Medicine and Health Sciences Commons^™

The Association Between Nurse Staffing And Quality Of Care In Emergency Departments: A Systematic Review, Jonathan Drennan, Ashling Murphy, Vera J. C. Mccarthy, Jane Ball, Christine Duffield, Robert Crouch, Gearoid Kelly, Croia Loughnane, Aileen Murphy, Josephine Hegarty, Noeleen Brady, Anne Scott, Peter Griffiths

Research outputs 2022 to 2026

Background: The relationship between nurse staffing, skill-mix and quality of care has been well-established in medical and surgical settings, however, there is relatively limited evidence of this relationship in emergency departments. Those that have been published identified that lower nurse staffing levels in emergency departments are generally associated with worse outcomes with the conclusion that the evidence in emergency settings was, at best, weak. Methods: We searched thirteen electronic databases for potentially eligible papers published in English up to December 2023. Studies were included if they reported on patient outcomes associated with nurse staffing within emergency departments. Observational, cross-sectional, prospective, …

Cognitive Behavioral Therapy To Prevent Nurse Burnout In Sub-Saharan Africa, Anna C. Johnson

MSN Capstone Projects

Overall, burnout prevention has been shown to foster nurse resilience, ability to cope with stressors, teamwork, and improving the personal value of “doing good” and “being good”; the effects have been shown to last between 6 months and one year. The current evidence is strong enough to recommend a change to current nursing practice via annual Cognitive Behavioral Therapy (CBT) trainings to strengthen nurse resilience.

This researcher proposes to implement a CBT-based burnout prevention program in Ghana’s capital of Accra in sub-Saharan West Africa. There is ample evidence that African nurses face many of the same burnout issues that nurses …

The Lived Experiences Of The Newly Graduated Generation "Z": Registered Nurse Entering The Intensive Care Unit, Matthew Robert Loveitt

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to illuminate, understand, and describe the meaning of the lived experiences of Gen Z new graduate registered nurses (NGRNs) transitioning directly into the ICU in their first position as registered nurses. Duchscher’s stages of transitional theory and the Strauss-Howe generational theory provided this study’s theoretical framework, focusing on the Gen Z NGRN transition into practice. This study answered the following central research question: What is the lived experience of Gen Z NGRNs transitioning into the ICU work environment employed in their first position as registered nurses? Data were collected for this study …

The Implementation Of Nurse Practitioner Residency Programs To Increase The Employment Retention Of New Graduates, Roni-Jo Panganiban

Master of Science in Nursing Family Nurse Practitioner

This review explores the effectiveness of Nurse Practitioner (NP) residency programs in addressing role strain, burnout, and retaining new graduates. It emphasizes the factors contributing to NP resignations and proposes formal residency programs to improve job satisfaction and retention rates. Research highlights benefits such as enhanced preparedness, credibility, and better patient care, advocating for increased program accessibility and funding. Additionally, the application of the theory of planned behavior underscores compliance with regulations, evidence-based practice, and environmental influences for patient safety in advanced practice registered nursing. The literature review on NP residency programs draws from six empirical articles, focusing on job …

Utilizing Mock Code Simulation To Enhance Nurses’ Confidence A Benchmark Project, Denecia Mark

MSN Capstone Projects

Each year, about 292,000 adult patients in the United States have an in-hospital cardiac arrest (IHCA), with substantial variance in their rate of survival (Merchant et al., 2020). Graduate nurses must be knowledgeable and prepared to respond to codes. Mock Codes or simulation-based teaching will allow nurses to practice skills, expand their knowledge, and gain self-confidence in a secure and controlled setting with no risk to patients, reducing nurses' anxiety. CPR certification is currently updated every two years, and research has shown that learned skills begin to deteriorate after three months. As a result, if simulated codes are introduced skills …

Pre-Shift Mindfulness: An Evidence Based Practice Benchmark Project, Whitney Turner

MSN Capstone Projects

Although a nursing shortage has existed for some time, it seems there is currently a flight of both experienced and young clinicians from the bedside. Over the course of the Covid-19 pandemic, healthcare organizations have seen dramatic increases in turnover and vacancy rates, leading to severe staffing shortages and compromised patient care. Historically, nursing has been a caring, service driven profession, and a calling for millions of professionals. However, nurses are increasingly concerned with their personal wellbeing.

