Business Commons^™

Adaptive Leadership: Nurse Executives Building Organizational Adaptive Capacity During Times Of Crisis, Challenge, And Change, Kristian Poitier

Dissertations

Purpose: The purpose of this exploratory phenomenological study was to identify and describe the strategies used by nurse executives in acute care hospitals to build an adaptive capacity based on the five key characteristics of adaptive leadership identified by Heifetz et al. (2009).

Methodology: This qualitative phenomenological study identified and described the perceived impact of adaptive leadership on building an organization’s adaptive capacity as perceived by nurse executives in acute care hospitals, for-profit and not-for-profit, with the title of chief nursing officer (CNO) or chief nurse executive (CNE) in Southeast, West, and North Florida. The researcher was part of a …

A Job Satisfaction Evaluation Of Nursing In The United States And Greece Utilizing The American Nurses Association's Scope And Standards Of Practice, Audrey Narhi

Honors Projects

Nursing is a multifaceted profession that is constantly evolving with the health needs of the populations it serves. Professional organizations within the field utilize evidence-based practice to provide guidelines of what best-practice nursing is. This study aims to evaluate if the American Nurse's Association (ANA), a professional nursing organization in the United States, supports the realities of nursing in a rural US hospital. An international perspective is also considered by evaluating the same principles to a urban hospital in Athens, Greece. Categories that align with ANA Scope and Standards, including workplace environment, career development, supervisor relationships, and personal work practice, …

Psychological Safety And Conflict Management Among Nurse Practitioners In Interprofessional Teams, Scott Faust

Electronic Theses and Dissertations

This quantitative correlational study explored the relationships between perceived psychological safety, conflict management styles, and perceived conflict management success among nurse practitioners (NPs) operating in interprofessional acute or critical care teams in the United States. Despite existing literature on conflict management and psychological safety, there is a noticeable gap concerning the interplay of these factors, specifically among NPs. A multi-item survey was developed from validated measures to assess psychological safety, conflict management success, and conflict management style. The final sample included 944 NPs. The findings revealed a statistically significant difference in the scores of perceived psychological safety, depending on the …

Implementation Of A Wellness Program For Nurse Leaders, Ericson A. Fernando

Master's Projects and Capstones

Background: The setting for this study is the implementation of a wellness program for nurse leaders at Hospital A, a healthcare organization servicing the South Sacramento area in California. Healthcare is a challenging and high-demand profession, and the COVID-19 pandemic has exacerbated an issue of burnout and unwavering job-related stress for physicians and employees. This remains true for nurse leader professionals who take on the responsibility to ensure safety and quality always remains at ideal measures for any facility.

Problem: During the past several years of the pandemic, the nurse leader role has had to endure several unknowns, placing significant …

Using Drama Therapy To Foster Peer Support Among Nurse Leaders, Chyela Rowe

Expressive Therapies Dissertations

This study explored the use of drama therapy to support the social-emotional experiences of nurse leaders at a mid-sized regional hospital system in the Southeastern United States. Nurse leaders have experienced profound changes to their work environments in recent years and burnout has been at an all-time high among healthcare workers globally. Organizational supports for nurses and nurse leaders are both inadequate to meet the needs and under-resourced. The research questions explored 1) whether the drama therapy peer support initiative improved outcomes and 2) whether there was a significant relationship between measures, and 3) what nurse leaders described as facilitators …

Burnout: An Examination Of How Human Services’ Cultures Impact Person-Centered Care And Job Satisfaction, Ebony Webb

Master's Projects and Capstones

In a world that demands the constant requirement of adaptability and technology, the need for ‘hands on the ground’ continues to persist, and perhaps even grow. This research project explores burnout in the healthcare and nonprofit settings, as a pre-existing and ongoing issue, that was brought to centre-stage during the Covid-19 pandemic. The researcher explores the intersections of burnout with workplace culture, person-centered care (PCC), sweat equity and duty-of-care, through expert interviews and literature reviews. Data collected provides an immediate understanding of current workplace cultures and environments for human service providers, in both healthcare and nonprofit sectors. While the data …

The Investigation Of Resilience As A Moderating Factor On Burnout And Intention To Stay In Nursing Professionals., Florina Karasik

