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Increasing Resiliency In Front-Line Nurse Managers, Adrianne N. Bunyard-Fallquist

Master's Projects and Capstones

Problem

According to Membrive-Jimenez et al. (2020), 29% of nursing managers experience emotional exhaustion due to work overload, conflict mediation, and a lack of support from senior leadership. In a central California hospital, front-line nurse managers struggle to meet organizational goals and support their teams, with 64% indicating dissatisfaction in their roles in fall 2023. This highlights the need to improve job satisfaction and retention.

Context

A large healthcare system in Northern California has implemented Caring Science (Foss et al., 2015) and HeartMath® (HeartMath, 2023) techniques in a rural hospital to improve nurse manager retention and job satisfaction. The project …

Going, Going, Gone: The Influence Of Job And Home Demands And Resources On Emergency Department Nurse Turnover, Jordan Gail Smith

All Dissertations

Nurse turnover, which challenged healthcare organizations even before the pandemic, reached alarming rates across hospitals worldwide during COVID-19. Due to the unprecedented and stressful nature of the pandemic, recent investigations have focused primarily on exploring job demands and nurse turnover intentions. While job demands are critical to understanding turnover, this narrow scope ignores the possible influence of other factors such as job resources and demands and resources external to the work domain. This study utilized archival qualitative data from a longitudinal survey of Emergency Department clinicians to analyze research questions and hypotheses. The first aim of this study was to …

A Leadership Training Program Improves Nurse Manager Retention, Lisa A. Longley

Doctoral Dissertations and Projects

The need to retain nursing managers is at an all-time high. The turnover rate for a local xxxxxxxxxx (removed to protect privacy) healthcare system is 14% post pandemic compared to 8% pre-pandemic. The nursing management team reported a need for nursing specific management orientation because the current training included all organizational supervisors and covered general concepts, failing to meet the complex needs of frontline nursing managers. Literature confirms that organizations that provide nursing management training develop role competency have higher satisfaction and lower turnover rates. An organizational-specific needs assessment designed within the American Organization of Nursing Leadership competency framework was …

Pre-Shift Mindfulness: An Evidence Based Practice Benchmark Project, Whitney Turner

MSN Capstone Projects

Although a nursing shortage has existed for some time, it seems there is currently a flight of both experienced and young clinicians from the bedside. Over the course of the Covid-19 pandemic, healthcare organizations have seen dramatic increases in turnover and vacancy rates, leading to severe staffing shortages and compromised patient care. Historically, nursing has been a caring, service driven profession, and a calling for millions of professionals. However, nurses are increasingly concerned with their personal wellbeing.

The term “burnout” appeared in the 1970s to describe the consequences of severe stress in “caring” professions, and include symptoms such as exhaustion, …

The Impact Of Shared Governance On Work Engagement And Job Satisfaction, Mikayla Adkins

MSN Capstone Projects

In 2023, the National Council of State Boards of Nursing revealed that 100,000 nurses left the workforce during the COVID-19 pandemic and another 900,000 plan to leave by 2027 due to stress, burnout, and retirement. Identifying and implementing practical strategies to reduce voluntary turnover as a result of stress and burnout is a top priority for nursing leaders across the country. Work engagement and job satisfaction have well been documented in the literature as antidotes to occupational stress and burnout in the nursing profession (Schaufeli & Bakker, 2004; Pressley & Garside, 2022). Evidence suggests that implementing shared governance is a …

Organizational Methods Of Reducing Burnout: The Impact Of Self-Rostering On Work-Life-Integration, Cory Authement

MSN Capstone Projects

With burnout being at an all-time high, organizations must find new ways to prioritize staff wellbeing and promote work-life balance. According to the Emergency Nurses Association (ENA) turnover in emergency departments ranges from 15-30% within the first year of nursing, and 43% within the first three years (Roncallo et al., 2020). These turnover rates cost a 300-bed facility approximately four million dollars in annual expenditure (Hesse, 2016). This level of loss and expenditure is unsustainable for the future of nursing and diverts resources away from our patients.

