Medicine and Health Sciences Commons^™

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 …

Role Of Intravenous Access Support In Novice Nurses’ Job Satisfaction And Intent To Stay, Shaji Kurian

Walden Dissertations and Doctoral Studies

The nursing shortage is a growing concern across the country, especially due to the Covid-19 pandemic. Novice nurse retention is essential to solving this national problem. The purpose of this study was to examine whether intravenous (IV) access support influences job satisfaction and retention among novice nurses to improve their retention. Herzberg’s two-factor theory guided this research; IV access support acts as the hygiene factor. The absence of IV access support can result in dissatisfaction among novice nurses, contributing to higher turnover rates. This quantitative nonexperimental causal-comparative research design utilized a nurse work satisfaction questionnaire and intent to stay scale …

Evaluation Of An Orientation Program For Graduate Nurses Transitioning Into Professional Practice, Kristy Patrick-Lewis

Walden Dissertations and Doctoral Studies

The transition from student nurse to practicing professional is extremely challenging. The local organization experienced increases in turnover among new graduate hires and determined that adjustments to their orientation program to better meet the needs of new graduates were warranted. The problem that this doctoral project addressed is the lack of evaluation of the effectiveness of the new orientation program. The practice-focused question examined the effectiveness of the new orientation program at reducing turnover and improving satisfaction with the quality of the orientation program among new graduate nurses. The framework used to guide this study was Patricia Benner’s novice to …

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 …

Lived Experiences Of African American Nursing Students In An Associate Degree Nursing Program, Monique Renee Merritt

Walden Dissertations and Doctoral Studies

Despite recognition of the barriers that African American nursing students encounter while pursuing nursing education, leaders of U.S. nursing programs continue to struggle to retain these students and promote their degree completion. Poor retention and lack of completion contributes to the unequal representation of African American nurses in the U.S. healthcare workforce compared to the overall population. The purpose of this qualitative study was to examine the experiences that helped to promote African American nursing students’ success or served as barriers to successful completion of an Associate Degree Nursing program. Tinto’s integration model was used as the theoretical framework. Semistructured …

Structural Empowerment And Employee Commitment Among Millennial Newly Registered Nurses, Janice Hill

Walden Dissertations and Doctoral Studies

AbstractThe nursing shortage is one of the most challenging issues in global healthcare. While not an all-encompassing solution, labor force retention could alleviate the crisis. The purpose of this study, guided by Kanter’s structural theory of organizational behavior, was to determine the relationships between access to power, opportunity for growth, structural empowerment (SE), and employee commitment among millennial newly registered nurses (NRNs) and to determine if there is a difference in SE between male and female millennial NRNs. Survey data collected from 148 participants were analyzed using Spearman rank-order correlation tests and showed statistically significant correlations between access to power …

Nursing Program Progression Requirements And Student Success At A U.S. Community College, Deborah Joleen Cipale

Walden Dissertations and Doctoral Studies

Although licensed registered nurses (RNs) comprise a significant percentage of the U.S. health care workforce, there is a lack of qualified nurses to meet patient needs. This shortage is expected to intensify as practicing nurses leave the profession. The problem that prompted this study was that an attrition-reduction program implemented in the nursing program at a U.S. midwestern community college did not show a reduction in the average attrition rate. The academic integration construct of Tinto's theory of student departure was used to examine archival academic performance records of 145 students enrolled in the local program from 2010 to 2012. …

Leadership Strategies To Improve Nurse Retention, Floyd Jordan Colwell

Walden Dissertations and Doctoral Studies

The nursing shortage and high turnover rates are a problem in the United States. The purpose of this multiple case study was to explore leadership strategies that hospital senior nurse managers in the Rocky Mountain states use to improve nurse retention. Participants were 6 hospital senior nurse managers including 3 chief nursing officers, 1 assistant chief nursing officer, and 2 directors who had demonstrated effective leadership strategies in retention of nurses. The leadership-motivated excellence theory was the conceptual framework. Semistructured interviews with open-ended interview questions were used to collect data; organization websites and documents were used to help corroborate evidence …

