Nursing Commons^™

Using A Strategic Model For Professional Development: The Importance Of Evidence-Based Competencies As A Foundation For Professional Practice., Peggi B. Winter

Doctor of Nursing Practice (DNP) Projects

Abstract

A nursing professional practice model (PPM) is designed to provide a framework for how nursing practices, communicates, leads, collaborates, and provides the highest quality of care as we navigate the complex healthcare system. An infrastructure for learning, competency, and performance needs to be integrated into this model as a foundation for accelerating business and clinical initiatives, promoting standardization, and sharing successful practices. It is now, more than ever, a necessity to have a well-trained, highly competent nursing workforce. Simply having the knowledge and the skill to do a job is insufficient; rather, it is implied that a competency has …

Improving The Patient Experience By Implementing Patient-Centered Care In A Community Hospital, Richard A. Billingsley Dnp, Mha, Rn

Doctor of Nursing Practice (DNP) Projects

Health care is a complex business currently undergoing extensive reform. These changes require new methods of care deliver and ways in which health care organizations are operating. At the forefront of this change effort is the 2010 Patient Protection and Affordable Care Act, which is transforming health care from a volume-based, fee-for-service process to the delivery of services that have value, improve quality outcomes, increase satisfaction, elicit greater efficiency, demonstrate improved safety outcomes, show cost-effectiveness, promote better access to services, and result in high reliability between providers and organizations. The goal of providing a more positive health care experience is …

Building A Framework For Professional Nursing Practice Across The Continuum Of Care, Elizabeth S. Bigby

Doctor of Nursing Practice (DNP) Projects

Nursing professional practice models are designed to unite and align nurses under one vision, set of values, and a professional practice model. The goal of this project was to implement and enculturate a professional practice model of nursing with assistant nurse managers and leaders across the continuum of care at an urban medical center and associated ambulatory medical offices. Staff engagement has been shown to improve satisfaction and decrease turnover and implementation and enculturation of a professional practice model improves engagement. The target population was nurse managers and leaders as they needed to embrace professional practice before the project was …

Preventing 30-Day Readmissions Of Clostridium Difficile Patients Utilizing Targeted Discharge Instructions, Keith A. Howard

Doctor of Nursing Practice (DNP) Projects

The Patient Protection and Affordable Care Act of 2010 ushered in a new era of fiscal accountability for healthcare organizations. Healthcare organizations and providers are now jointly held responsible for the improved quality of patient care and sustained reductions in patient care events termed healthcare-acquired conditions. To ensure compliance with this newly enacted legislation, the Centers for Medicare and Medicaid Services (CMS) began penalizing hospitals for targeted conditions leading to 30-day readmissions beginning in October 2012. Annually, CMS has focused attention on conditions that endanger patient health and welfare while secondarily attempting to reduce the excessive financial expenditures in …

Caution: Line-Of-Sight In Icu Designs, Diane C. Bartos

Doctor of Nursing Practice (DNP) Projects

It has been estimated that by the end of 2015, the U.S. will spend approximately $200 billion in new healthcare facilities construction. Infection prevention, patient and family satisfaction, and technologies influence contemporary designs of critical care units. All of these impacts have created larger patient care units, with a majority of single patient rooms. These larger spaces have created challenges for the clinicians to maintain the line-of-sight. The line-of-sight is one tool clinicians often use to maintain patient safety.

Since the seminal publication by the Institute of Medicine in 1999, patient safety concerns have escalated after revealing numerous deaths in …

Student Nurse Behaviors And Barriers To Successful Completion Of The Traditonal Bachelor's In Science Of Nursing (Bsn) Program., Carri Shaw

Honors Theses

Change is often said to be the only constant in life. This holds true to the rapidly growing field of nursing. In order to meet the demands of new challenges that emerge in nursing, the way future nurses are educated also has changed. Not all nursing students find that the profession is for them. Therefore, some attrition from school is expected. This descriptive study will explore factors that the literature suggests are related to attrition at a mid-sized public university in the Midwest. A survey given to two different level nursing cohorts will give insight to pre-licensure nursing students’ experiences …

The Effects Of Consistent Exercise On Work Productivity Among Anesthesia Providers, Samuel K. Self

