Medicine and Health Sciences Commons^™

Building Thriving Healthcare Teams Through Organizational Learning, Bret Lyman, Marie M. Prothero, Adrianna L. Watson

Faculty Publications

The purpose of this article is to provide practical steps nurse leaders can use to build thriving healthcare teams through organizational learning. The climate, culture, and activities associated with organizational learning are well-aligned with those needed to build thriving teams. Nurse leaders who leverage this alignment can effectively recruit and retain teams while enhancing their team’s ability to effectively navigate change.

Building Thriving Healthcare Teams Through Organizational Learning, Bret Lyman, Marie M. Prothero, Adrianna L. Watson

Faculty Publications

The purpose of this article is to provide practical steps nurse leaders can use to build thriving healthcare teams through organizational learning. The climate, culture, and activities associated with organizational learning are well-aligned with those needed to build thriving teams. Nurse leaders who leverage this alignment can effectively recruit and retain teams while enhancing their team’s ability to effectively navigate change.

Barriers To Cataract Surgery In Africa: Providers’ Perspective (Research Protocol), Cougar Hall, Scott Herrod, Benjamin Crookston, Sadik Taju Sherief, Akwasi Ahmed, Grace Chipalo Mutati, John Welling, Boatang Wiafe, Michae Gyasi, Joshua West

Faculty Publications

Purpose: Millions of individuals in sub-Saharan Africa are needlessly blind from cataracts. While progress was made towards the Vision 2020: The Right to Sight goals, Ethiopia, Ghana, and Zambia fell short of the recommended cataract surgical rate (CSR) on a national level. The purposes of this study were to describe possible economic factors impacting surgeon surgical productivity, possible barriers to attaining the recommended CSR, and surgical services in each of these countries.

Methods: An online survey was sent to ophthalmologists practising in Ethiopia, Ghana, and Zambia. Responses were collected between June 25, 2021 and January 30, 2022.

Results …

Covid-19 Lockdown: Impact On College Students’ Lives, Wendy C. Birmingham, Lori L. Wadsworth, Jane H. Lassetter

Faculty Publications

Objective: In light of COVID-19, leaders issued stay-at-home orders, including closure of higher-education schools. Most students left campus, likely impacting their employment and social network. Leaders are making decisions about opening universities and modality of instruction. Understanding students' psychological, physiological, academic, and financial responses to the shut-down and reopening of campuses can help leaders make informed decisions. Participants: 654 students from a large western university enrolled during the pandemic shutdown. Methods: Students were invited via email to complete an online survey. Results: Students reported stress, depression, loneliness, lack of motivation, difficulty focusing on schoolwork, restless sleep, appetite changes, job loss …

Meeting Patients Where They Are: A Nurse-Driven Quality Improvement Project To Provide Influenza Vaccinations In The Emergency Department, Stacie Hunsaker, Larry Garrett, Katreena Merrill, Rachelle Rhodes

Faculty Publications

Introduction: Influenza is highly contagious, vaccine-preventable, and may result in significant morbidity and mortality. While vaccination is the primary protection against influenza, vaccination rates remain low. Traditionally, primary care clinics, retail pharmacies, and public health departments offer influenza vaccines. However, offering influenza vaccines in new settings may increase their availability to the public and increase community uptake. This project aimed to add emergency departments as a new influenza vaccine location to increase the number of vaccines distributed during the 2020 to 2021 influenza season.

Methods: Adult patients discharged from 24 emergency departments were included in this pre- post-intervention project. A …

Building Organizational Learning Capacity: A Road Map For Nurse Executives, Bret Lyman, Marie M. Prothero, Joy Parchment

Faculty Publications

The purpose of this article is to guide nurse executives in building learning capacity within their organizations. The Organizational Learning Road Map provided is grounded in the American Organization for Nursing Leadership’s Nurse Leader Core Competencies. Key steps include: developing one’s self as a learning leader, sharing a learning-focused vision for the organization, establishing a culture of learning, charting a course toward becoming a learning organization, developing a leadership team to support learning throughout the organization, measuring progress toward the vision, and sustaining momentum.

Building Organizational Learning Capacity: A Road Map For Nurse Executives, Bret Lyman, Marie M. Prothero, Joy Parchment

Faculty Publications

The purpose of this article is to guide nurse executives in building learning capacity within their organizations. The Organizational Learning Road Map provided is grounded in the American Organization for Nursing Leadership’s Nurse Leader Core Competencies. Key steps include: developing one’s self as a learning leader, sharing a learning-focused vision for the organization, establishing a culture of learning, charting a course toward becoming a learning organization, developing a leadership team to support learning throughout the organization, measuring progress toward the vision, and sustaining momentum.