In recent studies, it was shown that burnout leads to difficulties for nurses …

Implementation Of A Nursing Peer Mentorship Program To Improve Nursing Retention And Job Satisfaction In An Acute Care Hospital: A Quality Improvement Project, Rebecca Cassel

Doctor of Nursing Practice (DNP) Manuscripts

Background and Significance: Currently staffing shortages are impacting patients and communities nationwide. This problem has been on the rise since the before the pandemic. COVID-19 has certainly increased the rate of nursing turnover, and vacancy, especially in acute care (Krofft & Stewart, 2021). Many factors contribute to nursing turnover, including nursing satisfaction, interprofessional relationships, and organizational support, and it is apparent that swift and effective action is needed, to ensure that safe, skilled nursing professionals are available to provide the necessary treatment that those seeking healthcare need. Nursing Mentorship programs have been shown to improve retention of nursing staff, …

Managing Burnout In Nursing, Karen Starnes Bell

Doctoral Dissertations and Projects

Burnout is a widespread phenomenon characterized by a reduction in energy that manifests in exhaustion, lack of inspiration, and feelings of frustration which may lead to reduced work efficacy and multiple absences. In the nursing profession, long hours, the pressure of quick decision-making, and the stress of caring for patients who may have poor outcomes may contribute to burnout. This integrative review was conducted to identify variables that contribute to nurse burnout and discover strategies organizations can implement to reduce or prevent nurse burnout.

Improving New Nurse Manager Orientation And Onboarding Program, Leanne E. Deegenaars

Doctor of Nursing Practice (DNP) Projects

ABSTRACT

Purpose: Identify and adapt the best evidence for nurse manager orientation and onboarding programs into practice. Assess the program's impact on job satisfaction and retention of new Nurse Managers (NMs) and Assistant Nurse Managers (ANMs).

Background: Constant turnover of ANMs and NMs within local and regional facilities is expensive and negatively impacts nursing leaders' work environment, job satisfaction, and patient outcomes.

Local Problem: The lack of formal orientation and onboarding at the focus facility impacts the retention and job satisfaction of NMs. The sunsetting of a regional hub model of new NM orientation and onboarding led to a just-in-time …

Effects Of Leadership Education And Mentoring For Assistant Nurse Managers, Karen T. Descent

Doctor of Nursing Practice (DNP) Projects

Background: Nurse manager knowledge and leadership styles influence quality of care, patient satisfaction, staff engagement, and retention. Dissatisfaction with the assistant nurse manager (ANM) role can lead to high job turnover with negative influences on patient satisfaction, quality of care, workforce engagement, and achievement of organizational goals.

Local Problem: Two hospitals and one free-standing ambulatory surgery unit of a large integrated healthcare organization experienced high ANM turnover due to role dissatisfaction, ANM frustration with low-quality care in the units they oversaw, and patient satisfaction metrics below the 65th percentile. The regional healthcare system leadership team recognized the need to increase …

Dnp Final Report: Conquering Rn Turnover: Implementing Flexible Scheduling To Improve Job Satisfaction, Camille Y. Parsee

DNP Final Reports

Nurse turnover is a complex problem for the nursing profession, especially in the behavioral health setting, where turnover rates are higher than the overall RN national average. The consequences of high nurse turnover include increased health costs, low-quality patient care, and staffing constraints. The association between nurse turnover and job satisfaction is profound because of their reciprocal relationship; therefore, implementing an intervention to help mitigate nurse dissatisfaction is essential to overcoming nurse turnover. Flexible scheduling is an intervention that gives nurses independence with their schedule which improves work-life balance and promotes nurse retention (Wright, 2017). The following PICOT question was …

Managing Nurse Leader Stress To Promote Leader Retention, Rebecca Sue Hawkins

Walden Dissertations and Doctoral Studies

Nurse leaders are a health care group that has been provided limited support to managestress and burnout symptoms, yet the impact of leader stress burden on staff satisfaction, patient outcomes, and their own health is vital to the provision of safe, high-quality health care. The problem of leader fatigue and burnout is the ability to retain current leaders and recruit the next generation. The purpose of this staff education project was to address leadership burnout due to stress and the lack of knowledge of how to manage stress in the moment. A combination of Watson’s theory of caring and Ray’s …

