Medicine and Health Sciences Commons^™

Regulatory Issues In Electronic Health Records For Adolescent Hiv Research: Strategies And Lessons Learned, Sara Ali Shaw Green, Sung-Jae Lee, Samantha Chahin, Meardith Pooler-Burgess, Monique Green-Jones, Sitaji Gurung, Angulique Y. Outlaw, Sylvie Naar

Publications and Research

Background: Electronic health records (EHRs) are a cost-effective approach to provide the necessary foundations for clinical trial research. The ability to use EHRs in real-world clinical settings allows for pragmatic approaches to intervention studies with the emerging adult HIV population within these settings; however, the regulatory components related to the use of EHR data in multisite clinical trials poses unique challenges that researchers may find themselves unprepared to address, which may result in delays in study implementation and adversely impact study timelines, and risk noncompliance with established guidance.

Objective: As part of the larger Adolescent Trials Network (ATN) for HIV/AIDS …

Improving Provider Retention Through Addressing Burnout At A Federally Qualified Health Center: A Quality Improvement Initiative, Emily Grattan

DNP Scholarly Projects

Background: Primary care providers employed by federally qualified health centers (FQHC) working with underserved populations experience high levels of burnout as patients are often medically complex, face healthcare disparities and societal stigmas. The aim of the project was to alleviate burnout and improve provider retention through introduction of organizational support measures. Participants involved were healthcare providers, as well as nurse management and senior leadership.

Methods: The quality improvement approach for this project utilized the Plan-Do-Study-Act (PDSA) cycle and a driver diagram to guide the selected interventions. Interventions were based on categories from Mayo’s Clinic’s Nine Organizational Strategies to Promote Engagement …

Recruitment And Retention Of Health Care Workers In Rural Areas, Robbie Marie Julian

Walden Dissertations and Doctoral Studies

Health care worker shortage is a global problem and is challenging for human resources managers. Human resource managers need more strategies to recruit and retain healthcare workers in rural areas to decrease healthcare worker shortages, unemployment rates, patient morbidity, and mortality rates. Grounded by Maslow’s hierarchy of needs theory, the purpose of this qualitative multiple case study was to explore strategies human resource managers use to recruit and retain healthcare workers in rural areas. The participants were three managers from Southern Louisiana rural area medical facilities with at least 5 years of experience developing and implementing successful recruitment and retention …

Recruitment And Retention Of Health Care Workers In Rural Areas, Robbie Marie Julian

Walden Dissertations and Doctoral Studies

Health care worker shortage is a global problem and is challenging for human resources managers. Human resource managers need more strategies to recruit and retain healthcare workers in rural areas to decrease healthcare worker shortages, unemployment rates, patient morbidity, and mortality rates. Grounded by Maslow’s hierarchy of needs theory, the purpose of this qualitative multiple case study was to explore strategies human resource managers use to recruit and retain healthcare workers in rural areas. The participants were three managers from Southern Louisiana rural area medical facilities with at least 5 years of experience developing and implementing successful recruitment and retention …

Distinctiveness In Hospital Safety And Security, Jimmy Reid Rollins Jr.

Doctor of Education Dissertations

The purpose of this research was to understand leadership and how these ideas feed into a professional dynamic of employee behavior, organizational leadership, motivation, and workplace culture, and how there is a real human interest as employees excel, grow, mature, and become better individuals.

Participants in this study were employees of a regional health organization and employed with the job title of public safety officer, public safety supervisor, or public safety administrator. This research used a mixed methodology approach in an explanatory design. A survey was completed followed by one on one interviews.

Conducting research into the safety and security …

The Heart And Soul Of Engagement In The Float Pool Team, Kymberly Dexter

Master's Projects and Capstones

Problem: The assistant nurse manager (ANM) role is considered an entry-level management position and is not intended as a permanent career role. The unintended consequence is that there is a high rate of organizational turnover, making it challenging to build and retain a solid, cohesive, and productive team.

Context: A new manager of a float pool team in a 166-bed community hospital found that with little financial investment, a significant impact is made by holding a safe space for listening to the ANM team and designing education and training around what is most important to frontline managers.