Women's Power In Hospital-Based Nursing: A Critical Qualitative Study, Kaitlyn C. George, Bret Lyman, Andy Pilarte Alcantara, Maya Stephenson

Faculty Publications

Aim: To understand the factors that affect power in hospital-based nursing and reveal how the female gender affects an individual's ability to feel empowered.

Design: Critical qualitative research design.

Method: Semi-structured interviews were conducted with nurses working in inpatient hospital settings in Utah and New Mexico. Data were collected from February to March 2022. Interviews were analysed using thematic analysis.

Results: Sixteen participants were interviewed. Six themes were identified from the data, four of which related to nurses' power at work, and two of which specifically related to how gender affects a nurse's ability to use power and feel empowered. …

Dating App Facilitated Sexual Assault: A Retrospective Review Of Sexual Assault Medical Forensic Examination Charts, Julie L. Valentine, Leslie W. Miles, Kristen Mella Hamblin, Aubrey Worthen Gibbons

Faculty Publications

Dating app facilitated sexual assault (DAppSA) is a concerning phenomenon with minimal published research. This retrospective study explored if DAppSAs were different than other sexual assaults (SAs) committed by acquaintances through a review of 3,413 sexual assault medical forensic examination (SAMFE) charts from 2017 to 2020 in a Mountain West state in the United States. Routine Activities Theory and Confluence Model of sexual aggression provided the theoretical framework for the study. Inclusion criteria for DAppSA cases included (1) victim was 14 years of age or older; (2) victim indicated meeting the perpetrator on a dating app; (3) SA occurred at …

Addressing Immunizations In Nursing Education: Immunization Resources For Undergraduate Nursing, Sheryl Buckner, Ruth Gallego, Diana Mcnaughton, Susan Brasher, Joan Stanley, Allison Jacobs, Jennifer Hamborsky, Sarah Schillie, Stacie Hunsaker, Kathy J. Kyler, Allison L. Lewis, Donna Page

Faculty Publications

Nursing faculty are challenged to integrate immunization content in prelicensure nursing curricula. Historically, most immunization content has been delivered in pediatrics courses, with less emphasis on other populations across the lifespan. Skills related to vaccine administration may be prioritized over the most current immunization science, such as pathophysiology, immunology, and epidemiology. As the most trusted profession rated by the public (Saad, 2020), nurses are ideally suited to address vaccine hesitancy and promote vaccination in the communities they serve. Nurses apply active listening, problem solving, and communication skills with patients and their families, contributing to a person's confidence in their decision …

Treatment Pearls: Management Of Physical Healthcare Needs In Patients With Mental Illness, Leslie W. Miles, Brandon Thatcher, Michael C. Thomas, Blaine Winters

Faculty Publications

Clinicians caring for persons with mental illness should be aware of increased mortality, physical problems, and health disparities in this population. This article provides a brief overview of physical health problems in the context of mental illness as well as those related to psychotropic medications, and discusses strategies to manage treatment effectively.

Contextual Factors Associated With Organizational Learning In Hospitals: An Instrument Development Study, Bret Lyman, Kylie C. Thorum

Faculty Publications

Aim: Develop a valid, reliable research instrument to measure contextual factors associated with organizational learning in hospitals.

Background: A valid, reliable instrument for measuring contextual factors associated with organizational learning is needed so nurse leaders and researchers can improve healthcare by facilitating and studying organizational learning.

Methods: The Organizational Learning in Hospitals model guided development of the Organizational Learning Instrument-Context. Content validity was refined and evaluated through cognitive interviews and expert reviews. The instrument was distributed to direct care nurses in Magnet® hospitals in the United States. Intraclass correlation coefficients validated the use of multilevel analyses. Construct validity was assessed …

Cross-Cultural Validation And Psychometric Testing Of The Debriefing Experience Scale (Des): A Cross-Sectional Study, Ya Dian Xie, Xin Yi Li, Qian Liu, Run Huang, Ting Li, Ya Xuan Fang, Dan Luo, Yonghui Wan, Bing Xiang Yang, Shelly J. Reed

Faculty Publications

Background

The Debriefing Experience Scale (DES) is a tool that is used to explore nursing students’ subjective experiences during a debriefing and to help determine best debriefing practices. A Chinese version of the scale has not been found; its development can enhance learning in simulation activites in Chinese healthcare education programs.