Doctoral Projects

Studies have been done that link various measurements of workplace productivity with varying levels of individual health. A thorough literature review examined the research to find any significant relation between regular exercise (as defined by the American Heart Association) and an improvement in workplace productivity among anesthesia providers. A Qualtrics survey was used to measure specific results regarding exercise activity and work productivity from anesthesia providers. This group included 53 certified registered nurse anesthetists and anesthesiologists. Descriptive analysis, Chi-square test of Independence, Fisher’s Exact test, and Cramer’s V test were all used to analyze the data. One significant correlation was …

Comparison Of Older Urologic Patients' Perceptions And Nurses' Assessments Of Discharge Readiness, Elizabeth Dodge

Master of Science in Nursing Final Projects

Purpose: The purpose of this study was to explore older urological patients’ perceptions and clinical nurses’ assessments of discharge readiness. In addition, this study examined the difference among older urological patients’ perceptions and clinical nurses’ assessments of discharge readiness.

Design: A descriptive, comparative, cross-sectional design was used.

Methods: Convenience samples of older urological patients and clinical nurses were recruited from three surgical units. Data were collected using The Patient Readiness for Hospital Discharge and Nurse Readiness for Hospital Discharge questionnaires.

Results: Patients perceived low total discharge and personal status readiness for discharge. This was in contrast to 93.9% of …

Nurses’ Knowledge And Attitudes Toward Implementation Of Electronic Medical Records, Cathy H. Abell, Tonya Bragg-Underwood, Lori Alexander, Caitlyn Elizabeth Abell, Vanessa Burd

International Journal of Faith Community Nursing

With the growth of Faith Community Nursing (FCN), one topic that needs further exploration is documentation. This includes the use of electronic medical records (EMRs). Nurses play a vital role in the planning and implementation of EMRs in the acute care setting and will also play a key role in Faith Community Nursing Programs that stand alone or partner with a health care agency. Individual computer expertise and/or attitude and knowledge of EMRs could be important in the successful implementation. Researchers utilized a modified version of the EMR questionnaire designed by Beiter and colleagues to examine nurses’ knowledge and attitudes …

Exploring The Career Pathways, Professional Integration And Lived Experiences Of Regulated Nurses In Ontario, Canada, Godfred O. Boateng

Electronic Thesis and Dissertation Repository

In the context of an enduring shortage of nurses, this study explores the career pathways and experiences of immigrant and Canadian-born nurses in two Ontario cities utilizing a qualitative research design consisting of 70 in-depth interviews. Differences in career entry and experiences of workplace conflict across immigration status and race are explored.

First, I explore successful immigrants’ pathways into the nursing profession and their social and economic integration into the Canadian economy in light of the traditional assimilation and segmented assimilation theories. The study reveals distinct career pathways taken by foreign-born nurses and Canadian born nurses. While Canadian-born nurses have …

The Relationship Between Inter-Professional Collaboration, Job Satisfaction, And Patient Safety Climate For Nurses In A Tertiary-Level Acute Care Hospital, Noha Mohammedali Hamlan

Electronic Thesis and Dissertation Repository

ABSTRACT

The purpose of this secondary data analysis study was to examine nurses’ perceptions about inter-professional collaboration (IPC), job satisfaction and patient safety climate and the possible relationship between them in a large tertiary care hospital in Ontario, Canada. The data used for this study came from a large quasi-experimental study to evaluate the impact of introducing a new model of IPC. D’Amour’s Inter-professional Collaboration, Hackman & Oldham’s Global Job Satisfaction, and Sexton’s Patient Safety Climate were the main instruments used in this study. Study results showed that nurses reported moderate levels of IPC (M= 3.56, SD= .65) as measured …

Improving Patient Satisfaction Through Reducing Nurse Overtime And Redesigning Nurse Staffing And Scheduling, Abby Romme

Master's Projects and Capstones

Increasing cardiac device patient demands within a large Midwest healthcare institution resulted in significant increases in staff shift requirements and corresponding patient complaints. The quality improvement project aimed to decrease patient complaints by executing a standard baseline daily full time equivalent (FTE) staffing strategy for future schedules, increasing nursing FTE, and maintaining institutional staffing standards. Standard calculated daily nursing requirements targeted 17.0 FTE. Implementation occurred over a three month period including schedule reprocessing, a pending incremental nursing FTE request, and a restructuring of unit based scheduling and paid time off guidelines. The completed schedule accurately captured staffing requirements for 100% …

Simulation And Educational Strategies To Decrease The Incidence Of Medication Errors In A Small Rural Acute Care Hospital, Queen Victoria Walters

Doctoral Projects

The Institute of Medicine (IOM) estimates 1.5 million medical errors occur per year (2007). Medication errors are the leading medical error. Medication errors are defined as adverse drug events, and are 100% preventable. Some categories of adverse drug events include, medications administered at the wrong time, by the wrong route, using the wrong method of administration, and administration of the wrong dose of medication. Adverse drug events also include administration of an overdose of medication or the omission of medications as well as administering the wrong medication.