Walden Dissertations and Doctoral Studies

The intention to stay in nursing staff working with adult patients in a hospital setting is a major concern for healthcare organizations because of its effect on patient health outcomes. Grounded in the social cognitive career theory, the purpose of this quantitative correlational study was to investigate resilience as a moderating factor in the relationship between burnout and intention to stay for licensed registered nurses with BSN degrees working with adults in a hospital setting. The participants were 80 licensed registered nurses with BSN degrees working with adults in a hospital setting in the United States of America. The results …

When "First, Do No Harm" Fails: A Restorative Justice Approach To Workgroup Harms In Healthcare, Pedro L. Flores

Dissertations

In healthcare, workgroup mistreatment is a pervasive problem that begins during medical education (medical and nursing school) and becomes embedded in the “hidden curriculum of professionalism,” which dissuades and even punishes learners for talking about abuse they witness. Furthermore, the mistreatment of healthcare providers (HCPs) pervades all disciplines in the healthcare delivery chain due to a combination of cultural factors, systemic pressures, dysfunctional hierarchies, and leadership’s tolerance of intimidating and disruptive behaviors. Not surprisingly, 18% of U.S. HCPs have left the medical field since the start of the COVID-19 pandemic, and burnout, stress, anxiety, and increased workloads have been identified …

Relationship Between Ethnic Diversity Of Nursing Leadership And Bedside Nursing Engagement, Neneh Iyesha Kamara

Walden Dissertations and Doctoral Studies

Ethnic diversity in the U.S. nursing workforce had not been well researched. This aspect of nursing is important to the advancement of the profession because ethnic diversity of nursing helps reduce health care disparities. The purpose of this quantitative correlational study was to examine the possible relationship between the perceived ethnicity of nurse leaders and the engagement of bedside nurses. Culture of care theory was the theoretical foundation for this study. The Utrecht Work Engagement Scale with additional demographic questions was used to survey 53 bedside nurses with 2 or more years of experience. Simple regression was used to analyze …

Increasing Nurse Leader Knowledge And Awareness Of Information And Communication Technologies, Cory Stephens

Walden Dissertations and Doctoral Studies

Due to the recent coronavirus disease (COVID-19) pandemic, rapid technological innovation and nursing practice transformation exposed a deepening divide in the knowledge and awareness of information and communication technologies (ICT) among nurses. This technological skills gap undermines the benefits of ICT to nursing practice such as increased nurse satisfaction, improved care quality, and reduced costs. Nurse leaders are positioned to promote the use of ICT among nurses but may suffer from the same knowledge deficit of ICT as their followers. Guided by Locsin’s technological competencies as caring in nursing theory, Staggers and Parks’ nurse-computer interaction framework, and Covell’s nursing intellectual …

Educating Nurse Leaders On The Application Of Watson’S Caring Science, Diane Lm Updyke

Walden Dissertations and Doctoral Studies

Nurse leaders’ creation of a culture of caring for their nursing staff has been shown to improve nurses’ job satisfaction and retention, and ultimately patient outcomes. At the project site, there was a perceived gap in nursing leadership practice in integrating a culture of caring into leadership and management practices. Although staff and leadership identified similar caring behaviors, staff members did not perceive nursing leadership as caring, which affected the former’s job satisfaction. The purpose of this education project was to provide site leaders with information on specific caring behaviors and how to model these behaviors with staff using Watson’s …

A Peer Feedback Process To Improve Assistant Nurse Manager Job Satisfaction, Juanita A. Jularbal-Walton

Doctor of Nursing Practice (DNP) Projects

Problem

Healthcare organizations offer different methods of training for emerging and newly hired Assistant Nurse Managers (ANM). Without sufficient orientation to what the role requires, new ANMs receive many requests without adequate guidance on how to respond to patient, staff, and leadership requests. This experience creates unhealthy work environments with low job satisfaction and high turnover rates.

Context

Peer feedback provides an opportunity to reflect on the purpose of the Assistant Nurse Manager role. With sufficient orientation and peer feedback, front-line assistant nurse managers develop competency and role satisfaction, as evidenced by reduced turnover and improved retention.