Interventions: A baseline …

U.S. Army Physician Assistant Retention: A Latent Class Analysis, Robert Greener

Theses & Dissertations

Introduction: Retaining employees is crucial to the success of organizations. While significant effort has been made to model employee retention, models have been unable to significantly predict retention. The purpose of this quantitative, non-experimental, cross-sectional study was to develop an improved employee retention model which could be used as a practical guide to improve employee retention. Materials and Methods: The study analyzed a survey created, implemented, and collected by the Statistical Cell at the U.S. Army Center of Excellence. In September of 2020, all 864 active-duty PAs were sent a link to the survey and 290 completed the survey, …

Computer-Based Learning For Opioid Use Disorder, Jordan Taylor Bentz, April Snell

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Over the last several decades, the prevalence of Opioid Use Disorder (OUD) has escalated in the U.S., leading to an opioid epidemic that ravages the wellbeing of the nation. Despite all alleviating efforts, opioid-related morbidity and mortality continue to rise across most states, including Tennessee. Currently, medication-assisted treatment (MAT) is the most highly regarded method of treatment for OUD; however, MAT programs differ significantly on the pharmaceutical agent of use, adjuncts to treatment, and philosophy of care. Unfortunately, this inconsistency often leads to poor treatment retention in MAT programs. This project aimed to improve MAT retention for patients with OUD …

Bridging The Patient Engagement Gap In Research And Quality Improvement Utilizing The Henry Ford Flexible Engagement Model, Heather A. Olden, Sara Santarossa, Dana Murphy, Christine C. Johnson, Karen E. Kippen

Journal of Patient-Centered Research and Reviews

Purpose: This paper was intended to share a flexible engagement model (FEM) for organizing a structure to obtain patient input regarding health care operations and research, provide greater detail on recruitment, retention, and dissemination strategies, and demonstrate successes and potential applications in other health care settings.

Methods: Utilizing a pragmatic approach, the Patient-Engaged Research Center (PERC) at Henry Ford Health System developed the FEM, a 7-step process to introduce interested patients/caregivers to the patient advisor program and to follow up with placements. PERC developed a meeting evaluation to measure participant satisfaction. Retention and dissemination methods to keep participants …

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 …

Manager Onboarding To Improve Knowledge And Confidence To Lead, Christine (Tina) K. Asiimwe

Doctor of Nursing Practice (DNP) Projects

Background: Primary care (PC) is increasingly the setting for affordable, coordinated, end-to-end patient care, with PC managers in charge of organizational performance. While PC managers are central to high-functioning teams, they often receive inadequate onboarding.

Local Problem: Primary care onboarding competes with other operational priorities and faces time constraints, lack of mentorship, and cost.

Context: At an integrated healthcare system, a need was identified to develop structured, role-specific onboarding for newly hired PC managers to improve knowledge and confidence to lead.

Interventions: Bauer’s Four Cs framework for onboarding guided the development of a manager onboarding program for 12 new PC …

Nurse Manager Satisfaction And Retention With Compressed Schedules, Ivan Pierce, Nancy Sweeney

College of Health Sciences Posters

Problem: Despite efforts to improve organizational metrics for nurse satisfaction and retention, nurse manager satisfaction/retention remains a challenge for many hospitals.

Purpose: This study sought to explore factors that impact nurse manager satisfaction/retention by implementing an intervention that could positively influence work life balance, thereby improving satisfaction and retention in areas with high nurse manager turnover.

EBP Question: Is there a significant difference in the perception of work-life balance, job satisfaction, and intent to leave among inpatient acute care nurse managers before and after the implementation of self-directed compressed work schedules?

Method: A pilot study involving inpatient acute care …

Successful Retention Strategies By Perfusion Managers To Reduce Perfusionist Attrition, Krysta Lynne Gleeson

Walden Dissertations and Doctoral Studies

Perfusion managers who lack strategies to mitigate perfusionist attrition place a strain on their remaining employees and incur replacement costs for their organization. Grounded in Vroom’s expectancy model, the purpose of this multiple case study was to explore strategies perfusion managers use to mitigate perfusionists attrition within open-heart centers in a northeast U.S. city. Data were collected through digital semistructured interviews with 5 licensed perfusionists who demonstrated successful staff retention. Perfusionist job listings were used as a secondary data source. Data were analyzed using Yin’s 5 step process. Four significant themes emerged: job satisfaction, work-life balance, surveys, and compensation. Perfusion …

An Exploratory Study To Identify Strategies For Retaining Laboratory Professionals In Hospital Setting, Ambrose E. Ewane

Walden Dissertations and Doctoral Studies

Medical laboratory professionals have faced more than 20 years of workforce shortages. The causes of these workforce shortages include poor retention of new professionals and an insufficient number of new graduates who enter the workforce. The purpose of this qualitative case study was to explore the strategies that are used by managers in hospitals for the retention of laboratory professionals. The theoretical framework comprised Mobley’s theory of turnover and Porter’s organizational commitment theory. The research questions for this study addressed what managers perceived as the biggest challenges for the retention of laboratory professionals and what effective strategies they thought could …

An Examination Of Student Performance In Pre-Requisite Coursework And Upper Division Nursing Coursework, Jennifer L. Brown, Cheryl M. Smith

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Admission and retention of qualified nursing students are essential in meeting the demands of a rapidly changing health care environment and nursing shortage. The purpose of this exploratory correlational study was to determine the relationship between student performance in quantitative pre-requisite coursework and student performance in upper division nursing coursework in order to identify students at-risk for attrition. A series of descriptive and correlational analyses were conducted using pre-existing institutional data. A moderate relationship existed among the chemistry II and first-year upper division nursing courses (r = .21 to r = .40). These results suggest that prerequisite chemistry course …

