Business Commons^™

The Development Of A Wayfinding Smart Phone Application As A Large Healthcare Facility Investment Opportunity, Jessie Fortson Marshall

Doctoral Projects

Health care is a continually growing field. New hospitals are constantly being built, while older facilities are experiencing renovation and expansion. With this growth comes a set of difficulties for patients as they try to navigate through large, multi-building facilities. Most large facilities have multiple parking garages, numerous buildings, and medical towers with an unending number of floors. Patients are forced to rely on directional signage to find their destination that is often insufficient. Attempting to navigate through large facilities is often overwhelming for visitors leading to frustration and stress.

New technology has allowed a convenient solution to this problem …

Examining The Relationship Between Registered Nurses’ Turnover And The Benefits Of An Affirming Climate Of Diversity As Mediated By Workplace Outcomes, James Mark Clardy

Human Resource Development Theses and Dissertations

The Affordable Care Act has created within health care a growing demand for primary care services in both the inpatient and outpatient settings. The anticipated growth in need for registered nurses (RN) of 19% by 2020 is compounded by a current estimated national turnover rate greater than 17%. Human Resource Development (HRD) practitioners in health care are challenged to develop and implement interventions that can influence turnover in RNs despite identifying variables that effect turnover. This research explored how RN turnover can be positively affected by a government mandated requirement that health care create a diverse workforce and cultural competency. …

Nursing Assignments Based On Patient Acuity: The Road To Nursing Job Satisfaction, Kristina Tomic

Evidence-Based Practice Project Reports

Challenges in the healthcare industry, including nursing shortages and low nursing retention, have resulted in nurses’ job dissatisfaction. Improving work environment and workload can lead to improved and equitable nursing shift assignments, which may improve nursing job satisfaction. The purpose of this EBP project was to (a) implement a patient acuity tool in the hospital unit, (b) assess its effectiveness in appropriating nursing shift assignments, and (c) evaluate its effect on nursing job satisfaction. The Evidence Based Medicine (EBM) Model was used as a guide to facilitate the transition of the best evidence into practice. As suggested within the evidence, …

Combating Workplace Violence: An Evidence Based Initiative, Diana L. Giordano

Evidence-Based Practice Project Reports

Patient/visitor violence against healthcare (HC) employees is a type of workplace violence (WPV) and considered a dangerous hazard within HC occupations (Bureau of Labor Statistics, 2015). Lack of recognition of the true incidence and underreporting of WPV may contribute to a false sense of security within a HC facility (HCF). Therefore, fully addressing the problem may be met with administrative resistance, resulting in poor employee perceptions of support and commitment for a zero-violence environment. A retrospective analysis was conducted on the HCF’s online incident reports, security request calls, and data from a previously deployed WPV employee survey. The emergency department …

Preparing For The Merit-Based Incentive Payment Structure: A Value-Based Business Plan, Ali R. Saheb

Doctoral Projects

The notion of delivering value-based care while maintaining corporate vitality in health care is a multifaceted process. Shaping a business model to reflect this process requires the alignment of quality implications, reimbursement initiatives, a framework that takes into account stipulations on reimbursement for different types of clinicians, and an understanding and preparedness for emerging guidelines and nationally recognized structures for quality indicators. When organizations recognize the need for change, but are not yet prepared to implement it, a comprehensive business plan can help the organization visualize a path to success. In this project, the foundation of requirements for a value-based …

Analyzing Organizational Commitment And The Effect On Job Turnover In Nurse Residents, Cory D. Church

Nursing Theses and Dissertations

This dissertation is an exploration of psychosocial concepts related to the experiences of a vital health human resource, newly licensed registered nurses. Newly licensed registered nurses are at risk for leaving their first job within the first year due to the difficulty of transitioning to practice. The pressure to gain competence and deliver quality care, all while navigating the workplace environment, can impact their commitment to an organization and the profession. The reader will notice these concepts threaded throughout the dissertation. While these concepts are explored in other nursing workforce populations, the researcher determined a gap in the research on …

The Influence Of Transformational Leadership On Nurse-Reported Patient Safety Outcomes, Sheila A. Boamah

Electronic Thesis and Dissertation Repository

Leadership is widely believed to be pivotal to providing high quality patient care and ensuring favourable organizational outcomes. To understand how nursing leadership affects patient outcomes, it is important to explore the mechanisms/ processes through which leaders produce desired patient outcomes. The purpose of this study was to examine how nurse manager use of transformational leadership behaviours creates empowering work environments that foster clinical leadership practices at the bedside, and ultimately, improve nurse and patient safety outcomes.