Intervention

This project …

Tiny Tusks Internship: Marketing Towards Breastfeeding: How Marketing Can Either Help Or Hinder How Breastfeeding Is Perceived, Hailey Tremmel

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Tiny Tusks Breastfeeding and Infant Support is a program run by faculty and students in the Eleanor Mann School of Nursing program that allows for breastfeeding mothers in attendance at the University of Arkansas sporting events to have a place to pump or provide care to their infant. How marketing towards breastfeeding is portrayed has a huge impact on helping breastfeeding mothers to feel properly educated and supported about the decision to breastfeed. The purpose of this literature review is to demonstrate how marketing tactics can affect the view of breastfeeding, whether that be positive or negative. The results found …

A Sequential Explanatory Mixed Methods Study Of Chief Nurse Executives On Creating A Culture Of Inclusiveness, Toloue Aria

Dissertations

Purpose: The purpose of this sequential explanatory mixed methods study was to identify and describe the leadership strategies that exemplary chief nurse executives use in inpatient acute care hospitals located in Southern California to create an organizational culture of inclusiveness using Kennedy’s (2008) 5 leadership qualities of cultural differences.

Methodology: A sequential mixed methods research design was selected to answer this study’s research questions. The researcher was a part of a thematic group of 10 peer researchers and 7 faculty advisors. Through purposeful sampling, the researcher selected 18 exemplary chief nurse executives for survey data collection using instrumentations developed …

Relationship Between Employee Satisfaction And Patient Satisfaction Within The Veterans Affairs Health Care System, Krista Penn

Walden Dissertations and Doctoral Studies

Within health care organizations, the experience of care is a critical measure of the quality of a health care system and is an important measure of success. Over the past several years, the quality and experience of care have been criticized within the Veterans Health Administration. Veterans Health Administration hospitals suffer from low patient satisfaction scores and high nurse turnover rates. Research shows a correlation between patient satisfaction and employee satisfaction within other health care organizations, yet there has been limited research on whether this type of relationship exists within facilities across the Veterans Health Administration. Using Donabedian’s quality health …

Relationship Between Nurse-To-Patient Ratios, Patient Satisfaction Scores, And Hospital Profitability, Patrick Ross Bumstead

Walden Dissertations and Doctoral Studies

In 2019, hospital profitability margins were at their lowest levels since the great recession due to a declining volume of patients. Hospital executives who fail to improve profitability are at risk of sustainability. Grounded in the service-profit chain theory, the purpose of this quantitative correlational study was to examine whether nurse-to-patient ratios and patient satisfaction scores significantly predict hospital profitability. Data were collected from 74 hospitals in Southern California from the Centers for Medicare & Medicaid Services government database and publicly available financial statements. Results from multiple regression analysis were not statistically significant. A key recommendation is for hospital executives …

Evidence-Based Hospice Care Education For Healthcare Clinicians, Nonie E. Weir

Walden Dissertations and Doctoral Studies

Vulnerable populations with a terminal illness, who reside in a nursing home setting, continue to experience psychological, physical, and emotional effects that lead to end-of- life (EOL) suffering and discomfort. Globally, millions of individuals receive care from a hospice provider. By 2030, this figure will triple due to the increased lifespan of the geriatric population. The literature review has revealed that the practical problem is the lack of hospice care education received by healthcare clinicians. It is, therefore, important to prepare and educate healthcare clinicians about a peaceful death through an individualized plan-of-care (POC) from a holistic approach. The purpose …

Perceptions Of Nurse's Personal Smartphone Use At Work, Esperanza Criscuolo

Walden Dissertations and Doctoral Studies

Distracted nurses who use their personal smartphone at work has resulted in the diversion of attention from patient care. The specific problem is the personal smartphone use by nurses in the hospital settings has resulted in distracted patient care, leading to wrongful release of patient’s information, medical errors, injury or preventable patient death. The purpose of this qualitative study was to describe the perceptions of nurses regarding distracted patient care in their clinical workplace due to personal smartphone use by nurses. The study was grounded in the distraction-conflict theory conceptual framework. The key research question examined the perceptions of nurses …

