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Leadership And Political Skill Preparedness Of The Doctoral Prepared Nurse, Wanda Montalvo

Dissertations

The Institute of Medicine Future of Nursing report recommended the development of more nurse leaders at every level and across all settings. The Accountable Care Act has led to a reformed healthcare system, placing a growing demand for nurse leaders. The doctoral prepared nurse must be able to fulfill leadership roles to educate future generations of nurses, translate research into practice, and influence organization-level research to meet federal performance indicators.

Organizational Context, Shared Governance Structure, And Outcomes In Veterans Affairs Hospitals, Bonnie J. Charland

Dissertations

For decades nurse executives have implemented shared governance structures as a nursing management innovation to transform the nursing organization from a bureaucratic hierarchy to a more organic, relational partnership. However, there is little generalizable evaluation of the effects of shared governance on nurse and patient outcomes. The purpose of this study is to examine organizational context and quality outcomes in relation to shared governance structures at VA hospitals. Structural contingency theory guided this ex post facto descriptive correlational study of the relationships between organizational context, nursing shared governance, and outcomes in VA hospitals in the United States.

Exploratory Study Of Nursing Leadership: An Inquiry Of Leadership Attributes Of Nurse Managers In Acute Care Hospitals And The Professional Practice Environment, Janet Henriksen

Dissertations

This study explored the perceived leadership attributes of nurse managers who enable the creation of positive professional practice environments for registered nurses in acute care hospitals. A general qualitative approach was used to explore the perceptions of ten acute care registered nurses using a three-interview method of inquiry. Three major categories emerged from the data analysis: nurse manager attributes, positive professional practice environment characteristics, and nurse retention, recruitment and job satisfaction. Eight themes emerged in the nurse manager attributes category: expert, mentor, participant, communicator/listener, problem-solver/critical thinker, supporter, arbitrator, and advocate. Seven themes emerged in the characteristics of a positive professional …

Exploring Resident-To-Resident Aggression In Long-Term Care From A Nurse Leader Perspective, Pamela E. Baxter, Sonia Udod, Sheila Boamah, Jessica Hsieh, Natalie O. Meisenburg

Sigma Foundation for Nursing Research Grant Reports

Resident-to-resident aggression (RRA) is one of the most common forms of violence in long-term care (LTC) and can have devastating physical, emotional and psychological consequences. Incidents of RRA remain under-recognized and underreported. The objective of this study was to understand nurse experiences with and responses to RRA in LTC homes in Ontario, Canada.

The Impact Of Cancer Caregiving On Cancer Caregivers: Stories Of Lives In Transition, Cynthia M. Steinwedel

Dissertations

The purpose of the study was to examine the impact of cancer caregiving on primary caregivers, exploring their personal narratives looking back on the entire experience from diagnosis, through treatment, and beyond. Caregiving is associated with exacerbation of stress-related disorders such as hypertension and heart disease and may also be associated with increased mortality rates. Transitions theory served as the conceptual framework for the study.

[Excerpt From] Core Competencies Of Civility In Nursing & Healthcare, Cynthia Clark

Sigma Publications: Book Excerpts

This item record pertains to an excerpt from Core Competencies of Civility in Nursing & Healthcare, which is provided free of charge by the publisher.

About this book:

Incivility and other workplace aggressions have a significant impact on the lives of healthcare professionals, faculty, and students, as well as the patients and families in their care. Incivility in academic and practice environments can provoke uncertainty and self-doubt, weaken self-confidence, and cause detrimental and lasting effects on individuals, teams, and organizations. These behaviors can fracture relationships and result in life-threatening mistakes, preventable complications, harm, or even the death of a …

Workplace Bullying: Exploring The Prevalence, Impact, And Consequences To Nurses, Peggy Ann Berry

Dissertations

Most novice nurses will experience workplace bullying (WPB) behaviors within 1-2 years of licensure. This exposure adversely affects work productivity. The purposes of this study were to (1) explore factors that resulted in the adoption of WPB behaviors; (2) determine the differences in perceived stress, anxiety state, and posttraumatic stress symptoms based on bullying exposure frequencies and select nurse characteristics; and (3) explore strategies to manage or stop WPB behaviors.

