Medicine and Health Sciences Commons^™

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 …

Preceptor As Frontline Leader Utilizing Emotional Intelligence, Dwanette Judkins

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem - This paper describes a DNP project implemented in an acute care hospital in 2020. The hospital implemented a nurse residency program, with an evidence-based preceptor role development (PRD) component, which proved to be beneficial in growing the nursing workforce and building infrastructure; however, nurse turnover increased.

Context – Preceptors expressed feeling unsupported and not valued. The nurse executive team recommended the recognition committee expand its efforts to develop strategies to develop frontline leaders by building preceptor resiliency and increase retention. Preceptor development could positively impact the nursing workforce.

Intervention - The DNP student, was the executive sponsor …

Transformational Leadership For Frontline Leaders, Marta L. Hudson

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem. Transformational leadership (TL) represents the gold standard of leadership styles in contemporary healthcare organizations. The transformational leader's ability to motivate, influence, stimulate, inspire, and attend to followers' individual needs is an antecedent to job satisfaction, quality, and patient safety. The project aimed to improve TL constructs among frontline leaders (managers and assistant nurse managers). Based on the results of a needs assessment, these frontline leaders were provided an opportunity to improve their TL style.

Context. Leadership development is a strategic priority for a medium-sized medical center in a healthcare system in Northern California. Frontline leaders within patient care …

The House We Built In Challenging The Status Quo: House And Ballroom Community Leadership And Health Justice, Jennifer Lee

Dissertations and Theses

Background: The House Ballroom Community (HBC), an underground queer subculture, has been leading actions in large urban cities throughout the Unites States to address health inequities exacerbated by stigma, systemic neglect, and economic disparities, such as the HIV/AIDS epidemic. The HBC is an inventive and dynamic space that posits new leadership paradigms for health equity and health justice, where collective actions and their resulting social impact center the embodied knowledge of their members to create social change.

Methods: Community-based participatory research (CBPR) was a fundamental method and framework for each of the studies (Aims 1, 2, and 3). The meaningful …

Exploring Resiliency During The Nursing Student Clinical Experience, Natalie N. Mcmullin

The Dissertation in Practice at Western University

In nursing programs, it is common for students to not complete their degree (Van Hoek et al., 2019). This problem is perpetuated as students who experience high stress and lack resiliency are more likely to be unsuccessful or take longer to complete their nursing degree (Van Hoek et al., 2019). Resiliency is not only important for students during their degree, it is essential to continuously strengthen it throughout their nursing career (Turner & Kaylor, 2015). The aims of this organizational improvement plan will be to empower nursing students to be more resilient in the clinical setting so that they are …

Strategic Planning At Nationwide Children’S Hospital, Stella Choe

Masters Theses/Capstone Projects

The strategic planning department at Nationwide Children’s Hospital works to plan and make decisions regarding the wellbeing of patients with behavioral health disorders. This project involved an 8-hour workday everyday Friday and on site involvement in the strategic planning department at Nationwide Children’s Hospital. During this process, I was able to support providers specifically in the Youth Crisis Stabilization Unit (YCSU), Nursing Staff in BHP, President & Vice President of Behavioral Health.

The Effects Of Nursing School Peer Tutoring On Tutors, Yelyzaveta Soboleva

Undergraduate Honors Theses

An integrative review was used to examine the effects of being a tutor versus not being a tutor. The matrix method was used to guide the research process, to identify articles that met the inclusion criteria, and to reduce data into common topics of peer tutoring. The results of the integrative review yielded 20 articles and suggested that students in the position to assist others are more confident in communicating in groups and have higher knowledge in the subject they help with than their fellow peers. The literature showed that students in the position to assist others have defined personal …

Analyzing Leadership Opportunities Through Participant Perspective, Cathryn Yaggie Heinen

Theses/Capstones/Creative Projects

The Anatomy Academic Assistant (AAA) practicum is a peer-mentoring program that helps participants further develop leadership skills. The goal of this research was to analyze leadership qualities through participant perspective and analyze the effectiveness of the AAA practicum in enhancing these leadership qualities. A 25-question survey, measuring participant perspective, was designed to include both rating-scale questions and free response questions. Rating-scale questions used a Likert scale with a corresponding assigned value. Free response questions also provided qualitative data that was grouped into overarching themes in a generated word cloud. The assigned value averages showed that participants largely agreed with the …

Leadership Roles In The Field Of Occupational Therapy, Christina Pitts

Student Capstone Papers

The idea of this capstone project was to learn about leadership through expertise and experience. The first portion of the project consisted of reviewing the literature and interviewing four occupational therapists that currently have a leadership role within the healthcare industry to gain insight into leadership qualities. The second potion included being at a facility (Advent Therapy in Richmond Hill, G.A.) for 14 weeks to observe and learn about current programs, and with the guidance of the therapists and management of the facility, develop and implement a program that was deemed to be beneficial to the client population.