A Review Of Some Diverse Models Of Summer Bridge Programs For First-Generation And At-Risk College Students, Berverlyn Grace-Odeleye, Jessica Santiago

Administrative Issues Journal

Many colleges are pursuing innovative alternative approaches for the development of education I that aims to accelerate students’ progress in gaining important academic competencies. Summer bridge programs are one such approach. These bridge programs offer underprepared and at-risk students the opportunity to advance toward college-level coursework during the summer before their freshman year. These summer bridge programs have grown increasingly popular, as a strategy for providing students with the foundational college courses, knowledge and skills required for college success. Many integrated programmatic approaches and resources have been developed to address this issue, including general education freshman courses in reading, writing, …

Relationship Between Self-Determination And Employee Retention, Tiffany Edwards

Walden Dissertations and Doctoral Studies

Retention of registered nurses (RNs) is essential to the sustainability of quality health care services. More than 55% of hospitals in the United States have not translated retention initiatives into a formal retention strategy. The purpose of this study was to examine the relationship between training programs, new hire onboarding processes, frozen positions, and nurse retention. The self-determination theory was the theoretical framework for this study. Secondary data were collected from the 2016 Texas Hospital Nurse Staffing Survey. Data were analyzed using multiple linear regression. The results of the multiple linear regression were statistically significant, with F(3, 251) = .602, …

Certified Nursing Assistant Turnover & Impacts On Rural Skilled Nursing Facilities A Qualitative Study & Recommendations For Practitioners, Marisa E. Hansen

All Graduate Theses, Dissertations, and Other Capstone Projects

The cumulative growth in the aging population in the U.S. calls for a high demand for long-term care (LTC) facilities. Furthermore, the LTC (e.g., nursing homes and assisted living facilities, etc.) consumers have become widely diverse (i.e., not just limited to older groups but now included children and adults with disabilities); demand for wide range of needs and support services. In coping with this changing environment, the LTCs, especially operating in rural settings, are faced with multifaceted challenges related to direct care staffing and turnover. In response to this outlook, the present study explores a research question to understand, how …

Strategies For Increasing Volunteer Engagement In Nonprofit Healthcare Organizations, Sanja Katina Hudson

Walden Dissertations and Doctoral Studies

Implementing effective strategies to address the challenges of volunteer engagement is critical for helping ensure the sustainability of nonprofit healthcare organizations. Nonprofit healthcare leaders seek strategies to increase the volunteer workforce and enhance volunteer engagement. Through the conceptual lens of Deci and Ryan's self-determination theory, the strategies nonprofit healthcare leaders used to reduce volunteer turnover were explored in this single-case study. Data were collected using semistructured interviews with 5 nonprofit healthcare leaders from a single organization in the southwestern United States. Analysis of internal and external organizational documents and publicly available data were manually coded and thematically organized. The use …

Impact Of Empowerment And Autonomy On The Nursing Director's Intent To Stay, Tiffany Bergquist

Walden Dissertations and Doctoral Studies

Retention of nursing directors is important to the viability and success of the healthcare industry because they have a large impact on nursing job satisfaction, overall retention of nurses in an institution, productivity, and patient outcomes. Factors that retain nurse directors, such as autonomy and empowerment, appear to be important to job satisfaction, but there is little in the current research to corroborate these findings. The purpose of this quantitative study was to determine what factors impact nursing directors' intent to stay in their current role and what effect role autonomy and empowerment have on their intent to stay as …

Factors Contributing To The Persistence Of African American And Hispanic Undergraduate Males Enrolled At A Regional Predominantly White Institution, Reginal R. Hall

Administrative Issues Journal

The purpose of this study is to explore factors that may contribute to the persistence and graduation rates of African American and Hispanic undergraduate males enrolled at regional four-year public universities in Texas. African American and Hispanic males have lower graduation rates in both secondary and post-secondary education than their White peers (Harper, 2010; Swail, Cabrera, Lee, & Williams, 2013). The qualitative research investigated characteristics that exist among African American and Hispanic undergraduate males who have persisted and were retained at the university through their senior academic year. The research problem was explored through the lens of critical race theory …

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 …

Losing New Graduate Bedside Nurses, A Practice Improvement Initiative, Beverly Elaine Miller

Walden Dissertations and Doctoral Studies

New graduate nurses (NGNs) at bedside are faced with numerous challenges, which prompt them to leave jobs in their first year. The transition from being a student to competent nurse requires a NGN to have the necessary skills and experience. Subsequently, hospitals continue to face shortages of staff because of high turnover and low retention levels. Nonetheless, evidence from reviewed literature has indicated that the use of residency programs can increase NGNs' stay at bedside, improve retention, reduce costs of operations, and return employees' turnover. The purpose of this quality improvement project was to identify the likelihood of NGNs remaining …