Managing Nurse Leader Stress To Promote Leader Retention, Rebecca Sue Hawkins

Walden Dissertations and Doctoral Studies

Nurse leaders are a health care group that has been provided limited support to managestress and burnout symptoms, yet the impact of leader stress burden on staff satisfaction, patient outcomes, and their own health is vital to the provision of safe, high-quality health care. The problem of leader fatigue and burnout is the ability to retain current leaders and recruit the next generation. The purpose of this staff education project was to address leadership burnout due to stress and the lack of knowledge of how to manage stress in the moment. A combination of Watson’s theory of caring and Ray’s …

Retention Of New Nurses In The Cardiovascular Operating Room, Hannah Shufeldt

Doctor of Nursing Practice Projects

Background

In January of 2020, a hospital in Springfield, Illinois started the year with seven full-time circulating nurses in the cardiovascular operating room (CVOR). Three of those nurses left before the end of the year and an additional four nurses were hired. In January of 2021, the CVOR began the year with eight nurses. Five of these nurses left by the end of the year and seven more were hired, one of which left before the end of 2021. This department has struggled to retain nurses, with a turnover rate of 42.9% in 2020 and 62.5% in 2021.

Purpose

The …

Effects Of Resilience Coaching On Behavioral Health Nurse Burnout, Dalila Franklin

Dissertations

Abstract

Background: Inpatient, staff nurse burnout negatively impacts nurses’ mental and physical health, hospital nurse retention and turnover, and patient care. The Stress First Aid for Health Workers program attempts to bolster resilience and subsequently reduce burnout among mental health nurses in this project.

Method: This quality improvement (QI) project was an observational pre-post survey design and was conducted on a cohort sample of inpatient, behavioral health nurses at an urban, mid-sized, Midwestern hospital psychiatric unit to assess personal, work-related, client-related, and overall burnout utilizing the Copenhagen Burnout Inventory (CBI) tool to quantitatively measure burnout pre- and three months post-implementation …

Evaluation Of Nurse Burnout And Currently Used Prevention And Treatment Interventions, Karina Burton

Doctor of Nursing Practice Scholarly Project

The purpose of this scholarly project was to determine the feelings of nurse burnout and intervention techniques utilized and available to registered nurses at a regional medical center in the Midwest on a Cardiac-Telemetry unit. A survey was provided to 61 registered nurses to evaluate the feelings of nurse burnout and evaluate intervention resources available to gain a better understanding of the feelings of burnout on a Cardiac-Telemetry unit.

Implementing And Evaluating A Mentorship Program For New Graduate Nurses In A Medical-Surgical Unit: A Quality Improvement Pilot, Nicholas Dull, Jennifer Jakobe, Carol Reichel, Sonja Meiers

Nursing DNP Projects

The purpose of this quality improvement project was to pilot and test the acceptability of implementing an eight-week voluntary evidence-based mentorship program for new graduate nurses within a medical-surgical unit. This project was guided by the Iowa Model of Evidence-Based Practice and an adaptation of the Academy of Medical Surgical Nurses Mentoring Program. Nurse leaders may want to consider creative ways to incentivize mentees and involve them in tailoring mentoring programs during the final phases of the orientation program.

Nurse Job Satisfaction In The Midst Of A Pandemic, Reynaldo Gonzales

Doctor of Nursing Practice Scholarly Projects

Strategies and intervention for nursing recruitment and retention are critical needs at the hospital unit management level especially during this time of coronavirus disease of 2019 (COVID-19) pandemic.

Research Question: What are the unit-levels of nurse job satisfaction among eight satisfaction dimensions (i.e., satisfaction with extrinsic rewards, scheduling, family/work balance, co-workers, interaction, professional opportunities, praise/recognition, and control/responsibility) in an acute medical-surgical unit?

Objectives The objective of this project is to systematically obtain unit-level input to explore nurses’ views and experiences as it relates to job satisfaction.