The purpose of this capstone project was to increase the competency of nurses …

Organizational Support And Job Satisfaction Of Frontline Clinical Managers: The Mediating Role Of Work Engagement, Alexandra Peterson

Electronic Thesis and Dissertation Repository

Effective frontline clinical managers (FLM’s) strongly influence the safe and optimal delivery of healthcare. However, the motivational potential of FLMs working with limited job resources can be hindered, affecting healthcare unit staff morale and adversely impacting organizational performance and patient outcomes. Since managers act as role models for employees, it is crucial for organizations to understand the positive influence of job resources on motivation in order to foster positive FLM working conditions and promote their effectiveness. The purpose of this study was to test propositions drawn from the Job Demands Resources Model, specifically the motivational pathway, to examine the relationships …

Elevating Research: An Important Role For Nurse Leaders, Katreena Collette Merrill, Diane Andrews, Barbara B. Brewer, Diane Storer Brown

Faculty Publications

As leaders, we recognize the importance of professional scholarship to provide the evidence needed to transform practice. One key initiative for the American Organization of Nurse Executives (AONE) is the elevation of nursing research and AONE competencies for nurse executives emphasize utilization, dissemination and participation in studies. However, given our current healthcare climate and competing priorities, nurse leaders must often focus efforts on fiscal responsibility and operational effectiveness, making time and resources to support nursing research challenging. Initiatives that do not directly impact patient care, such as research, may be given a lower priority. Given today’s pressures, nurse leaders may …

Process Change At An All-Volunteer Run Clinic With Pcmh Level 1 Recognition, Erin Flynn

Master's Projects and Capstones

This project directly involves the Clinical Nurse Leader (CNL) essential Informatics and Healthcare Technologies, and the CNL role function will be to act as a Team Manager. (AACN, 2013). The global aim of this process improvement is to improve the clinic workflow to increase patient and provider satisfaction in a Patient-Centered Medical Home (PCMH). The need for this project was discovered during the process of applying for PCMH recognition (of which the clinic has now earned level 1), and successful implementation of this project will meet PCMH guidelines. While applying for PCMH recognition, a clinic workflow document had to be …

An Innovative Approach To Adult Education In A Two-Year Bscn Program: Creating Partnerships In Learning, Baiba Zarins, Lorraine M. Carter Dr., Tammie Mcparland

Quality Advancement in Nursing Education - Avancées en formation infirmière

Abstract

In the program described in this paper, innovation in nursing education is presented as a response to specific tensions between academic and practice environments in the nursing field. As a unique partnership between a university in northern Ontario and three health care delivery organizations in a large urban environment, the Scholar Practitioner Program (SPP) is an accelerated two-year post degree leading to a Bachelor of Science in Nursing.

Using narrative inquiry and cognitive apprentice pedagogies, SPP partners developed an experiential program in which students act as inquirers and co-creators as opposed to receivers of knowledge. Students are also immersed …

The Influence Of Nurse Manager Transformational Leadership On Nurse And Patient Outcomes: Mediating Effects Of Supportive Practice Environments, Organizational Citizenship Behaviours, Patient Safety Culture And Nurse Job Satisfaction, Elizabeth A. Higgins

Electronic Thesis and Dissertation Repository

The Canadian Adverse Events Study (Baker, et al., 2004) revealed that the rate of adverse events in Canadian hospitals is 7.5% and almost 37% of these are preventable. Given these statistics, it is essential that healthcare organizations develop strategies and engage in leadership practices, which will address the complexity of healthcare processes and ensure that care is provided in a consistent, reliable manner in order to achieve the desired outcomes (Frankel, Gandhi & Bates, 2003). It is equally vital that leaders create supportive practice environments that promote a non-punitive culture of learning, continuous improvement, inter professional collaboration, and professional autonomy, …

