and not for relationship creation or maintenance. In this case, personal self-disclosure

and intimacy levels are expected to be lower for non-relationship interactions, as this

communication is primarily between boss and employee or student and professor.

Intimacy is not required, or even desired, for these professional relationships.

Modality limitations. Instead of professional correspondence, however,

Cummings et al.’s (2002) review of the HomeNet project focused on already established

relationships and CMC’s effect on relationship maintenance. The HomeNet researchers’

sole dependence on email communication as CMC may have contributed to the lower

levels of intimacy and closeness among Internet relationships as compared to non-

Internet relationships (as cited in Cummings et al., 2002). The barriers of non-personal

communication in email could be a factor in this project, and this could lead to less

intimacy among these Internet partners. If alternate modalities of CMC were studied in

both already established and professional relationships, perhaps these results would have

resembled those of the previously mentioned research.

VARYING DEFINITIONS OF ONLINE COMMUNICATION

8

Conclusions and Future Study

In order to gain a complete understanding of CMC’s true effect on both online

and offline relationships, it is necessary to conduct a study that examines all aspects of

CMC. This includes, but is not limited to, email, IM, voice-chat, video-chat, online

journals and diaries, online social groups with message boards, and chat rooms. The

effects on relationships of each modality may be different, and this is demonstrated by

the discrepancies in intimacy between email and IM correspondence. As each mode of

communication becomes more prevalent in individuals’ lives, it is important to examine

the impact of all modes of CMC on online and offline relationship formation,

maintenance, and even termination.

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VARYING DEFINITIONS OF ONLINE COMMUNICATION

9

References

Cummings, J. N., Butler, B., & Kraut, R. (2002). The quality of online social

relationships. Communications of the ACM, 45(7), 103-108.

Hu, Y., Wood, J. F., Smith, V., & Westbrook, N. (2004). Friendships through IM:

Examining the relationship between instant messaging and intimacy. Journal of

Computer-Mediated Communication, 10, 38-48.

Tidwell, L. C., & Walther, J. B. (2002). Computer-mediated communication effects on

disclosure, impressions, and interpersonal evaluations: Getting to know one

another a bit at a time. Human Communication Research, 28, 317-348.

Underwood, H., & Findlay, B. (2004). Internet relationships and their impact on primary

relationships. Behaviour Change, 21(2), 127-140.

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VARYING DEFINITIONS OF ONLINE COMMUNICATION

10

Appendix A

The HomeNet Project

Started at Carnegie Mellon University in 1995, the HomeNet research project has

involved a number of studies intended to look at home Internet usage. Researchers began

this project because the Internet was originally designed as a tool for scientific and

corporate use. Home usage of the Internet was an unexpected phenomenon worthy of

extended study.

Each of HomeNet’s studies has explored a different facet of home Internet usage,

such as chatting, playing games, or reading the news. Within the past few years, the

explosion of social networking has also proven to be an area deserving of additional

research. Refer to Table A1 for a more detailed description of HomeNet studies.

Table A1

Description of HomeNet Studies by Year
Year
 of
 Study
  Contents
 of
 Study
 
1995-­‐1996
  93 families in Pittsburgh involved in school

or community organizations
1997-­‐1999
  25 families with home businesses
1998-­‐1999
  151 Pittsburgh households
2000-­‐2002
  National survey

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VARYING DEFINITIONS OF ONLINE COMMUNICATION

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Appendix B
Demographic Information for Cummings et al. (2002)’s Review

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