Perceptions Toward A Restraint-Free Practice: A Case Study, Suzanne Barnum Goetz

Dissertations

The importance of reducing the use of psychiatric-mental health mechanical restraints has been the focus of clinical nursing practice. A hospital with two psychiatric-mental health units has demonstrated a sustained success related to reducing mechanical restraints. In this qualitative case study, nurses were interviewed to understand how the reduction of mechanical restraints on the psychiatric-mental health units impacts the practice culture and the perception of the psychiatric nurses toward a mechanical restraint-free practice. This study provided new knowledge related to evidence from the psychiatric-mental health nursing practice, themes of barriers, and facilitators toward a restraint-free practice. The participants describe the …

Weaving Empathy Into Simulation Pedagogy: Nursing Simulation Faculty Barriers And Strategies To Cultivating Empathy In Nursing Simulation Pedagogy, Tamara Holland

Dissertations

The purpose of this interpretive phenomenological study was to develop a deeper understanding of the strategies and barriers to weaving empathy into simulation pedagogy so stakeholders and educators may be able to develop a blueprint for improving simulation pedagogy and improving empathy levels of nursing students. The conceptual framework that guided this research was the National League of Nursing Jeffries simulation theory (Jeffries, 2016). This investigation used an interpretive phenomenological design consistent with principles originally identified by Heidegger (1927/1962) and a modified hermeneutic analysis further developed by Diekelmann, Allen, and Tanner (1989).

A Web-Based Learning Adaption Of The Ending Self-Stigma (Ess) Program, Shari Harding

Dissertations

The purpose of this practice project (SPP) was to implement and evaluate a web-based learning adaptation of the Ending Self Stigma (ESS) curriculum, a group-based program to reduce mental illness self-stigma. The literature currently supports group-based, psychoeducational, face-to-face interventions for self-stigma. This project adapted current evidence-based content to the web-based learning modality as an individual, technology-based, intervention. The intervention was evaluated using a mixed methods approach with a pre- and post-test design among adults receiving outpatient mental health services. The dependent variables of interest in this project were the self-stigma of mental illness and recovery orientation. This study found that …

Development And Evaluation Of A Nurse Practitioner-Directed Medication Adherence Program For Adults With Hypertension In An Academic Medical Center, Adrienne E. Thorne

Dissertations

Hypertension affects one in three American adults and is the leading modifiable risk factor of atherosclerotic cardiovascular disease deaths (Arnett et al., 2019). Medication adherence to antihypertensive medications plays an important role in controlling hypertension. Adherence is affected by multiple factors such as medication side effects, multiple medication regimens, and being asymptomatic, as well as social and economic factors, patient-related factors, therapy-related factors, comorbid conditions, and health care system factors (Egan, 2019). Frequent interactions between patients and providers and medication refill reminders have shown to improve medication adherence in cardiac patients (Lambert-Kerzner et al., 2015), thus this project focused on …

Empowering Nurses Of Minority In The Face Of Incivility And Bullying: Through The Lens Of Phenomenology, Corrine M. Floyd

Dissertations

Up to 85% of nurses have reported exposure to incivility in the workplace (Hunt and Marini, 2012). The often-subtle nature of incivility toward nurses in a minority population may partially explain why it remains a problem. Healthcare organizations realize the need for civility to counter the high turnover rate, staff shortages, and low job satisfaction reported by nurses, but lack understanding of how nurses of a minority population perceive incivility and bullying. This study aimed to answer the research question how do nurses with minority representation experience incivility and bullying versus empowerment in the workplace? A descriptive phenomenological design used …

Improving Tobacco Cessation Processes For Behavioral Health Professionals In Primary Care, Iesha R. Floyd

Dissertations

The purpose of this quality improvement project was to develop evidence-based tobacco cessation recommendations through a pre-program evaluation of current tobacco cessation processes at a Federally Qualified Health Center in Casa Grande, Arizona. The primary investigator explored tobacco screening and counseling practices within the behavioral health department. The project took place alongside two similar projects focused on the pharmacy and primary care departments. Together the three projects functioned together to develop evidence-based recommendations, for implementation by future Doctor of Nursing Practice student cohorts.

Provider-Focused Lgbtqia+ Education: A Quality Improvement Effort, Amir W. Raad

Dissertations

The purpose of this quality improvement doctoral project was to implement an educational session at Southwest Behavioral & Health Services (SB&H) in rural Kingman, Arizona. The provider education focused on promoting transformational change in mental health provider awareness through education on health disparities, health related risk factors, interpersonal communication, and cultural sensitivity specific to the lesbian, gay, bisexual, transgender, queer/questioning, intersex, and asexual/allies population (LGBTQIA+).