The term “burnout” appeared in the 1970s to describe the consequences of severe stress in “caring” professions, and include symptoms such as exhaustion, …

Implementation Of Coping Strategies For Compassion Fatigue Through Counseling, Caleb R. Turner

MSN Capstone Projects

Many healthcare organizations are struggling to retain nurses due to the recent COVID-19 pandemic. Understanding common reasons for decreased retention in nursing begins with evaluating job satisfaction and how it can be affected (Cuartero-Castañer, 2021). Compassion Fatigue (CF) and Burnout (BO) are two leading causes of decreased job satisfaction (Compassion Satisfaction (CS)). The Professional Quality of Life Scale (PROQoL) (see Appendix C) is designed to identify individuals at higher risk of CF and BO. Using this scale in conjunction with the Peer-Support coaches in the hospital setting allows nurses to have conversations and communicate effectively with coaches trained to have …

Workplace Violence In Emergency Departments, Education And De-Escalation Training: A Benchmark Study, Summer Block

MSN Capstone Projects

Most people do not go to work and fear being assaulted or harassed daily. However, for emergency nurses in this county that is exactly what it has come to. Up to 96% of emergency department nurses state they have been verbally abused. This entails name calling, verbal threats, being shouted at and being sworn at. Anywhere from 25% to 60% of these nurses have had to face physical assaults while on the job. (Al-Aadi, 2020; Copeland & Henry, 2017; Grinberg, 2022; Li et al., 2019; McDermid et al., 2019). Physical assaults can include being spit on, slapped, punched, kicked, choked, …

Mindfulness Meditation To Reduce Nurse Burnout: An Ebp Implementation Project, Lester Denson Jr

MSN Capstone Projects

Hospitals across the United States are suffering from poor staffing (American Nurses Foundation, 2021). A common thread throughout those facilities is that nurses are leaving their jobs due to self-reported burnout, contributing to the staffing shortage and low morale (Shah et al., 2021).

Mindfulness training plays a part in decreasing emotional exhaustion for staff nurses. A reduction of emotional exhaustion has been discovered after the implementation of mindfulness-based intervention programs, with continued improvement after completion of the program (Sarazine et al., 2021; Bianchini & Copeland, 2021). The benefit of this implementation would be a reduction of nurse burnout which ultimately …

Development Of A Resilience Program To Combat Burnout In Nursing Practice, Maggie Lynch

DNP Scholarly Projects

Burnout has been identified as a national health crisis, with implications for the retention and health of critical healthcare workers. Acknowledging the innate stressors of providing healthcare it is the responsibility of leaders in the industry to mitigate burnout to sustain the workforce critical to healthcare in the United States. Understanding resilience and how to foster it in nurses will contribute to burnout prevention and consequently improve the quality of health care provided Americans. Resilience training has been identified as a valuable approach to retention of the workforce. This scholarly project developed a resilience training program for newly licensed registered …

Job Satisfaction And Burnout In Nursing, Tasha M. Tovar

MSN Capstone Projects

Job satisfaction, or lack thereof, can directly lead to burnout. Nursing is known globally as a high-stress career, thus leading to an increased level of burnout. Job burnout is among the most important occupational disorders and phenomena which have received great attention in the recent century (Nabizadeh et al., 2020). Multiple studies have proven that subtle, low-cost interventions can decrease the burnout experienced by nurses, leading to reduced turnover rates and an increase in the quality of patient care. Higher quality of care leads to improvement in patient satisfaction scores and also to increased reimbursement rates (Jun et al., 2021). …

A Scoping Review Of Nurse-Led Randomised Controlled Trials, Marion Eckert, Kate Kennedy, Kim Neylon, Claire M. Rickard, Samantha Keogh, Richard Gray, Sandy Middleton, Caroline Homer, Lisa Whitehead, Greg Sharplin

