Nursing Administration Commons^™

Implementation Of A Hospital-Wide Surge Plan To Reduce Emergency Department Length Of Stay, Laura Massey

Student Scholarly Projects

Practice Problem: Suboptimal patient flow throughout the hospital has resulted in an increased length of stay (LOS) for emergency department patients and the potential for adverse events.

PICOT: In admitted and discharged emergency room patients (P), how does a hospital-wide surge plan (I) compared to current throughput plan (C) affect the length of stay (O) within 8 weeks?

Evidence: The literature evidence reviewed supported the implementation of a hospital-wide surge plan approach positively impacts the emergency room length of stay and patient outcomes.

Intervention: The primary intervention for this project was the implementation of a hospital-wide surge policy. Targeted …

Implementation Of Post Falls Huddles In Skilled Nursing Facility, Princess Lomax

Evidence-Based Practice Project Reports

The purpose of this paper is to discuss the quality improvement project, implementation of the post fall huddle in a long-term care facility. Falls are the most common problem in adults 65 years and older. Falls in this population can have devastating effects, often leading to significant changes in morbidity or death. Adults in long term care settings have an increased risk of falling and having a subsequent fall due to an acute illness, weakness, or confusion (CDC, 2015). At the skilled facility, there has been a significant increase in hospitalizations due to injuries sustained from falls. To address this …

A Multifactorial Intervention To Reduce Weight Bias In Healthcare Providers, Rose M. Flinchum

Evidence-Based Practice Project Reports

No abstract provided.

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 …

The Application Of Grounded Theory: An Example From Nursing Workforce Research, Latoya J. Lewis-Pierre 4572586, Joann Kovacich, Linda Amankwaa

The Qualitative Report

The application of grounded theory was the conduit to theory development in this study. The intent was to explore nurse manager, educator, preceptor, and new graduates’ perceptions of workplace readiness for new graduates entering an Intensive Care Unit. Research participants were drawn from five different ICUs: Medical, Coronary Care, Surgical, Neuroscience, and Trauma. One-on-one interviews were conducted to collect participants’ perspectives on readiness to practice in the ICU. Using grounded theory, four themes emerged giving rise to the novice nurse embracing the ICU theory (NNEIT). Reflections on the type of grounded theory used, reasons for the selection, challenges faced in …

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 …

Improving Patient Safety Through High Reliability Organizations, Jared Padgett, Kenneth Gossett, Roger Mayer, Wen-Wen Chien, Freda Turner

The Qualitative Report

Preventable medical errors result in the loss of 200,000 lives per year with associated financial and operational burdens on organizations and society. Widespread preventable patient harm occurs despite increases in healthcare regulations. High reliability organization theory contributes to improved safety and may potentially reverse this trend. This single case study explored the introduction of a safety culture and subsequent improvements in patient safety in a reliability-seeking organization. Fourteen participants from a subacute nursing facility were selected using purposeful sampling criterion. Data were collected through participant interviews, document reviews, and group observation. Five themes emerged from an analysis of collected data …

Warmth And Competence Traits: Perceptions Of Female And Male Nurse Stereotypes, Randolph E. Gross

Dissertations, Theses, and Capstone Projects

A nursing shortage looms ahead; 1.03 million new nurses will be needed by 2022 to meet society's healthcare needs. A major barrier to recruitment of women and men are nurse stereotypes. The literature suggests four female and four male stereotypes exist; however, no quantitative research exists that explores perceptions of non-nursing undergraduate students. Approximately, 90% of college students do not consider nursing as a career option, and 72% have misconceptions of what nurses do in reality.

According to social cognitive theory's Stereotype Content Model (SCM), perceptions are viewed through a combination of two dimensions: warmth and competence. The author devised …

Strategic Community Healthcare Management, Stephanie Penrod

Master's Projects and Capstones

Federally Qualified Health Centers(FQHC) and Community Health Centers are growing with the Affordable Care Act. This paper introduces literature that supports the need for Community Health Centers and management of low income patients with chronic illnesses. This paper also reviews the fieldwork experience at a FQHC. It reviews the goals, project, methods and findings of the fieldwork. This paper also elaborates on the scope of the project and a quality improvement report for the FQHC in observation. It discusses the future potential implementation of the recommendations and the benefits for both employees and patients. This paper concludes with follow up …

Exploring The Career Pathways, Professional Integration And Lived Experiences Of Regulated Nurses In Ontario, Canada, Godfred O. Boateng

Electronic Thesis and Dissertation Repository

In the context of an enduring shortage of nurses, this study explores the career pathways and experiences of immigrant and Canadian-born nurses in two Ontario cities utilizing a qualitative research design consisting of 70 in-depth interviews. Differences in career entry and experiences of workplace conflict across immigration status and race are explored.