Caring For The Caregiver: Second Victim Recovery Following A Serious Medical Error, Beulah Patrice Vance

Walden Dissertations and Doctoral Studies

In 1999, it was estimated that 98,000 deaths were attributed to medical errors and were the fourth most common cause of death in the United States. In 2016, medical errors were estimated as the third leading cause of death, with a mean death rate of 251,454 each year. Nurse involved in errors are known as second victims. Almost one in seven staff members reported that they had experienced a patient safety event within the last year that caused personal problems such as anxiety, depression, or concerns about their ability to perform their job. This project explored whether nurses are able …

Improving Clinical Communication And Collaboration Through Technology, Michelle Machon

Doctor of Nursing Practice (DNP) Projects

Problem: Over the last 30 years, clinical communication methodologies in healthcare have evolved to become such disparate systems that they lead to confusion, wasted time, and clinician dissatisfaction. The Joint Commission (2016) reports up to 78% of sentinel events in hospitals are linked to communication failures, which have obvious implications for hospital systems in the quality and safety of their current communication systems.

Context: The purpose of this project was to determine the effectiveness of implementing a unified clinical communication technology platform in an acute care hospital setting and to make recommendations from that implementation to the organization’s larger health …

Chief Nurse Executive Work Engagement: System Leadership Through A Natural Disaster, Strike, And Pandemic, Ryan Fuller

Doctor of Nursing Practice (DNP) Projects

Problem. In a 21-hospital region of a 39-hospital integrated health system, CNE turnover peaked at 63% (12 CNEs) in 2015. Interviews were conducted in 2019 with 12 CNEs across the region to understand potential issues related to CNE job satisfaction. Responses revealed concerns regarding empowerment, alignment, work-life balance, information transparency/sharing, and recognition. While identifying a solution to address CNE concerns, the organization experienced successive crisis events during a 12-month period that included a record-setting wildfire, multiple labor union strikes, and a novel pandemic. The regional leadership team (RLT) required new approaches to facilitate effective communication during a crisis between the …

A Strategic Plan To Thread Genomics Competencies Into Undergraduate Curriculum, Holly Mathis

Dissertations

Problem: Genomics in undergraduate nursing education has experienced slow adoption in the United States. Various approaches have been proposed but do not address barriers to successful implementation.

Methods: A strategic plan was developed to increase the amount of genetics and genomic content in the curriculum of an undergraduate nursing program. A gap analysis was performed on the curriculum revealing a paucity of content. A SWOT analysis informed the strategic plan, which included a faculty education program using the ANA/ISONG’s Essentials of Genetic and Genomic Nursing: Competencies, Curricula Guidelines and Outcome Indicators (2^nd ed.) (2009) as a foundation.

Results: Faculty …

A Study Of Job Satisfaction And Turnover Intention Among Acute Care Nurses Working In Rural And Urban Settings, Yasin Yasin

Electronic Thesis and Dissertation Repository

In Canada, a close look at the nursing workforce shows a decline due to limited supply and increasing demand resulting in a looming shortage in the near future. Retaining nurses’ is a key strategy to overcome the shortage by limiting nurses’ turnover. Nurses’ job dissatisfaction is the most significant predictor of turnover intention and is associated with undesired outcomes such as nurses’ absenteeism, burnout, low service quality, and patient dissatisfaction. The differences in factors affecting job satisfaction between rural and urban nurses have not been fully studied. This study aimed to identify the differences and similarities in the extrinsic and …

Therapeutic Communication Skills For Nurses Working With People Living With Hiv, Charaine Ferguson

Walden Dissertations and Doctoral Studies

Internalized stigma experienced by people living with HIV (PLWH) has been associated with numerous untoward health outcomes. Nurses' and healthcare professionals’ ability to effectively communicate can significantly affect the experience of stigma in PLWH. The practice-focused question was whether an interactive educational project could improve the knowledge and intent to use collective communication skills in nurses. This project uses concepts from Peplau's interpersonal relationship theory, principles of therapeutic communication, and unconscious bias. Online training content included patient testimonials related to stigma, discussions of unconscious bias by the Institute for Healthcare Improvement and Mayo Clinic professionals, review of Harvard University’s Implicit …