The Benefit Of Leadership Using First Choice For New Graduate Nurse Retention, Jodie Marie Lyons

Walden Dissertations and Doctoral Studies

The United States has a nursing shortage that is projected to grow to over 500,000 by the year 2030. This is an issue for leaders because the nursing shortage affects health care organizations sustainability. The purpose of this qualitative descriptive phenomenological study was to identify and report the lived experiences of new graduate nurses (NGNs) in oncology and whether unit of first choice (UFC) effected their intention to remain after 2 years of practice. The research question considered the lived experiences of NGNs in oncology units who either had oncology as their UFC or were placed on an oncology unit …

Impact Of The Prophecy Job Fit Predictor On New Graduate Nurse Satisfaction, Joi Alesha Johnson

Walden Dissertations and Doctoral Studies

Research has shown that job satisfaction influences retention of nurses, and policies focused on nursing satisfaction are more beneficial for retaining new nurses than adjusting work hours and wages. The prophecy job fit predictor is a quality improvement initiative designed to identify where a nurse should be assigned based on behavior, clinical capabilities, and personality assessment. The practice-focused question for this project focused on whether satisfaction rates of recently graduated registered nurses were influenced by their unit placement. The conceptual frameworks that guided this project were the plan, do, study, and act method and Herzberg's 2-factor theory. Data were obtained …

Accelerated Online And Hybrid Rn-To-Bsn Programs: A Predictive Retention Algorithm, Melissa Knight

Walden Dissertations and Doctoral Studies

Predicting retention and time to graduation within accelerated online and a hybrid RN-to-BSN programs are significant elements in leveraging the pipeline of qualified RNs with BSN degrees, but the literature lacks significant accounts of retention and time to graduation outcomes within these programs and predictive algorithm developments to offset high attrition rates. The purpose of this study was to quantitatively examine the relationships between pre-entry attributes, academic integration, and institutional characteristics on retention and time to graduation within accelerated online RN-to-BSN programs in order to begin developing a global predictive retention algorithm. This study was guided by Tinto's theories of …

Educating Nurses About Nurse Residency Program, Tammy Lea Franklin

Walden Dissertations and Doctoral Studies

Educating Nurses About a Nurse Residency Program

by

Tammy Lea Franklin

MSN, Walden University, 2012

BSN, Oklahoma City University, 2010

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

May 2019

The problem addressed in this project was the challenges related to retention of new graduate nurses. This includes Registered Nurses (RNs), Licensed Practical Nurses (LPNs), and Bachelor of Science Nurses (BSNs) on two medical/surgical units in an acute care facility. The purpose was to work with a project team to develop an education module and accompanying resources to present to …

Improvement In The Retention Of Graduate Nurses In A Long-Term Acute Care Hospital, Angie Lim Torres

Walden Dissertations and Doctoral Studies

The high turnover rate of graduate nurses is a challenge in the United States' hospitals because of high job dissatisfaction rates. The premature disaffiliation of the graduate nurses is costly for organizations and can significantly affect the quality and safety of patient care due to the inadequate supply of adequately prepared staff nurses, particularly in the long-term acute care hospitals. The purpose of the project was to decrease the turnover rate of graduate nurses in a long-term acute care setting from 40% to 20% through modification of the nurse residency program by applying an intervention based on Bauer and Erdogan's …

Nursing Candidates' Perceptions Of The Greatest Challenges To Becoming A Professional Nurse, Lee Ann Williams

Walden Dissertations and Doctoral Studies

Nursing candidates' overall goal is to become a professional nurse. To reach this goal, the student must graduate from an associate or baccalaureate nursing program and pass the state board, National Council Licensure Examination (NCLEX). Student retention in nursing programs and passing the NCLEX continue to be a problem for educational institutions throughout the United States. The purpose of this study was to examine nursing candidates' perceptions of their greatest challenges in becoming a professional nurse. Wenger's social learning systems and the community of practice comprised the conceptual framework that guided this study. The research questions pertained to nursing students' …

Compassion Fatigue And Burnout: Awareness And Prevention For The Novice Nurse Population, Jamie B. Lopez