Research outputs 2022 to 2026

Background: Nurses comprise the largest portion of the healthcare workforce worldwide. However, nurse representation in the leadership of clinical research and research funding is largely unknown. The Australasian Nursing and Midwifery Clinical Trials Network was established to provide a coordinated network, focussed on building research capacity in nursing and midwifery. To support this work, this scoping review of nurse-led randomised controlled trials was conducted to summarise research activity, as well as highlight future research directions, gaps and resources. Midwife-led trials will be reported elsewhere. Aim: To quantify number, type and quality of nurse-led randomised controlled trials registered between 2000–2021. Design: …

Integrative Review: Factors Impacting Effective Delegation Practices By Registered Nurses To Assistants In Nursing, Carol Crevacore, Elisabeth R. Jacob, Linda L. Coventry, Christine Duffield

Research outputs 2022 to 2026

Aim

To identify the evidence on factors that impact delegation practices by Registered Nurses to Assistants in Nursing in acute care hospitals.

Design

An integrative review.

Data Sources

Database searches were conducted between July 2011 and July 2021.

Review Methods

We used the 12-step approach by Kable and colleagues to document the search strategy. The (Whittemore & Knafl. 2005. Journal of Advanced Nursing, 52(5), 546–553) integrative review framework method was adopted and the methodological quality of the studies was assessed using Joanna Briggs critical appraisal instruments.

Results

Nine studies were included. Delegation between the Registered Nurse and the …

A Hybrid Systematic Narrative Review Of Instruments Measuring Home-Based Care Nurses' Competency, Khairul D. B. Rusli, Wei L. Chua, Wei H. D. Ang, Seng G. M. Ang, Ying Lau, Sok Y. Liaw

Research outputs 2022 to 2026

Aim: The aim of the study was to identify and synthesize the contents and the psychometric properties of the existing instruments measuring home-based care (HBC) nurses' competencies. Design: A hybrid systematic narrative review was performed. Review Methods: The eligible studies were reviewed to identify the competencies measured by the instruments for HBC nurses. The psychometric properties of instruments in development and psychometric testing design studies were also examined. The methodological quality of the studies was evaluated using the Medical Education Research Study Quality Instrument and COSMIN checklist accordingly. Data Sources: Relevant studies were searched on CINAHL, MEDLINE (via PubMed), EMBASE, …

Feasibility Of A Mindfulness Education Module For Nurses: An Evidence-Based Practice Project, Executive Summary, Emily Looper, Palmer Gleason, Dr. Katherine Newnam

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

Nurse burnout is a well-defined problem that has been exacerbated by the COVID-19 pandemic and negatively affects nurses’ mental health, nursing shortages, patient safety, and quality of care. Evidence shows that mindfulness is an effective strategy for managing stress and decreasing burnout in nurses. This article describes an evidence-based practice project that translated this evidence into practice via a vetted mindfulness educational intervention for nurses in intensive care and acute care settings. The purpose of this project was to assess the feasibility of this educational intervention, processes, and outcomes with the goal to extend the project hospital-wide. Pre-intervention levels of …

Influence Of Job Stress, Fatigue, Happiness On Sleep Quality Of Shift Work Nurses, Minjeong Kang, Yeon Sook Kim, Insun Jang

Nursing Faculty Publications

Purpose: This descriptive study aimed to identify relationships among shift work nurses’ job stress, fatigue, happiness, and sleep quality and the factors causing decrease in sleep quality to establish fundamental data for effective intervention strategies. Methods: The data were collected using a structured questionnaire from June 11 to 19, 2018, and study participants were 198 nurses working rotating shifts in a university hospital. Results: The quality of sleep showed a mean of 15.77±5.30 and was varied depending on the number of night shifts (p=.001), health status (p=.008), and the number of discomforts at work (p<.001). Sleep quality also showed a significant relationship with job stress (r=.15, p=.040), fatigue (r=.35, p<.001), and happiness (r=-.24, p=.001). Multiple regression analysis (Adj R2=.275) indicated that factors affecting the quality of sleep included the number of discomforts (β=.31, p<.001), fatigue (β=.22, p=.002), and the number of night shifts (β=.19, p=.002). Conclusion: This study suggests that individuals, hospitals, and social systems need to coordinate the number of night shifts and improve discomfort and fatigue by considering factors influencing rotating shift work nurses’ sleep quality.