Methods

A simplified Chinese version of the DES was developed and tested using 34 Chinese undergraduate (second year) nursing students. They participated in six simulation scenarios and debriefings. Eight experts were consulted to determine the content validity of the scale. Critical ratio method, Cronbach’s alpha, intraclass correlation coefficient, correlation …

Diversity, Equity, Inclusion: Crucial For Organizational Learning And Health Equity, Bret Lyman, Joy Parchment, Kaitlyn C. George

Faculty Publications

Achieving health equity requires a diversity of perspectives, values, and insights, yet the composition of the United States’ nursing workforce does not reflect the communities where they practice. Nurse leaders can advance health equity and exemplary clinical outcomes by creating diverse, equitable, and inclusive health care teams. Such teams are well-equipped for organizational learning, a crucial process for advancing health equity. Nurse leaders advance health equity by fostering diversity, equity, inclusion, and thus organizational learning in the workplace.

Mechanisms Of Organisational Learning In Hospitals: An Instrument Development Study, Bret Lyman, Emily L. Smith, Kaitlyn C. George

Faculty Publications

Aim: To develop a valid, reliable research instrument to measure mechanisms associated with organisational learning in hospitals.

Background: A valid, reliable instrument for measuring mechanisms of organisational learning would enable nurse leaders and researchers to improve health care through facilitation and study of organisational learning.

Methods: The Organizational Learning in Hospitals model was used as a framework to develop the Organizational Learning Instrument-Mechanisms. Cognitive interviews and expert reviews were used to refine and evaluate item-level and scale-level content validity. The instrument was distributed by email to a random sample of nurses working in inpatient hospitals in Utah (n = 1253). …

Acculturation Implications On Obesity Among Ethnically Diverse Teens, Tien Vo, Lori A. Spruance

Faculty Publications

Obesity is a prevalent public health concern among children, especially those from minoritized backgrounds. In order to understand how acculturation and race/ethnicity influence obesogenic behavior in adolescents, a national convenience sample of 11- to 14-year-olds was recruited to participate in a survey about acculturation, physical activity, nutrition, and the school and home environment. Preliminary results showed significant differences in obesogenic behaviors when comparing White to non-White groups. Time spent watching TV, time spent playing video/computer games, and physical inactivity was higher for non-White Westernized adolescents compared to White adolescents. self-reported obesity, participation in school meals were both positively correlated with …

Effects Of Positive And Negative Emotion On Picture Naming For People With Mild To Moderate Aphasia: A Preliminary Investigation, Tyson G. Harmon, Courtney Nielsen, Corinne Loveridge, Camille Williams

Faculty Publications

Purpose: To investigate how emotional arousal and valence affect confrontational naming accuracy and response time in people with mild to moderate aphasia compared with adults without aphasia. We hypothesized that negative and positive emotions would facilitate naming for people with aphasia but lead to slower responses for adults with no aphasia.

Method: Eight participants with mild to moderate aphasia, 15 older adults, and 17 young adults completed a confrontational naming task across three conditions (positive, negative, neutral) in an ABA case series design. Immediately following each naming condition, participants self-reported their perceived arousal and pleasure. Accuracy and response time were …

Ability To Consent To A Sexual Assault Medical Forensic Examination In Adult Patients With Serious Mental Illness, Leslie W. Miles, Eleanore Knox, Nancy Downing, Julie L. Valentine

Faculty Publications

When a patient reporting a sexual assault (SA) presents with signs and symptoms of serious mental illness (MI), medical providers or forensic examiners may have concerns regarding the ability to legally consent to a sexual assault medical forensic examination (SAMFE). Numerous encounters have occurred where a SAMFE was not offered to a cooperative adult patient because the patient exhibited signs and symptoms of MI. Medical providers and examiners may be motivated by beneficence (believing that treating the patient's MI must take priority over the SAMFE) and/or non-maleficence (a concern that the in-depth SAMFE may worsen the patient's psychological state). Situations …

Mental Illness As A Vulnerability For Sexual Assault: A Retrospective Study Of 7,455 Sexual Assault Forensic Medical Examinations, Leslie Miles, Julie L. Valentine, Linda Mabey, Nancy R. Downing

Faculty Publications

Background: Persons with severe mental illness (MI) are at a high risk of becoming victims of sexual assault (SA). Vulnerability for SA with any type of MI is unknown. This study aimed to identify the prevalence of preexisting MI and other significant factors in patients reporting preexisting MI at the time of their SA medical forensic examinations (SAMFEs).