A Clinical Practice Guideline: Hospice Care In The Emergency Room, Samer Saad

Dissertations

Hospice patients use the emergency department (ED) for the management of symptoms, making it necessary for ED nurses to be equipped with the knowledge and skills to care for hospice patients. EDs should have staff specially trained to address end-of-life needs due to ED staff's minimal knowledge of treating and managing hospice patients. When healthcare organizations fail to provide clinical practice guidelines (CPG) and collaborate with significant stakeholders adequately, gaps in care delivery can occur, and hospice care is often not delivered safely. Standardized guidelines on end-of-life care in the ED should provide adequate guidance for ED nurses in bridging …

Combining Self-Care Strategies And Principles Of Adult Learning: Supporting Rn-To-Bsn Students During The Covid-19 Pandemic, Christine R. Espina, William Lonneman

Creating Healthy Work Environments (CHWE)

In the early phases of COVID-19, faculty adjusted assignments to support and center RN-to-BSN students as practicing nurses. This presentation will discuss how faculty combined theory-guided self-care strategies and principles of adult learning to strengthen the learning community as a source of strength and support for working nurses in COVID-19.

Transforming Perceptions Of Communication And Trust Through Utilization Of Unit-Based Shared Governance And Transformational Leadership, Shelby Do

Creating Healthy Work Environments (CHWE)

Leadership is essential at the unit-level where interprofessional collaboration is critical to quality of care, workforce satisfaction, and employee retention. Shared governance councils are composed of engaged employees. Utilizing this resource, with transformational leadership, can directly impact the communication and trust perceived and support collaborative relationships between leaders and staff.

Organizational Readiness For Mentorship In Nurse Anesthesia Programs, Gloria Chan

Creating Healthy Work Environments (CHWE)

Mentorship and its benefits has been studied in the literature, including the beneficial effects it has toward Resident Registered Nurse Anesthetists. This descriptive study assessed and analyzed the state of mentorship in nurse anesthesia programs, and the organizational readiness to implement mentorship from the perspective of nurse anesthesia program directors.

Set Up For Success: How The Pathway To Excellence® Framework Supports Ambulatory Care Nurses, Patience Harris, C. Preston Lewis, Rebecca Graystone

Group: American Nurses Credentialing Center (ANCC)

Healthcare is undergoing dramatic and unprecedented change. In particular, care delivered by nurses in ambulatory care settings, chiefly telehealth, has seen explosive growth in 2020 fueled by COVID-19. Now more than ever, ambulatory care nurses are called upon to coordinate and provide care in an array of hospital-based and nonhospital settings. Although the COVID-19 pandemic has exacerbated the existing demand for new nonacute care delivery models and settings, several factors have contributed to this tipping point.

Automated Medication Dispensing Cabinet And Medication Errors, Marie Walsh

Dissertations

The number of deaths due to medical errors in hospitals ranges from 44,000 to 98,000 yearly. More than 7,000 of these deaths have taken place due to medication errors. This project evaluated the implementation of an automated medication dispensing cabinet or PYXIS machine in a 25-bed upper Midwestern critical access hospital. Lewin's stage theory of organizational change and Roger's diffusion of innovations theory supported the project. Nursing staff members were asked to complete an anonymous, qualitative survey approximately 1 month after the implementation of the PYXIS and again 1 year later. Questions were focused on the device and its use …

An Outcome Evaluation Of An Evidenced-Based Leadership Framework On Nursing Retention In A Tertiary Medical Center, Robbie G. Rabe

Dissertations

An evidence-based leadership (EBL) framework is an intervention designed to facilitate organizational changes such as the reduction of nursing turnover and the improvement of nursing job enjoyment. This project provides an overview of the effect of nursing turnover on an organization, presents the components of the EBL framework, and provides an evaluation of the influence of EBL on nursing turnover and job enjoyment. The EBL framework provided a method for reducing variance in leadership skill and behavior by outlining specific methods necessary to reduce inconsistency. The project objective was to determine if the implementation of an EBL framework for 820 …

Reducing Parental Concern For Vaccine-Associated Pain In Infants, Mona K. Abukhaled

DNP and Student Works

Vaccines are the most common source of iatrogenic pain in infants and studies have shown that parental concern for this pain contributes to vaccine hesitancy. Addressing these concerns can encourage parents to consent to infant immunization. The purpose of this evidence-based practice project was to perform non-pharmacological pain relief methods for infants up to six months old and assess the effect on parental concerns for vaccine-associated pain. For this, a pre- and post- method design was performed over eight weeks. A statistically significant reduction in the level of parental concern for infant pain from pre- to post- implementation was observed. …

Improving Patient Satisfaction In The Medical-Surgical Setting, Victoria A. Ogundeko

DNP and Student Works

Patients' experiences at hospitals are multidimensional, and their satisfaction with the service is linked to the quality of patient care provided. In evaluating the quality of care of a hospital, the nursing handoff of patients, and the engagement efforts of healthcare staff is an important element of patient satisfaction. In adult medical-surgical patients, does the implementation of nursing bedside handoff reports, compared to the current method of nursing practice desk handoff reports, improve patient satisfaction scores by 10% within two months?