Impact Of Moral Injury On Work Performance In Nurses Following The Covid-19 Surges, Annette Callis, Trisha Saul, Ross Bindler

Articles, Abstracts, and Reports

Background

Moral Injury (MI) was defined by Jonathan Shay in 1994 as committing acts that betray one’s moral compass in high-stakes situations, while under the authority of another, that severely affect one’s well-being. MI was measured solely in the military prior to the COVID pandemic.

Aims

1.Explore the relationship between moral injury (MI) and perceived work performance in hospital nurses following the pandemic surges. 2. Determine relationships between MI and select participant demographics and between work performance and select demographics.

Sample

A convenience sample of 191 nurses from seven Southern California Hospitals participated in the study from March to June …

Using Simulation To Develop Clinical Judgment In New-To-Practice Emergency Department Nurses: An Evidence-Based Benchmark Project, Moreno Divine Comiskey

MSN Capstone Projects

In the past 6 months, the Emergency Department at the George Washington University Hospital has onboarded over twice as many new-to-practice nurses as experienced emergency nurses. Studies suggest that these new-to-practice nurses often are deficient in clinical judgment, and our observations at our hospital support these findings. Researchers have found that onboarding programs that include simulation have success in improving clinical judgment, and advocate for its use. Simulation gives another angle to the onboarding program in addition to preceptorship and classroom learning, and allows participants to bridge the gap between theory and practice safely and without fear of harming a …

Promoting Nurse Well-Being During A Global Pandemic Through The Community Resiliency Model, Sherissa Manganello

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

Since the COVID-19 pandemic started a few years ago, there has been an increase in mental health issues due to the chronic emotional, physical, and psychological stress that everyone has had to endure. COVID-19 has had long-lasting consequences on the entire healthcare system, especially with nurses as the foundation for providing quality patient care. While nurses are the trusted professionals, they also have one of the most emotionally and physically demanding careers (Ward-Miller et al., 2020). In addition, there is a global health crisis of nursing shortages that continues to grow through COVID-19, which directly affects patients’ quality of care …

Factors Influencing The Development And Implementation Of Nurse Practitioner Candidacy Programs: A Scoping Review, Lisa Whitehead, Diane E. Twigg, Rebecca Carman, Courtney Glass, Helena Halton, Christine M. Duffield

Research outputs 2014 to 2021

Background

To meet the growing needs of a diverse population, it is critical that healthcare service provision is underpinned by innovative, cost-effective, and sustainable services and solutions. The role of the nurse practitioner creates an opportunity to meet the increasing demands of complex care and enables greater access to high quality care. Understanding how best to support nurse practitioner candidates to develop into the nurse practitioner role will create greater opportunities to transform service delivery and improve healthcare outcomes.

Aim

To identify key factors that support and positively impact the implementation of nurse practitioner candidacy programs and candidate experiences.

Methods …

Health Promotion Within High-Risk Communities: Become An Agent Of Change To Enhance Vaccination Acceptance In Communities, Natalie A. Fischetti Dr., Susan Mee Dr.

Open Educational Resources

This is a course of six self-paced modules for nursing students to learn about vaccines, vaccine safety and patient education regarding vaccines.