Bass’s (1985) transformational leadership theory provided the theoretical framework for the research. Transformational leadership behaviour was hypothesized to have positive effects on workplace …

Strategies To Improve Job Satisfaction And Reduce Voluntary Employee Turnover Of Nurses, Stewart Proctor

Walden Dissertations and Doctoral Studies

Job satisfaction and employee turnover affect the health care industry in the form of overworked staff, inadequate health care, and loss of profits. In 2015, the United States health care industry had a shortage of over 923,000 registered nurses. Health care organizations lose an estimated $1.4 to $2.1 billion each year because of registered nurse (RN) turnover. These factors indicate that some managers lack the strategies to increase job satisfaction and reduce RN turnover. The purpose of this single case study was to use the Herzberg 2-factor theory to explore strategies 5 health care leaders use to improve nurses' job …

Integrating A Code Of Professional Conduct And Ethics: An Action Research Approach, Ciara Kissane

Theses

A new version of the Code of Professional Conduct and Ethics for Registered Nurses and Registered Midwives (NMBI, 2014a) was published in 2014. A nurse’s fitness to practice, and the associated patient experience, is determined by the extent to which the nurse accords with the duties outlined in the Code. Professional misconduct among members of the nursing profession has been highlighted within recent reports and enquiries. The failure to act on unethical care is also a feature. The literature suggests that Codes are poorly understood and can be problematic to integrate in practice. This study sought to; explore the impact …

Strategies Clinic Managers Use To Reduce Missed Medical Appointments, Sophea Ey Skym

Walden Dissertations and Doctoral Studies

Patients who miss their medical appointments increase health care costs for themselves and for clinics. The purpose of this qualitative, single exploratory case study was to explore strategies health care clinic managers use to reduce medical no-shows for patient-scheduled appointments. Change management theory guided the scope and analysis. The data collection included a single clinical operations manager who have strategies to mitigate no-shows for patient-scheduled appointments participated in a semistructured interview in southeastern Virginia, the direct observation of 2 office workers in their natural setting of scheduling appointments, and for methodological triangulation, a review of organizational archival documents about missed …

Strategies To Reduce Effects Of Organizational Stress In Health Care Workplaces, Kate Chinyere Mbidoaka

Walden Dissertations and Doctoral Studies

Workplace stress has become a frequent occurrence in the race for competitive business advantage. This stress leads to negative physiological consequences in the workplace, causing productivity and profitability to suffer. The purpose of this single case study was to explore the stress management strategies that some health care business leaders used to reduce the effects of work-related stress on their employees to improve productivity. The interview process included 3 managers employed at a health care institution in Houston, Texas, with records of implementing successful strategies for mitigating the effects of workplace stress. The conceptual framework was job demands-resources model, pertinent …

Effects Of Authentic Leadership Style And Nurse Engagement On Patient Satisfaction, Kimberly Dawn Washburn

Walden Dissertations and Doctoral Studies

Ineffective leadership and disengaged nurses reduce the quality of care and patient satisfaction in healthcare organizations. Healthcare leaders can benefit from understanding the factors that improve leadership ability and nurse engagement to improve healthcare outcomes. The purpose of this correlational study was to examine the relationship between the demonstration of authentic leadership characteristics and nurse engagement. The study's population comprised acute care registered nurses in a rural hospital in central Washington State. Authentic leadership theory and engagement theory constituted the theoretical framework. Independent variables were the 4 constructs of authentic leadership theory, self-awareness, balanced information processing, relational transparency, and internalized …

Hospital Administrators' Strategies For Reducing Delayed Hospital Discharges And Improving Profitability, Sheree Boyd

Walden Dissertations and Doctoral Studies

Inefficiencies in leadership and limited leadership strategies in hospitals contribute to delayed hospital discharges and an increased financial burden on a hospital. Three administrators from 2 hospitals who are part of a hospital conglomerate in Chicago, Illinois were selected for interview in this qualitative multiple case study to explore how hospital discharge strategies reduce delayed hospital discharges and improve profitability. Contingency was the primary theoretical theory for this study. The purposive sampling consisted of the selections of individual who were knowledgeable and had experience to organize, manage, and implement processes in an organization. Data collection occurred using face-to-face semistructured interviews, …

Primary Care Nurse Practitioners And Organizational Culture, Leanne Christine Rowand

Walden Dissertations and Doctoral Studies

Nurse practitioners (NPs) were introduced to the British Columbia healthcare system 12 years ago. Integration challenges related to infrastructure and relationships between administrators and physicians continue. The purpose of this project was to understand how nurse practitioners, working in primary care roles, experience the organizational climate within their healthcare agency. Kanter's empowerment theory guided this project. Data were collected using the Nurse Practitioner Primary Care Organizational Climate Questionnaire. A total of 64 NPs relayed their degree of perceived organizational support. NPs scored highest on Autonomy and Independent Practice (Mean [M] = 3.54, Standard Deviation [SD] = 0.59). Organizational Support and …