Motivating Factors For Nurses Aged 65 Years And Older To Extend Their Work Life, Dr. Cynthia M. Dobek

Walden Dissertations and Doctoral Studies

Nurses age 65 years and older who retire will leave a knowledge gap in the workforce unless motivated to continue working. A knowledge gap in the workforce is of concern to human resource professionals because healthcare professionals may not be able to keep pace with the increase in patients needing medical care. Grounded in Maslow’s hierarchy of needs theory, the purpose of this qualitative single case study was to explore what factors motivated nurses aged 65 years and older to extend their work life. The participants comprised 6 nurses aged 65 years and older who were still working or semiretired …

Coaching Nurse Leaders In Conflict Management And Team Building To Improve Retention, Jeanette Black

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: Retention of assistant nurse managers (ANMs) was identified as a concern from interviews with executive leadership and ANMs employed at a large hospital within a Northern California integrated health system. The nurse leader orientation training was reviewed, with gaps identified in conflict management and team building.

Context: The attrition rate of U.S. nurse managers in 2010 was 8.3%, higher than executive nurse leaders, with replacement costs equal to 75% - 125% of a nurse manager’s salary (Loveridge, 2017). Employee turnover and dissatisfaction due to conflict can have detrimental effects on retention, productivity, morale, and quality of patient care. …

A Market Analysis Of Pay Rates For New Graduate Certified Registered Nurse Anesthetists, Zachary Halliwell

Doctoral Projects

The profession of Certified Registered Nurse Anesthetists (CRNA) is a thriving occupation. In their national Occupational Outlook Handbook, the Bureau of Labor Statistics (U.S. Department of Labor, 2018), reported the national market for CRNAs is predicted to continue its steady growth through 2026. The Bureau of Labor Statistics (BLS) provides numerous statistics, as previously mentioned, on their website. However, the stats available include CRNAs of varying experience levels. The Mississippi Department of Employment Security (MDES) has a few statistics, online, regarding the market for CRNAs. The data provided by MDES, while appreciated, is lacking in numerical significance, given the minuscule …

Academic Center Tiered Operating Room Strategy (Action): Comparing A High Efficiency Or To The Conventional Or, Moaz Bin Yunus Chohan

Electronic Thesis and Dissertation Repository

Canadian healthcare system is under immense economic pressure. In an attempt to resolve the problem, outpatient surgical services were offered to patients presenting with orthopaedic surgical complaints. An observational cohort study was carried out, comparing the conventional surgical setup to the newly designed high-efficiency setup that provided similar care, with a significantly lower operating cost. A total of 200 patients were enrolled in the study. Standardized and unstandardized questionnaires were used to evaluate pre-operative and post-operative patient data that reflected quality of life outcomes. Data was collected at enrolment and during post-operative follow-ups of up to 6 months. Results indicate …

Ambidexterity And Innovation In Chief Nursing Officers In The Healthcare Setting, Jennifer Wasilewski

Walden Dissertations and Doctoral Studies

Leaders in the healthcare setting are challenged with competing responsibilities as they seek to provide high-quality services, ensure the implementation of safety measures, and engage in workforce maintenance. Many researchers have described innovation as a strategic approach to organizational concerns and have noted a failure to implement innovative measures in healthcare. This study was an investigation of the impact of ambidexterity in healthcare leaders on innovation. The purpose of this quantitative study, guided by the ambidexterity theory of leadership for innovation, was to analyze the extent to which ambidextrous leadership characteristics of healthcare executives and chief nursing officers (CNOs) influence …

Strategies For Reducing Nurses' Turnover In Specialty Care Clinics, Lawrence Benjamin

Walden Dissertations and Doctoral Studies

The nursing shortage and high turnover rates are a problem in Canada and the world over. The purpose of this single case study was to explore leadership strategies that nurse leaders in specialty care clinics in Canada use to reduce nurse turnover. The participants were 7 nurse leaders from a single organization with specialty care clinics across Canada who all had above average nurse retention rates when compared to the case organization's average nurse retention rate. The authentic leadership theory was the conceptual framework. Data sources for this study were company documents, participants' semistructured interview responses, member checking of the …