Leading Rural Nurse Academic Progression, Cynthia Jean Larsen

Dissertations (1934 -)

Higher levels of nurse education have been associated with improved patient outcomes and lower healthcare costs. Members of rural populations are vulnerable, having poorer outcomes than urban inhabitants on a number of health indicators. Rural nurses are more likely than urban nurses to enter practice with associates degrees. Hence, academic progression is important for rural nurses and for the health of rural patients and communities. Rural nurse leaders work to promote the academic progression of rural nurses. Grounded theory methodology was used in this study to describe the concerns of and the actions taken by nurse leaders in the promotion …

Radiation Actions And Dimensions Of Radiation Safety Among U.S. Radiologic Technologists, Quentin T. Moore

Graduate Research Theses & Dissertations

Background: Radiation safety culture is a fundamental contributor to procedural justification, exam optimization, and dose-limiting practices in medical imaging. Multiple intrapersonal, interpersonal, institutional, community, and policy factors could influence the outcomes of radiation safety culture.

Purpose and Aims: The purpose of the study was to examine the determinants of radiation safety culture among U.S. radiologic technologists. The specific aims were to: 1) develop a survey instrument tailored to radiation actions and dimensions of radiation safety with a sequential use of multiple techniques; 2) examine determinants of radiation safety culture employing McLeroy’s socioecological model; 3) examine relationship between the determinants of …

Registered Nurse Engagement And Patient Falls In The Acute Care Setting, Jenna Zaliauskas

Walden Dissertations and Doctoral Studies

Falls are a critical problem for inpatient medical-surgical adult patients. Past research has indicated a link between nurse disengagement and unsafe care. The purpose of this study was to improve the understanding of the relationship between nurse engagement and patient falls with injury on medical surgical units in health care facilities in the United States using the National Database of Nursing Quality Indicators. Retrospective data were reviewed from 13 U.S. hospitals in the Midwest covering Q1 (2018) and Q2 (2018) on medical-surgical units related to nurse engagement and patient falls. A correlational and MANOVA design was used to determine the …

Effects Of Transformational Leadership On Direct Home Healthcare Employee Turnover, Lisa K. Johnson

Walden Dissertations and Doctoral Studies

Ineffective leadership and excessive direct home healthcare workers’ intent to resign may decrease home healthcare worker satisfaction, increase workplace accidents, and hinder the quality of patient home healthcare. Home healthcare leaders have a problem of retaining direct home healthcare workers and can benefit from comprehending the factors that enhance leadership and mitigate the turnover of home healthcare workers. Grounded in transformational leadership theory, the purpose of this quantitative correlational study was to examine the relationship between the perception of transformational leadership behaviors and direct care intent to resign. The population consisted of direct home healthcare workers who reported to frontline …

Leadership And End-Of-Life Planning Among Elderly Patients With End-Stage Renal Disease, Elizabeth R. Armstrong-Fears

Walden Dissertations and Doctoral Studies

More than 8-million people in the United States possess no kidney function. The purpose of this quantitative casual-comparative research study is to examine the relationship between ethnicity status of African American and European American patients suffering from end-stage renal disease, and advanced care planning and end-of-life decision-making among patients who are 55 years of age and older. The health belief model is the selected explanatory framework used to examine (a) whether ethnicity status is a significant predictor of whether decedents had written end-of-life care instructions, (b) whether ethnicity status is a significant predictor of whether treatment decisions were made, and …

The Relationship Between Program Leadership, Resident Physicians’ Wellbeing, And Quality Of Care, Fatima Msheik

Walden Dissertations and Doctoral Studies

Research studies have shown that organizational leadership and support affect organizational outcomes in many sectors, including healthcare. However, less is known about how organizational leadership influences the quality of patient care by physicians. This study was guided by the perceived organizational support theory and leader-member exchange theory that provide general understanding of how supportive leadership influences staff wellbeing and productivity. Ninety-five resident physicians residing in Lebanon participated in this cross-sectional study and completed an online survey, which consisted of demographics and five tools, namely, the Leader-Member Exchange 7, Perceived Organization Support 8, Maslach Burnout Inventory 7, Utrecht Work Engagement 9, …

Evaluating The Impact Of Nurse Leader Professional Development, Celeste Rogers Romp

Walden Dissertations and Doctoral Studies

A health care organization’s success is impacted by its leaders’ knowledge, confidence, and training. A quality improvement (QI) project was undertaken by a 300-bed acute care medical center to determine the impact of providing nurse leaders with education and training in increasing the leader’s knowledge and confidence in their role and in improving nursing satisfaction, catheter-associated urinary tract infection (CAUTI) rates, and fall rates. The FOCUS-PDSA QI model and the nurse manager leadership collaborative learning domain framework were used to guide the QI project and its evaluation. There were four primary sources of evidence. A nurse leader professional development pre- …

Urgent Care Centers And Workers’ Compensation Medical Cost Containment, Drema M. Thompson

Walden Dissertations and Doctoral Studies

In response to healthcare payment policy reforms, billions of dollars in healthcare provider charges are challenged annually. Following the implementation of the Virginia workers’ compensation medical fee legislation, healthcare organizations experienced declining worker compensation medical fee schedule reimbursements and lack of profitability. Grounded in the adaptive cycle model, the purpose of this qualitative single case study was to explore strategies 2 urgent care center (UCC) leaders in Virginia used to increase profits after implementing the Virginia workers’ compensation medical fee legislation. Data were collected via in-depth interviews and a review of company documents. Thematic analysis was used to analyze data. …