Coincidental Collaboration: Creating A Global Nursing Leadership Community Of Practice, M. Kathleen Murphy, Lisa Darsch, Vicky Treacy-Wong, Amy L. Anderson, Kaci Hickox, Kate White

International Nursing Research Congress (INRC)

Communities of Practice are an efficient and effective way for global nurse leaders to connect, enhance leadership practice, and create a sustainable infrastructure for nursing leadership development and advancement.

Chronicling Resident And Staff Outcomes Throughout The Implementation Of A Professional Nursing Practice Model In One Midwest Continuing Care Retirement Community: A Longitudinal Analysis, Kimberly Michele Bergen-Jackson

Dissertations

This research used a case study approach to chronicle the process of seeking the American Nurse Credentialing Center's Pathway to Excellence in Long-Term Care designation in one Midwest community. The PTE-LTC practice standards framework guided the implementation of professional nursing practice which focused on a positive practice environment, shared decision-making, accountability for resident care, and the leadership development of nursing staff. These practice standards are outlined in the study and incorporated the major components necessary to implement Professional Nursing Practice and Shared Governance in long-term care. The components of the designation process over a five-year period were documented and compared …

Essential Oil Therapy For Alleviation Of Discomfort In Surgical Patients, Nenhuan Huang

DNP and Student Works

Post-surgical pain (PSP) has not been sufficiently managed despite routine opioid use. The adverse effects of opioids led to the search for non-pharmaceutical intervention. The PICOT question that guided this project was, "In an acute hospital surgical setting, does essential oil therapy complement pain and discomfort relief comparing to conventional pain management alone after 6 weeks?" Seven clinical studies, five systematic or integrative reviews, and four conference proceedings were reviewed. The evidence supported lavender essential oil for the alleviation of PSP and discomfort. Patients breathe through a personal lavender essential oil inhaler hourly or every 2 hours. The percentage means …

The Effect Of Medication Reconciliation Timeout On Patient Safety: An Evidence-Based Project, Renante Dizon

DNP and Student Works

There was a report of a high rate of medication errors from inaccurate medication reconciliation during admission to a local hospital in South Texas. The medication error rate was 14.88% on 20 reviewed charts, and 85% of all evaluated charts contained at least one medication discrepancy.

This evidence-based, system-change project was guided by the following PICOT question: For nurses administering medication in a long-term acute care hospital, does the implementation of Medication Reconciliation Timeout Process (MRTP) decrease the medication errors, compared to the usual medication practice, in one month?

Improving The Timeliness Of Retinal Exams, Laura Edwards, Andrew Nydegger

Group: Samford University Moffett & Sanders School of Nursing

Diabetic retinopathy (DR) is a deterioration of the retina due to damage caused by diabetes. This condition can cause vision distortion and blindness. Screenings for this condition are an important part of regular diabetes management. Currently there are more than 30 million people with diabetes mellitus. Veterans have a 2.5 higher rate of diabetes than the general public and are therefore at higher risk of DR. It is important that healthcare professionals treating diabetic patients routinely screen for this condition. Early detection can help guide care and prevent deteriorations that could lead to blindness. Currently, the national goal for the …

Using Simulation To Enhance Environmental Cleaning Practices In Diverse Healthcare Settings, Alaina Herrington, Michelle Parr, Meg Ziminsky

Group: Samford University Moffett & Sanders School of Nursing

Inadequate cleaning and disinfection practices in the healthcare setting create an environment in which infectious pathogens can linger for days or even weeks on high-touch surfaces, presenting an increased risk of infection transmission to healthcare workers and patients. The World Health Organization recently cited environmental cleanliness as a key element for infection control across all healthcare settings. Yet researchers have found that less than half of all surfaces in United States healthcare settings are adequately cleaned. In the three study settings, administrators have recently documented significant incidences of non-compliant environmental cleaning behaviors of healthcare workers, related patient complaints, and the …

Acuity-Based Assignments To Decrease Missed Nursing Care, Peggy Hershberger

Group: Samford University Moffett & Sanders School of Nursing

Nurses strive to deliver quality patient care in a healthcare environment that can be very challenging at times. High patient acuity is one of many variables that contribute to the difficulties that nurses face in the acute care setting. Despite the greatest intentions and persistence to attend to every need and complete every task, nurses may find themselves omitting care when assigned multiple high acuity patients. Previous studies have found that elements of nursing care included in this project are missed an average of 62% across hospitals worldwide. In the study hospital, the nurses on the inpatient renal unit reported …