Walden Dissertations and Doctoral Studies

Compassion fatigue (CF) and burnout (BO) in the novice nurse population can negatively affect the organization, patient safety, patient satisfaction, and the individual. Novice nurses are susceptible to the development of CF and BO due to a lack of knowledge about the causes and the stress experienced as the novice nurse transitions to practice. The purpose of this staff education project was to fill the gap in practice by creating awareness about CF and BO during the nurse orientation process and by providing prevention strategies. The relationship-based care model and the theory of planned behavior were used to guide the …

Educating Nurse Managers To Create A Culture Of Nurse Retention, Stacey Trotman

Walden Dissertations and Doctoral Studies

Nurse managers are stakeholders in creating a culture of nurse retention. The purpose of this staff education project was to identify evidence-based best practices that promote nurse retention and to educate nurse managers about these strategies. Knowles's theory of adult learning was the theoretical framework for the project. The practice-focused question addressed whether an education program for nurse managers would increase their understanding of evidence-based strategies to create a culture of nurse retention. The education program centered on 4 themes: professional development, communication and relationships, culture and work environment, and organizational structures and support. The concepts of 5 domains-- status, …

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 …

Improving Nurse Mentor Retention Through The Use Of Nurse Residency Programs, Morgan Newman

Walden Dissertations and Doctoral Studies

Graduate nurses beginning their nursing career require a collaborative relationship with an expert nurse mentor to make this transition successful. However, high turnover among these experienced nurse mentors is causing a problematic gap in knowledge transfer, experience, and expertise in the nursing workforce. This project investigated whether nurse mentors who mentored in a Nurse Residency Program (NRP) remained with the organization longer and were more satisfied with their mentoring experience than nurse mentors who mentored outside of a NRP. The diffusion of innovations theory was used to support the project and process of dispersing information on the outcome of the …

Differentiating Successful And Unsuccessful Nursing Students, Trilla Mays

Walden Dissertations and Doctoral Studies

Administrators of nursing programs in community colleges are aware of the need to retain and to graduate students to meet the growing demand for licensed practical nurses (LPNs). High attrition in a 2-year nursing program in South Carolina affected the number of students either graduating as a LPN after completing the third semester, or continuing in the program to become a registered nurse (RN). Guided by Jeffreys's nursing undergraduate retention and success model, this causal comparative study investigated the differences between students who were and were not successful in the initial 3 semesters of the program. Archival student records for …

The Transition Phase Influence On Nursing Career Satisfaction And Retention, Amanda Lee Machesky

Walden Dissertations and Doctoral Studies

Qualified registered nurses are needed to provide bedside care to patients, yet there is a known registered nurse shortage in the United States, which has a global impact on the healthcare industry. Contributing to the nursing shortage is turnover, which is partly due to the inadequacies of preparation for role transition of newly qualified registered nurses. The purpose of this quantitative descriptive study was to determine if there was a relationship between retention and nursing career satisfaction of registered nurses who experience a transition to practice program and those who did not. Duchscher's transition shock theory served as the theoretical …

An Evidence-Based Mentorship Program For Experienced Nurses, Roma Allen

Walden Dissertations and Doctoral Studies

Turnover of experienced nurses is a component of the nursing shortage, which has created a lack of expert nurses administering bedside care. The project site is a Chicago suburban hospital with an average first year turnover of experienced nurses at 35%. This rate is above the 27% first year turnover reported by the Metropolitan Chicago Healthcare Council. This project focused on development and evaluation of an evidence-based mentorship program supported by theory that can contribute to an increase in experienced nurse retention. A detailed literature review references causative factors of turnover, such as an increasing workload, a multigenerational and aging …

Relationships Between Early Academic Indicators And Accelerated-Baccalaureate Student Nurse Success, Bonnie J. White