Physician Assistant Burnout And Fulfillment Related To Career Development And Physician Relationship, Kari Sue Bernard

Walden Dissertations and Doctoral Studies

Physician workforce shortages are driving increased clinical and administrative use of non-physician healthcare providers. As a result, physician assistants (PAs) may experience role expansion in a positive or negative manner. The purpose of this study was to determine if aspects of PA career development related to role expansion interacted with the quality of the collaborative physician (CP) relationship to predict PA well-being. The job demands-resources (JD-R) model was used as the theoretical foundation and the National Academy of Medicine’s conceptual model of clinician well-being was used as the conceptual framework. Research questions addressed whether PA experience level predicted well-being, and …

Registered Nurses’ Assessment Of Clinical Leadership Knowledge And Competence, Valerie D. Wright

Walden Dissertations and Doctoral Studies

As a prevalent component of the health care workforce, clinical nurse leaders play a vital role in reducing costs and promoting quality patient outcomes. The purpose of his project was to assess clinical leadership skill of nurses at a 160-bed rehabilitation hospital in a metropolitan city in the southeast United States. Guided by the Academy of Medical-Surgical Nurses model (AMSN), the practice-focused question explored the extent to which nurses perceived that they held clinical leadership knowledge and leadership competencies which impact positively on the nurse workforce and patient care. Thirty clinical registered nurses (RN) participated. According to the clinical leadership …

Healthcare Organizational Design Strategies To Improve Performance, Katherine Madonna Chubbs

Walden Dissertations and Doctoral Studies

Business leaders are exploring ways to improve organizational performance through organizational design, including reviewing the structures of their organization. Grounded in McKinsey’s 7S framework, the purpose of this qualitative single case study was to explore organizational design strategies healthcare leaders used to improve organization performance. Participants were 6 leaders within a healthcare organization in Alberta, Canada, who successfully developed and implemented organizational design strategies to improve organizational performance. The data collection techniques included a review of internal and external documents, a reflective journal, and semistructured interviews. I used methodological triangulation and thematic analysis to complete the data analysis. The data …

Nurses’ Aesthetic Responses And Emotional Judgements To Senior Leaders’ Symbolism, Lucinda A. Easler

Walden Dissertations and Doctoral Studies

Stress can be heightened during a merger; understanding how acute care nurses who work in a hospital undergoing a merger, experience senior leaders’ use of symbolism may help to promote hospital and leader sustainability. Executive symbolism unfolds into aesthetic experience, normally considered a response to art, with few studies of its existence and benefit to organizational life. The purpose of this phenomenological-hermeneutic study guided by Parker’s aesthetic theory was to examine acute care nurses’ emotional responses and experiences with senior leaders’ use of executive symbolism in the midst of the organizational change. Interviews with 11 acute care registered nurses were …

Utilizing Cdc Framework For Program Evaluation To Inform Assessment Of An Interprofessional Leadership And Teamwork Curriculum, Madeline Aulisio

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background
The ability to collaborate effectively and lead a team when the need arises has become an expectation of health professionals. Graduates of health professions programs are expected to possess skillsets that will allow them to both collaborate and lead effectively in addition to their profession-specific knowledge. Leadership Legacy, an interprofessional elective created at the University of Kentucky in 2009, was designed to address this need.

Methods
After nearly ten years of cohorts, an opportunity arose for program evaluation with a reliable method such as the Centers for Disease Control and Prevention Framework for Program Evaluation. The novel use of …

Improving Processes For Implementing Evidence-Based Practice In Midwifery: Development Of An Etool(Kit) For Midwives, Annemarie June De Leo

Theses: Doctorates and Masters

Evidence-based practice (EBP) is well-established as the gold standard for service delivery of quality healthcare around the world, yet there remains a significant gap between best available evidence and its everyday use in maternity services. The numerous benefits of EBP are therefore never realised and although a considerable body of knowledge has evolved on how to promote the uptake of new EBPs, little is known about midwives’ experience of implementing EBP or leading practice change projects in clinical areas.

The aim of this study was to work collaboratively with midwives towards the co-development of an evidence implementation resource, designed to …

Exploring Leadership And Research In Nurse Practitioner Roles Across Australia And Ireland: A Mixed-Methods Study, Mary Ryder

Theses: Doctorates and Masters

Introduction

The Nurse Practitioner role is recognised as the highest level of clinical nursing. Leadership and research are identified as core attributes for Nurse Practitioners in the regulatory frameworks. There is an expectation that as clinical leaders, Nurse Practitioners have the ability to transform healthcare delivery within their specialist area of practice.

Background

The voice of Nurse Practitioners is limited in the current literature related to how they view their leadership contribution to Nursing. There has been some criticism in the evidence to date related to volume, consistency and transferability of Nurse Practitioner research. However, there is a shortage of …