Methodology: This is a descriptive cross-sectional convenience study measuring job satisfaction among Registered Nurses …

Retention Strategies For The Current Nursing Workforce, Jennifer Higgins

Walden Dissertations and Doctoral Studies

Retaining a robust nursing workforce is essential to care delivery. As the generation gap in the nursing field widens, retention strategies that align with the current nursing workforce must be considered. Rapid turnover is a looming concern as baby boomers retire and millennials become the leading generation in the nursing workforce. Nurse leaders must identify and deploy strategies that will provide a meaningful work environment to retain nurses in this majority group. The purpose of this project was to address the gap in practice of rising turnover, low nurse engagement, and reliance on premium labor to deliver care. The sources …

Nurse Manager’S Leadership And Communication Skills And A Registered Nurse’S Organizational Citizenship Behavior, Satisfaction, And Intent To Leave, Emmitte J. Hall

Walden Dissertations and Doctoral Studies

The Veteran’s Health Administration (VHA) is the largest employer of registered nurses in the United States. The American Association of Colleges of Nursing predicts there will be a nursing shortage through the year 2030 and replacing and training each nurse is expensive and negatively impacts patient care. A review of the literature showed organizations with high levels of organizational citizenship behavior (OCB) had high levels of job satisfaction, which reduces turnover, but there was no research on the existence and impact of OCB in a federal health care facility, specifically the VHA. The purpose of this quantitative, correlational research was …

The Impact Of A Structured Civility Educational Module And Cognitive Rehearsal Training (Crt) On Job Satisfaction And Turnover In Rural Healthcare Employees: A Quality Improvement Pilot Project, Laurel Matthews

Doctor of Nursing Practice (DNP) Manuscripts

Incivility is a top-cited stressor resulting in decreased job satisfaction and turnover. Uncivil behaviors jeopardize patient safety through poor communication and team ineffectiveness. This project aimed to determine if a structured civility educational module with CRT positively impacted job satisfaction and turnover of healthcare employees.

A pretest using the Workplace Civility Index (WCI) and investigator generated questions determined current civility behaviors, notable civility issues, and attitudes surrounding job satisfaction and turnover. The interactive, virtual modules highlighted dilemmas regarding incivility and their consequences to patient care. During CRT, the participants responded to filmed, uncivil conflicts using provided frameworks to curate civil …

Administrative Interventions To Increase New Graduate Nurse Retention, Adam Ruff

MSN Capstone Projects

Topic: Administrative Interventions to Increase New Graduate Nurse Retention

PICOT Question: In acute care units (P), how do employee engagement interventions from nursing administration (I) compared to no employee engagement interventions (C) affect new nurse turnover (O) within 3 months of hire (T)?

Rationale: New nurse retention and turnover is arguably the most significant factor affecting health administrators on a regular basis. This issue becomes even more pertinent as it is estimated that up to 40% of the nursing workforce is expected to retire within the next decade with new nurses becoming the best option to replace them. Administrative nursing …

Mentoring Program For New Graduate Nurses, Kathryn Palermo

Student Scholarly Projects

Practice Problem: The high turnover rate among newly licensed nurses has a negative impact on organizational costs, healthcare spending and patient outcomes. The turnover rate among newly licensed nurses, within their first year of practice, at the designated facility was 50%.

PICOT: The PICOT question that guided this project was “In new graduate nurses, how does a formal mentorship program, compared to no formal mentorship, affect the intent to leave within six weeks?”

Evidence: The scientific evidence supported both one-on-one and group mentoring. Retention and/or turnover was shown to be a positive outcome of formal mentor programs.

Intervention: The …

Gap Analysis, Development, And Evaluation Of An Advanced Practice Clinician Mentorship Program, Boyon Yun

Doctor of Nursing Practice Projects

Purpose: The purpose of this five-step quality improvement project is to identify and address gaps between the current and desired state of an advanced practice clinician (APC) onboarding process. Specific aims: (1) determine organization-specific needs of APCs, (2) develop a mentorship program for newly hired APCs, and (3) conduct a program evaluation (process and outcomes).

Background: Although the APC workforce is rapidly growing, health care organizations struggle with high APC turnover. Effective mentorship has been shown to help APCs, who are either new to practice or new to an organization (Pop, 2017).