First, I explore successful immigrants’ pathways into the nursing profession and their social and economic integration into the Canadian economy in light of the traditional assimilation and segmented assimilation theories. The study reveals distinct career pathways taken by foreign-born nurses and Canadian born nurses. While Canadian-born nurses have …

The Effect Of Education On Compassion Fatigue As Experienced By Staff Nurses, Kathryn L. Zehr

Evidence-Based Practice Project Reports

Historically, nursing has been perceived as a highly rewarding profession. Yet, due to the increasing complexity of today’s healthcare, nurses are faced with greater challenges in their work environments. Registered nurses who work in tertiary care settings are exposed to disturbing patient situations including trauma, death, abuse, or chronic disease. Joinson (1992) described this experience as compassion fatigue and symptoms include headaches, short attention span, or fatigue. A review of literature has identified that nurses should be educated about risk factors and coping strategies to combat compassion fatigue. Guided by the Model for Evidence-Based Practice Change and Jean Watson’s Theory …

Re-Cognizing Power In The Culture Of Dementia Care Knowledge, Ryan T. Deforge

Electronic Thesis and Dissertation Repository

In light of increasing system demands, system regulations, and constrained resources, those living and working with dementia in the long-term care sector are vulnerable to oppressive care practices. This is true so long as our understanding of how social power affects the ways in which dementia care knowledge is created, shared, and enacted remains limited. Based on prolonged field observations and on informal and formal interviews with care recipients, family members, and staff, the aim of this critical qualitative research was to examine the culture of dementia care knowledge in two sites: a specialized dementia care unit in a long-term …

Perceptions Of Workplace Bullying Among Practicing Registered Nurses, Crystal Regina Threadgill

Dissertations

Workplace bullying (WPB) is a social and organizational problem. Within the health care arena, employees, particularly registered nurses, are at risk. WPB has several adverse effects and has been cited in the literature as closely associated with burnout and nurses leaving their positions. This quantitative study examined workplace bullying among practicing registered and its relationship with burnout and nurses’ intent to leave their current position.

The surveys utilized were the Negative Acts Questionnaires-Revised (NAQ-R), Maslach Burnout Inventory Survey, Intention to Turnover Scale and a demographic survey. Of the surveys distributed, a total of 185 were returned from one selected hospital …

The Percentage Of Beds Designated For Medicaid In American Nursing Homes And Nurse Staffing Ratios, Christopher Donoghue

Department of Sociology Faculty Scholarship and Creative Works

Previous analyses of the inverse relationship between a nursing home's Medicaid census and its quality of care have been based on samples limited to specific geographic regions, for-profit entities, or only skilled care facilities. The present study uses national-level data from the 1999 National Nursing Home Survey to examine the association between the proportion of beds designated for Medicaid residents and nurse staffing ratios. The results indicate that homes which designate a higher proportion of their beds for Medicaid recipients maintain lower ratios of registered nurses and nurse's aides to residents, even when key facility characteristics are controlled. It was …

Voluntary And Involuntary Nursing Home Staff Turnover, Christopher Donoghue, Nicholas G. Castle

Department of Sociology Faculty Scholarship and Creative Works

The goal of this study was to identify nursing home characteristics that have differential associations to voluntary and involuntary turnover among formal caregivers (i.e., registered nurses, licensed practical nurses, and nurse aides). Primary data from 354 facilities from four states were merged with data from the 2004 Online Survey, Certification and Recording system. Multinomial logistic regression analyses were conducted to determine whether organizational characteristics were related to a greater probability of high or low levels of voluntary and involuntary turnover among formal caregivers. The analysis revealed that a higher ratio of nurses to beds, a smaller number of quality-of-care deficiencies, …

Development Of An Instrument To Identify The Virtues Of Expert Nursing Practice: ‘Byrd’S Nurses Ethical Sensitivity Test’ (Byrd’S Nest), Lisa Marie Byrd

Dissertations

The purpose of this research was to develop and analyze the psychometric properties of Byrd’s Nurse’s Ethical Sensitivity Test (Byrd’s NEST). An instrument to evaluate nurses’ ethical sensitivity in practice by examining choices of action in ethical dilemmas based on nursing virtues: compassion, fidelity to trust, moral courage, justice, self-confidence, resilience, practical reasoning, and integrity (Benner, Tanner, & Chelsa, 1996; Volbrecht, 2002). Benner’s theory of skill acquisition-novice to expert was the theoretical framework for this research which surveyed for correlations between a nurse’s ethical sensitivity and educational level, years of experience, certification, and work setting. Until now, there have been …