Method: A retrospective SAMFE chart review of patients ( N = 7,455) from 2010 to 2020 was conducted. Sexual assault nurse examiners completed SAMFEs. Inclusion criteria included (a) aged 14 years and older, (b) completed SAMFE with SA kit evidence collection, and …

Filling The Knowledge Gap For Nurse Leaders: Next Steps Following Covid-19, Mikel W. Hand, Catherine Alexander, Bret Lyman, Joy Parchment, M Lindell Joseph, Esther Chipps

Faculty Publications

The purpose of this article is to share gaps in knowledge and research related to pandemic management identified by nurse leaders during the COVID-19 pandemic. As part of a larger Delphi study, nurse leaders responded to an open-ended question about gaps in research they saw as important following the pandemic. Responses were analyzed using directed content analysis. Results are presented as 4 supercategories: Organizational leadership preparedness, adaptive leadership in crisis, innovations in care delivery, and health, well-being, and resilience.

Pre-Licensure Nursing Students' Experiences Of Psychological Safety: A Qualitative Descriptive Study, Bret Lyman, Camille R. Mendon

Faculty Publications

Background: Organizational learning is essential for consistently providing safe, efficient, high-quality patient care. Psychological safety is foundational for organizational learning. For pre-licensure nursing students psychological safety is crucial for both their learning and patient safety. Understanding pre-licensure nursing students' experiences of psychological safety can guide efforts to cultivate clinical environments conducive to learning and excellent patient care.

Objectives: The objective of this study was to gain insight into pre-licensure nursing students' first-hand experiences with psychological safety in clinical settings.

Design: A qualitative, descriptive design was used for this study.

Settings: Participants were recruited from 12 different nursing programs across eight …

Organizational Learning During Covid-19: A Qualitative Study Of Nurses' Experiences, Bret Lyman, Morgan K. Horton, Alyssa Oman

Faculty Publications

Aim: The aim of this study is to test the validity of the Organizational Learning in Hospitals model in the context of the COVID-19 pandemic.

Background: Organizational learning is especially crucial in circumstances of intense, complex, enduring change, as with the COVID-19 pandemic. Nurse managers need additional guidance for fostering organizational learning under such circumstances. The Organizational Learning in Hospitals model may be a helpful resource but requires additional validation.

Methods: Semi-structured interviews were conducted to gather 19 nurses' first-hand experiences of organizational learning during the COVID-19 pandemic. Data were analysed using deductive thematic analysis.

Results: Nurses' experiences of organizational …

Setting The Research Agenda For Nursing Administration And Leadership Science: A Delphi Study, Esther Maria Chipps, M Lindell Joseph, Catherine Alexander, Bret Lyman, Logan Mcginty, Heather Nelson-Brantley, Joy Parchment, Reynaldo R. Rivera, Mary Anne Schultz, Danielle M. Ward, Susan Weaver

Faculty Publications

Objective: The aim of this study was to identify and prioritize research topics for nursing administration and leadership science.

Background: Nursing administration and leadership research priorities should provide a framework for building the science needed to inform practice.

Methods: The Association for Leadership Science in Nursing (ALSN) and American Organization for Nursing Leadership (AONL) Foundation (AONL-F) for Nursing Leadership and Education collaborated on a Delphi study. Initial input on research priority items were received from ALSN and AONL members. National experts participated in a 3-round Delphi study.

Results: Top-ranked priorities included: 1) nurses' health, well-being, resiliency, and safety in the …

Creating A Work Environment Conducive To Organizational Learning, Bret Lyman, Marisa E. Biddulph, V Grace Hopper, Morgan K. Horton, Camille R. Mendon

Faculty Publications

Through organizational learning, health care teams can consistently provide excellent patient care in a complex and changing environment. Nurse managers, educators, and other leaders can facilitate organizational learning within their teams by promoting certain contextual factors in the clinical work environment. This article provides an overview of contextual factors associated with organizational learning, includes practice-based examples of these factors, and offers evidence-based recommendations for creating a learning-focused work environment.