Understanding Nurses' Knowledge Work, Heidi M. Siu

Electronic Thesis and Dissertation Repository

Hospitals are increasingly investing in technologies and electronic knowledge management systems to improve patient care outcomes. Yet, effective implementation of these initiatives has been difficult with questionable return on investment outcomes (Ontario Hospital Association [OHA], 2007, 2008). Paton (2009) argues that understanding how employees put their knowledge into action at work is essential to successful knowledge management for organizations. Thus, strategies that target nurses’ knowledge work may be more effective for hospitals; particularly in times of mounting fiscal deficits and demands for health services.

This study examined the behaviors, influences, and outcomes of nurses’ knowledge work. The hypothesized model was …

The Effect Of Longitudinal Changes In Rn Specialty Certification Rates On Total Patient Fall Rates In Acute Care Hospitals, Diane Kay Boyle Phd, Rn, Faan

Diane Kay Boyle PhD, RN, FAAN

Background: Researchers have studied inpatient falls in relation to aspects of nurse staffing, focusing primarily on staffing levels and proportion of nursing care hours provided by registered nurses (RNs). Less attention has been paid to other nursing characteristics, such as RN national nursing specialty certification.

Objective: To examine the relationship over time between changes in RN national nursing specialty certification rates and changes in total patient fall rates at the patient care unit level.

Method: We used longitudinal data with standardized variable definitions across sites from the National Database of Nursing Quality Indicators®. The sample consisted of 7,583 units in …

Leadership Style And Patient Safety: Implications For Nurse Managers, Katreena Collette Merrill

Faculty Publications

OBJECTIVE: The purpose of this study was to explore the relationship between nurse manager (NM) leadership style and safety climate.

BACKGROUND: Nursing leaders are needed who will change the environment and increase patient safety. Hospital NMs are positioned to impact day-to-day operations. Therefore, it is essential to inform nurse executives regarding the impact of leadership style on patient safety.

METHODS: A descriptive correlational study was conducted in 41 nursing departments across 9 hospitals. The hospital unit safety climate survey and multifactorial leadership questionnaire were completed by 466 staff nurses. Bivariate and regression analyses were conducted to determine how well leadership …

Alumna's Dedication To Nursing Spans 50 Years

DePaul Magazine

2014 marked the 20th anniversary of Professional Healthcare Resources for founder and president Eileen DeCesare (LAS MS ’78). Her home health care, hospice and personal care services organization in Washington, D.C. that was one of a handful of agencies preapproved to take affected patients when a health care fraud crackdown in 2014 closed 10 agencies. DeCesare talks about her nursing career and the legacy she hopes to leave.

Diabetic Prevention The Hard Way: Modified Diet And Increased Exercise, Torrie Reese St.Julien

Doctor of Nursing Practice Final Manuscripts

Background and Purpose: In the United States, 79 million people are pre-diabetic: most have no symptoms. If left untreated, 37% will develop diabetes within 4 years. Fourteen percent of United States health care expenditures are related to diabetic complications. This Evidenced Based Project (EBP) involved a behavioral lifestyle change with the purpose of 7% weight loss and a minimum of 150 minutes of physical activity a week. It was also designed to reduce risk factors and glycated hemoglobin A1c (HgA1c) levels.

Methods: The interventional approach was modeled after the Diabetes Prevention Program (DPP) and Group Lifestyle Balance Program. Participants were …

Perinatal Patient Management, Natalie Whitten

Master's Projects and Capstones

The medical center has lacked the bed capacity and nursing staff to accommodate the needs of maternity patients. Patients are redirected to other network and non-network medical centers due to lack of bed availability, inadequate nurse staffing, and poorly managed patient movement. This project aims to improve patient management in the perinatal departments, including the discharge process. We will have 100% staff participation to facilitate bed management. The patient management project was conducted in a 200-bed hospital serving the residents of an urban area. The perinatal areas of labor & delivery (L&D), antepartum, and postpartum (OB) are highly productive units …

Improving Patient Safety: Reducing Medication Errors In The Microsystem, Erica M. Dent

Master's Projects and Capstones

In a 72-bed for-profit long-term acute care hospital located in an urban setting, there has been a fifteen percent increase of medication errors that the pharmacy department has detected across nursing, and pharmacy departments, as well as with physicians from both day and night shifts. Over the last month there has been a total of twenty-eight medication errors including the transcription, administration, evaluation, and documentation processes. The microsystem consists of a telemetry/medical-surgical unit as well as a small intensive care unit consisting of ten beds.