Code Gray Response Team, Charlie A. Brizzee

IPS/BAS 495 Undergraduate Capstone Projects

This video presentation addresses the declining feeling of safety by frontline clinical staff due to the recent escalation of combative patients and workplace violence in the healthcare setting, identified through Emotional intelligence and the approach created to address it. This project was crafted as an innovative and creative approach to addressing the issue in the clinical setting without adding additional staff or additional expense to the organization. Additionally, the approach had to be innovative and creative as the author does not own the current process, and knowing to receive stakeholder acceptance, the ownership had to remain with the current stakeholder. …

Registered Nurses’ Images Of Nursing During A Pandemic, Abigail Slaktowski

Honors Projects

The purpose of this research study was to discover any new or transformed images of nursing during the COVID-19 pandemic in the United States. The research question was “What are Registered Nurses’ images of nursing while working during a pandemic?” Registered nurses submitted an image and a brief narrative of the image through REDCap ©, a secure database, describing how the image and culture of nursing is impacted by the COVID-19 pandemic. Using Leininger’s Four Phases of Data Analysis (1991), the five submitted photos and narratives were analyzed. Data analysis revealed fourteen categories, then five patterns, then two final themes: …

Post-Partum Skin-To-Skin Care And Infant Safety: Results Of A State-Wide Hospital Survey, Eileen Tyrala, Md, Michael H. Goodstein, Md, Erich Batra, Md, Barbara Kelly, Md, Judy Bannon, Mba, Ted Bell, Ms

Department of Medicine Faculty Papers

Objectives: Survey current experience with Skin to Skin care (SSC) in Pennsylvania Maternity Centers.

Study Design: The nursing director of each Maternity Center in PA (n = 95) was sent an on-line confidential survey querying SSC practices. Responses were compared by delivery size, location, and nature of affiliation. Statistics analyzed by chi-square and student t-test.

Results: Of these 64/95 MCs (67%) responded. All allowed SSC after vaginal deliveries, 55% after C-section, 73% mother’s room. Monitoring included delivery room nurse (94%) with support from other providers (61%), family members (37%), and electronic monitoring (5%). If SSC occurred in mother’s …

Research Regarding The Stress And Coping Practices Of Neonatal Intensive Care Unit Nurses, Gabriella Musto

Honors College Theses

No abstract provided.

Meaningful Recognition And The Effect On A Medical-Surgical Unit's Staff Satisfaction And Retention, Lindsey Greene

MSN Capstone Projects

The current state of the American healthcare system is riddled with challenges. Nurse administrators are faced with the formidable tasks of decreasing operating costs; improving the patient experience; delivering high-quality and safe patient care; and decreasing the mounting rates of nurse turnover. Nurse leaders must understand the complexities of their work environment, including the key drivers for nurse satisfaction and retention. In 2005, the American Association of Critical Nurses developed six standards for creating a healthy work environment. (American Association of Critical Care Nurses, 2016). An adult, medical-surgical unit at a South Texas hospital was faced with rising rates of …

Evolving Nurse Leadership Role In 2020, Nasreen Rafiq, Farida Bibi Mughal

School of Nursing & Midwifery

No abstract provided.

Law Library Blog (December 2020): Legal Beagle's Blog Archive, Roger Williams University School Of Law

Law Library Newsletters/Blog

No abstract provided.

Organizational Strategies To Promote Nurse Resilience In The Acute Care Hospital Inpatient Setting: An Integrative Review, Marcia A. Depolo

Doctoral Dissertations and Projects

Nurses practicing in acute care hospital environments are exposed to constant stressors from a variety of sources. Workplace stress can lead to unhealthy coping behaviors, illness, and burnout, with intent to leave the organization or the nursing profession altogether. Resilience-building strategies can be employed to foster coping, improve nurse wellbeing, increase job satisfaction, promote retention, and enhance quality patient outcomes. This integrative review provides a synthesis of scholarly publications on nursing resilience from January 2014 through October 2020. Themes to promote nursing resilience occurred at three levels: personal or individual, unit or group, and organizational. This paper will provide a …

The Training Support And Access Model Practice-Based Clinical Mentorship Program In Rwanda: Mentors' Perceptions Of Their Role, Marie Chantal Murekatete, Yolanda Babenko-Mould

Africa Western Collaborations Day 2020 Abstracts

No abstract provided.