Anemia Management In Rural Haitian Children: A Mixed Methods Study, Marc-Aurel Martial, Kathy A. Sward, Janice M. Morse, Andrew R. Wilson, Cempaka S. Martial, Debra S. Penney, Elie Nicolas

Faculty Publications

Introduction: We examined factors influencing anemia outcomes in rural children following implementation of a prevention program. Method: Mixed methods study of children, parents, and clinicians utilized statistical modeling and content/ ethnographic analysis. Retrospective chart abstraction evaluated treatments administered and measured hemoglobin in children aged 6 to 59 months (n = 161). Prospective interviews/questionnaires examined parent (n = 51) and clinician (n = 19) perceptions. Results: Anemia prevalence decreased by 21.2%. Predictors of increased hemoglobin were clinic visit number and age at first visit. Once anemia improved, children were likely to remain improved (P = .65). Despite favorable program perceptions, stakeholders …

Why Parents Say No To Having Their Children Vaccinated Against Measles: Social Determinants Of Parental Perceptions To Vaccine Hesitancy, M. Lelinneth B. Novilla, Michael C. Goates, Mallory Showalter, Lynneth Kirsten B. Novilla, Tyler Leffler, Russell B. Doria, Michael T. Dang, Katelyn Aldridge

Faculty Publications

Background: Although national and state immunization coverage rates are high, the resurgence of measles points to local pockets of under-vaccination that correspond with higher non-medical exemptions and lower parental confidence on vaccines. The reported geographic clustering of vaccine hesitancy, particularly against MMR, points to social drivers that shape parental perceptions and decisions on immunization.

Objectives. To analyze: (1) why parents delay or refuse vaccination, specifically MMR; (2) social context of vaccine hesitancy and perceived reliable sources of vaccine information between vaccine-hesitant and vaccine-compliant parents/guardians; (3) role of families in countering vaccine hesitancy; (4) strategies at the public health, primary care, …

Family Behaviors As Unchanging Obstacles In End-Of-Life Care: 16-Year Comparative Data, Renea L. Beckstrand, Jasmine B. Jenkins, Karlen E. Luthy, Janelle L. B. Macintosh

Faculty Publications

Background Critical care nurses routinely care for dying patients. Research on obstacles in providing end-of-life care has been conducted for more than 20 years, but change in such obstacles over time has not been examined.

Objective To determine whether the magnitude scores of obstacles and helpful behaviors regarding end-of-life care have changed over time.

Methods In this cross-sectional survey study, questionnaires were sent to 2000 randomly selected members of the American Association of Critical-Care Nurses. Obstacle and helpful behavior items were analyzed using mean magnitude scores. Current data were compared with data gathered in 1999.

Results Of the 2000 questionnaires …

Nurses' Experiences Of Organisational Learning: A Qualitative Descriptive Study, Bret Lyman, Marisa E. Biddulph, V Grace Hopper, Julie L. Brogan

Faculty Publications

Aim: To explore the validity of and expand upon a model of organisational learning in hospitals.

Background: Organisational learning is a positive change in an organisation's collective knowledge, cognition and/or action, leading to improved hospital performance. A current model offers an evidence-based, theoretical representation of organisational learning in hospitals, yet the intricacies of organisational learning in clinical practice are not fully understood. Additional guidance is needed to effectively foster and study organisational learning.

Method: Semi-structured interviews were used to gather 15 first-hand experiences of organisational learning from 14 nurses. Data were analysed via deductive thematic analysis.

Results: Organisational learning was …

Measuring Learning And Engagement During Debriefing: A New Instrument, Shelly Jensen Reed

Faculty Publications

Background: Debriefing is considered to be where the bulk of learning takes place. Examination of debriefing is needed to help determine if facilitation methods effectively contribute to the learning process. More instruments are needed to evaluate all key debriefing elements, and no tools exist that evaluate participant engagement in the learning process.

Method: Kolb’s experiential learning theory was used to inform tool development. The focus of the new instrument is behaviors that indicate engagement with the learning process as the learner moves through Kolb’s learning cycle. A qualitative study of debriefing facilitators was performed, and a behaviorally anchored instrument was …

Hereditary Cancer Syndrome Recognition And Testing: Beyond Brca, Deborah O. Himes, Hanford B. Shuman

Faculty Publications

Hereditary cancer syndromes, resulting from mutations of tumor suppressor genes, can significantly increase the risk for breast cancer. Although hereditary breast and ovarian cancer syndrome caused by BRCA1/2mutations is well-known, less well-known hereditary cancer syndromes also exist. This article focuses on 3 other syndromes, including Li-Fraumeni, Cowden, and Peutz-Jeghers. This article will help prepare nurse practitioners to recognize key clinical features of these syndromes and understand testing criteria. Additionally, this article discusses barriers to diagnosing hereditary cancer syndromes and the role of primary care nurse practitioners in ordering genetic tests and making genetic referrals for optimal patient care.