Leadership Development For The Formal Nurse Leader, Lori Neu

Walden Dissertations and Doctoral Studies

Nurse leaders are essential to the advancement of healthcare because of their ability to bridge the gap of knowledge between clinical practice and the business of healthcare. Developing nurse managers is imperative to the future of nursing given their influential role in healthcare. The central topic of exploration in the project was how nurse managers use the American Organization of Nurse Executives (AONE) Nurse Manger Inventory Tool to assess their management skills after exposure to the leadership development program currently available to them. In this project, the novice to expert theory was used to evaluate the existing leadership development program …

Servant Leadership And Its Effect On Employee Job Satisfaction And Turnover Intent, Dennis M. Mitterer

Walden Dissertations and Doctoral Studies

Experts expect a shortage of more than 900,000 nurses by 2022, according to the United States Bureau of Labor Statistics Employment Projections. Turnover in nursing contributes significantly to the shortage and often results from poor leadership of nurse managers. The purpose of this quantitative study was to investigate how servant leadership behaviors affected the psychological state and behavioral response of staff nurses as reflected by job satisfaction and turnover intention. Specifically, the research question addressed whether servant leadership positively contributes to the psychological states and the behaviors of staff nurses leading to greater job satisfaction. The study design was correlational, …

Engagement Strategies To Reduce Registered Nurse Turnover In Hospitals, Robert Neeley

Walden Dissertations and Doctoral Studies

Skilled and experienced registered nurse employees are critical to the organizational success and stability of hospitals, but an annual average registered nurse turnover rate of 14% can result in financial losses of millions of dollars annually for the typical hospital in the United States. The purpose of this multiple case study was to explore the engagement strategies hospital nurse managers use to retain registered nurses. The study population included 8 nurse managers employed by hospitals in West Central Florida who have successfully implemented engagement strategies to retain registered nurses. The conceptual framework for the study was based on systems theory …

How Does Organizational Culture Impact Rn Engagement, Veronica Anntionette Ruffin-Ellis

Walden Dissertations and Doctoral Studies

Lack of RN engagement in the acute care setting can result in poor staffing, nursing shortages, increased stress levels for nurses and decreased morale. When nurses are not engaged in their work setting, quality of care suffers. A wide range of literature focuses on the importance of RN engagement; however, few health care organizations have taken the initiative to implement programs that foster RN engagement, demonstrating a gap in practice. This study examined the relationship between the levels of RN engagement and their perceptions of their organizational culture. Kolcaba's humanistic approach to meeting the needs of RN staff was used …

The Relationship Between Nurse Manager Leadership Style And The Enculturation Of Shared Governance, Anna Elizabeth Keane

Walden Dissertations and Doctoral Studies

Shared governance, a participative model of governance, implemented by healthcare organizations for more than 30 years has been associated with empowerment, job satisfaction, and retention of registered nurses. Recent studies document a lack of participation in shared governance by registered nurses; the reason for the change is unknown. The nurse managers' role in this change is unknown. The purpose of this non-experimental, cross-sectional survey design study was to test Bass' theory of transformational leadership that examines the relationship between the leadership style of the manager and the enculturation of shared governance in acute care hospitals in the United States. A …

Strategies For Managing The Shortages Of Registered Nurses, Jody-Kay Mcfarlane Peterson

Walden Dissertations and Doctoral Studies

The purpose of this multiple case study was to explore strategies that healthcare facility leaders in Central Minnesota use to recruit and retain qualified nurses. Participants were 6 healthcare facility leaders including 2 nursing directors, 2 human resource personnel, 1 nurse supervisor/administrator, and 1 nurse recruiter who had the knowledge and experience in recruitment and retention of Registered Nurses (RNs) in healthcare facilities in Central Minnesota. The Herzberg 2-factor theory was the conceptual framework. Semistructured interviews were used to collect data. Data were analyzed using Morse's 4 steps data analysis process. The major themes were recruitment strategies and retention incentives. …

The Impact Of Communication Satisfaction On Paediatric Nurses’ Job Satisfaction And Intention To Stay, Gemma Doleman

Theses: Doctorates and Masters

Effective communication is the most central process within an organisation and is essential to organisational values, norms and expectations. There is a documented connection between job satisfaction, work commitment and organisational communication. However, nurses’ and nursing middle managers’ satisfaction with organisational communication has not been extensively studied in recent years and not at all among paediatric nurses. Therefore, the purpose of this study was to develop and test a theoretical model that examined paediatric nurses’ and middle managers’ satisfaction with organisational communication and the effect this has on paediatric nurses’ job satisfaction and intention to stay in their job.

Employing …