Design: A needs assessment survey was distributed to …

Mentor Programs As A Strategic Approach To Nurse Retention: Integrative Review, Nancy Jo Thompson

Doctoral Dissertations and Projects

The purpose of this integrative review is to identify commonalties of mentor program success demonstrated by registered nurse retention to support DNP leaders seeking to address the nursing shortage by retaining newly licensed and experienced registered nurses. Mentor programs offer nurse leaders a low-cost solution with a high return on investment to address nurse retention. The United States is facing a tremendous nursing shortage compounded by multiple factors, including an unprecedented global pandemic. An aging population is leaving the profession while the new generation of nurses struggle to find their niche. Registered nurses make up the largest sector of health …

Nursing Home Nurse Turnover And The Association To Workload, Absenteeism, And Number Of Beds, Justin Ryan Gracieux

Walden Dissertations and Doctoral Studies

The aging population in the United States has resulted in an increased need for quality nursing home care, which includes a stable nursing staff and reduced workforce instability. The purpose of this quantitative correlational study was to examine the relationship between direct care nursing staff turnover rates for RNs, licensed vocational nurses (LVNs), and certified nursing assistants (CNAs) concerning workload, absenteeism, and number of beds in Texas nursing homes. The relational coordination theory provided the theoretical framework for understanding the underlying issues and communication needs that may relate to staff turnover. Secondary data from 11,336 direct resident care nursing staff …

The Impact Of A Digital Intervention On Perceived Stress, Resiliency, Social Support, And Intention To Leave Among Newly Licensed Nurses: A Randomized Controlled Trial, Lisa Concilio

Electronic Theses and Dissertations

The nursing shortage has been deemed a public health crisis with the turnover rate of newly licensed nurses (NLNs) growing (Robert Wood Johnson Foundation, 2014). One out of five NLNs are leaving the profession due to work dissatisfaction and feelings of inadequacy (National Academy of Medicine, 2017). NLN attrition during the first year of hire has been associated with feelings of overwhelming stress and decreased sense of support which negatively impact patient safety (Spence Laschinger et al., 2016). As seasoned nurses are attempting to retire amidst a nursing shortage (American Association of Colleges of Nursing, 2018), NLNs require more support …

Preceptor Education And Structured Onboarding Process, Charles Morato

Master's Projects and Capstones

Problem: Staff nurse retention is an ongoing problem for this intensive care unit (ICU). Through exit interviews from staff who left, inadequate onboarding and education made them feel unprepared for their job and not part of the team. The preceptors on the unit have never been trained on the roles and responsibilities of being a preceptor. The current onboarding process consists of pairing new hires with a preceptor who either happens to be willing to do it that day or someone who has been there the longest. There is no consistency or personalizing the orientation information to the new hire. …

Managing Nursing Incivility: An Integrative Literature Review, Tina Carlson

Nursing Masters Papers

Incivility among nurses is a problem that affects healthcare at multiple levels. Incivility can lead to intimidation that can distract clinical judgment, putting patient safety in jeopardy. Incivility affects patient safety as it is a “contributing factor to 98,000 deaths each year in acute care settings” (Lesater, Mood, Buchwach, & Dieckmann, 2015 p.17). In addition, incivility impacts healthcare organizations related to nursing turnover rates and can cost hospital organizations up to 125% of a registered nurse’s (RN) annual salary to replace each individual nurse who leaves their job (Stagg, Sheridan, Jones, & Speroni, 2013). The Joint Commission and American Nurses …

The Influence Of Nurse Residency Programs On Retention Rates, Jennifer Wagner

Nursing (graduate) Student Scholarship

Background: New nurses face many challenges when starting their jobs, leading to job vacancy if the challenges are not addressed. Turnover can be costly for an institution due to training costs. Nurse residency programs have become more common to reduce turnover rates. Additionally, nurse residency programs provide support and professional development opportunities as new nurses’ transition into their new positions. Mentorship, preceptorship and the duration of orientation are all components of nurse residency programs that are necessary to evaluate. The purpose of the paper is to investigate how nurse residency programs affect retention rates of new nurses after one year. …