Establishing A Nurse Mentor Program To Improve Nurse Satisfaction And Intent To Stay, Sara Jane Jones

Doctor of Nursing Practice Projects

Retention of new graduate registered nurses (RNs) is a problem within the healthcare system negatively impacting patient safety and health care outcomes. The problem of retention of qualified RNs is compounded by the potential shortage of RNs, the aging RN workforce and the aging US population. During a period of transition, a novice RN requires the guidance of others to learn to apply theoretical knowledge to real life clinical experiences. In the linear progression of Benner’s levels of clinical competency, the beginning two levels of nurses need a resource person to guide their progression in clinical practice. A mentoring relationship …

Strategies To Retain Employees In Clinical Laboratories, Amber Rose Phipps

Walden Dissertations and Doctoral Studies

With 30 million citizens gaining access to U.S. healthcare through the Affordable Care Act by 2016, healthcare managers need preanalytic employees to ensure quality healthcare services can be provided. The purpose of this qualitative single case study explored strategies used to retain preanalytic employees. The target population consisted of 10 clinical laboratory managers in a single community-based clinical laboratory in the mid-southern United States, selected because of prior success in improved employee retention strategies. The conceptual framework grounding this study was the theory of work adjustment. Data triangulation occurred from using semistructured interviews and company documents. All interpretations from the …

Exploring Leadership Strategy Influence On Nursing Personnel Retention Within Safety-Net Hospitals, Carl Brown

Walden Dissertations and Doctoral Studies

Frequent turnover among a hospital's nursing staff can profoundly impact organizational operating costs. With a national turnover rate of 17% in 2015, understanding the impact of management approaches on nurse attrition is vital to business success. Guided by Homan's social exchange theory, the purpose of this single case study was to explore leadership strategies used by safety-net hospital leaders to increase nursing personnel retention. Data collection consisted of semistructured interviews from a purposive snowball sampling of 8 senior directors working at a safety-net hospital in southern Maryland. Additional information collected involved documents and artifacts related to human resources management policies …

Comparing Generational Differences In Job Satisfaction And Retention (Anticipated Turnover) Among Nurses Working In Magnet Versus Non-Magnet Designated Hospitals, Laura E. Cima

Seton Hall University Dissertations and Theses (ETDs)

Background and Purpose of the Study: Experts in the nursing profession predict a catastrophic nursing shortage by 2025. Nursing shortages have devastating effects on hospitals from a quality of care, patient and family satisfaction and financial perspectives. Given these issues, the most logical approach to this shortage is retention of nurses rather than recruitment. The Magnet designation is one mechanism to retain nursing staff.

Another phenomenon exists within the work environment that makes this shortage different from others. Currently, there are four generations of nurses working in the healthcare environment. Each of these generational cohorts has different values and …

Healthy Work Environment Orientation Training And Psychiatric Nurse Retention, Lawanda Rollins

Walden Dissertations and Doctoral Studies

According to recent research, more than 75% of newly employed nurses leave employment within 6 months. Changes in organizational training programs are needed in order to improve psychiatric nurse retention, nationally and globally. A healthy work environment (HWE) has been described as an environment that includes mentoring for good communication skills; it is also one that explores collaborative strategies for safe practice; professional advancement; and empowerment through research, education, and skill development. Examination of the impact of this HWE psychiatric nurse orientation training program on nurse retention was done using Rogers' theory of diffusion. Study variables included the length of …

Implications Of Out-Of-Class Engagement: Exploring The Experience Of Obu Students, Neal Ellis

Administrative Issues Journal

In addition to learning, the college experience involves building relationships with peers and university faculty. For many students, interactions with faculty take place only in the classroom. For students at small liberal arts colleges, though, students and faculty often meet serendipitously both on and off campus. This study focuses on the unplanned interactions that occur between students and faculty. Data obtained from an interview, a focus group, and a campus-wide survey indicate that students who interact with their professors out-of-class (OOC) gain more value from their college experience and enjoy greater academic success than students who meet their professors in …

Leaders Of Today Are Challenged By Generation X Workforce Retention, Joyce K. Kutin

Joyce K Kutin RN, MSN, MOL

Many organizations today are comprised of a culturally diverse workforce. In addition to organizational diversity related to gender, ethnicity, race, or religious beliefs, there are also four different generations working side by side. Today’s workforce includes the Silent Generation, the Baby Boomers, Generation X, and Generation Y. The Silent Generation is known for their lifestyle approach of consistency, uniformity, conformity, law and order, hard work and playing by the rules. Baby Boomers were the first generation to grow up with television; they were the first to have broad access to news, issues, advertising, and a variety of programming. Generation X …