The prospectus details a project implemented to reduce medication errors within the microsystem. The steps …

An Investigation Of The Relationships Between And Among Power, Trust And Job Satisfaction Of Nurse Managers In Acute Care Hospitals Using Rogers Science Of Unitary Human Beings, Maureen A. Schneider

Seton Hall University Dissertations and Theses (ETDs)

Background: Defined as control and freedom, power is often characterized as hierarchical. Power-as-freedom exists as a unitary manifestation of the whole and is acausal. Thus a worldview that emphasizes mutual process rather than a causal (control) view supports a culture of trust in the healthcare environment that generates a committed and a thriving work force. When nurse leaders support a climate of trust, managers develop a sense of commitment to the organization which may lead to job satisfaction. However, there is a lack of empirical evidence supporting the relationship between power, trust and job satisfaction among nurse managers.

Purpose: The …

Factors Contributing To Registered Nurse Job Satisfaction In The Nursing Home, Michael Shipley

Seton Hall University Dissertations and Theses (ETDs)

Over the next several years the aging population will increase the number of patients suffering from chronic illness. A sicker aging population, coupled with changes in healthcare reimbursement will require nursing homes to admit sicker patients for shorter lengths of stays. To meet the needs of the increased number of chronic patients and those patients with higher acuities, nursing homes will require more skilled, registered nurses. Registered nurses (RNs) are the linchpin to providing high-quality care in the healthcare environment and especially in nursing homes.

Understanding the factors of RN job satisfaction in the nursing home is important in increasing …

Implementation Of The Transition To Practice Regulatory Model For Nurse Preceptors In A Rural Setting, Donna Renee Honour

Doctoral Projects

Registered nurse turnover is a recurring problem for healthcare organizations. The inability of hospitals to retain registered nurses threatens the adequacy of healthcare delivery and increases personnel and patient care cost. The purpose of this capstone project was to take a leadership role in translating evidence into practice by successfully preparing preceptors to help new graduates transition successfully from the role of student to that of a profession nurse.

Healthcare organizations require a stable, highly proficient and totally engaged nursing staff to provide effective and efficient levels of patient care. The first year of practice for a nurse graduate, the …

The Effects Of Implementing Best Practices On 30-Day Readmission Rates In Adults Following Cabg Surgery, Linda Elaine Kline

Evidence-Based Practice Project Reports

Coronary artery bypass graft (CABG) surgery is one of the most frequent and expensive cardiac surgical procedures in the U.S. today. Complications from CABG surgery are one of the top causes of 30-day hospital readmissions. Readmissions after CABG surgery are often preventable and add to health care costs. Recent government legislation mandates penalties for hospitals with excess readmission rates. The purpose of this evidence-based practice project was to determine if implementation of best practice recommendations effected 30-day readmission rates following CABG surgery. A critical appraisal of the literature was conducted to identify best practice recommendations. The Iowa model and Lewin’s …

Health Care In The Community: Developing Academic/Practice Partnerships For Care Coordination And Managing Transitions, Mary E. Fortier, Edd, Rn, Cnl, Donna M. Fountain, Phd(C), Aprn, Phcns-Bc, Maryelena Vargas, Phd, Rn, Lisa Heelan-Fancher, Phd, Fnp-Bc, Anp-Bc, Tracy Perron, Phd, Rn, Katherine Hinic, Phd, Rn, Anp-Bc, Beth Ann Swan, Phd, Crnp, Faan

College of Nursing Faculty Papers & Presentations

Executive Summary

The delivery of health care is quickly changing from an acute care to a community-based setting.

Faculty development and mastery in the use of new technologies, such as high-definition simulation and virtual communities are crucial for effective student learning outcomes.

Students' benefit include opportunities for hands-on experience in various patient care scenarios, real-time faculty feedback regarding their critical reasoning and clinical performance, interdisciplinary collaboration, and access to a nonthreatening learning environment.

The results of this study provide some evidence of the benefits of developing faculty and nursing curricula that addresses the shift from an illness-based, acute hospital model, …