Walden Dissertations and Doctoral Studies

In 2013, the National Council Licensure Examination for Registered Nurses' (NCLEX-RN) passing standard was increased, leading to a decrease in NCLEX-RN pass rates. The passing standard increase was prompted by an advisory panel's determination that a gap in safe, competent practice existed among new graduate nurses. New graduates' success on NCLEX-RN is critical to meet workplace demand for new nurses. The purpose of this study was to examine whether cumulative grade point average at completion of 200-level nursing courses and scores on the standardized final exam in the 200-level fundamentals course were related to on-time nursing program completion and a …

Retention Of The Experienced Nurse, Tina Melissa Brinegar

Walden Dissertations and Doctoral Studies

The nursing profession is facing a potentially devastating shortage of nurses by the year 2020. Contributing to the shortage is the retirement of experienced nurses who are over the age of 45, and an aging baby boomer population. The loss will place a considerable strain on the overloaded health systems. As a result, it is important to identify successful strategies for addressing the problem of experienced nurse retention. Therefore, the purpose of this project was to conduct a systematic review of literature to answer the question of what retention strategies have been used to prevent the loss of the experienced …

Factors Related To Nursing Student Persistence In An Associate Degree Program, Patricia Ann Farley

Walden Dissertations and Doctoral Studies

The retention of nursing students remains a challenge in higher education, and the need for nurses in the United States is projected to increase. The purpose of this study was to investigate nursing student persistence in an associate degree program by examining differences in the presence of key social, environmental, and academic factors across 2 types of students: completers and non-completers of the 1st course in a registered nursing program. The study framework was based on Tinto's Student Integration Model and the Nursing Undergraduate Retention and Success Model, which identify key social, environmental, and academic factors as critical to student …

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 …

Case Study Of Stakeholders' Views On Retention And Self-Efficacy In Texas Nursing Programs, Durcilla Kay Williams

Walden Dissertations and Doctoral Studies

Retention of students through the completion of the nursing degree is a problem that exists at local Texas nursing programs, adding to the nursing shortage at local Texas hospitals. The purpose of this qualitative research study was to identify the best practices used by a local Texas college with graduation rates above the benchmark of 85% set by the Texas Higher Education Coordinating Board. The study framework was based on Bandura's theory of self-efficacy and Tinto's theory of student retention. The research questions for the study focused on reasons the college maintained a high retention rate, best practices currently used, …

The Influence Of Nursing Academic Leadership On Faculty Retention, Carol Turrin Turrin

Walden Dissertations and Doctoral Studies

The critical nursing faculty shortage in the United States affects the ability of nursing schools to train an adequate number of nurses to meet increasing health care demands. Researchers have focused on the nursing faculty shortage; however, insufficient information exists on the relational influence leadership has on faculty retention. The research problem addressed in this study was the lack of information identifying how and in what ways leadership influences retention and intent to stay in academia. The purpose of this phenomenological study was to explore the perceptual views of current faculty, using the leader-member exchange theory. Focusing on baccalaureate nursing …

Transformational Leadership As A Means Of Improving Patient Care And Nursing Retention, Carla D. Thomas

Walden Dissertations and Doctoral Studies

The Joint Commission (TJC) sets standards to assist healthcare organizations in improving performance. The hospital for which this project was developed did not meet national TJC benchmarks for patient satisfaction and nurse retention. Based on direct observation, discussion with staff, and results of the Multifactorial Leadership Questionnaire given to 39 staff nurses before this project was chosen, evidence suggested that the leadership style of the charge nurses was transactional, which is less effective than transformational leadership (TFL). Framed within the Plan, Do, Study, Act model, the purpose of this quality improvement project was to design an educational curriculum including didactic …

Student Perceptions Of Factors Affecting Retention In A Rural Associate Degree Nursing Program, Jodi Garcia

Walden Dissertations and Doctoral Studies

High nursing student attrition rates at a community college in a southwestern state were noted as a significant problem by nursing faculty and college administration because of a nursing shortage and subsequent health care issues in the surrounding community. The purpose of this project study was to explore the perceptions of nursing graduates regarding the influences that led to or impeded their success in completion of the associate degree nursing program. Additionally, perspectives of the usefulness of remediation sessions provided for students failing a course were investigated. This qualitative case study, guided by transformative learning theory, included a sample of …