Nursing Commons^™

The Effects Of A Care Delivery Model Change On Nursing Staff And Patient Satisfaction, Kathleen Gier

Nursing Theses and Capstone Projects

Hospitals across the nation are faced with the challenge of providing high-quality, cost-effective patient care. The purpose of the research study, The Effects of a Care Delivery Model Change on Nursing Staff and Patient Satisfaction, was to examine the impact of implementing a team-approach care delivery model on defined outcomes of staff satisfaction and patient satisfaction. A quasi-experimental design study was utilized to examine the effects of implementing a team-approach care delivery model on a 33-bed Medical-Surgical unit. Prior to and after implementation of the new care delivery model, data were collected regarding patient and staff satisfaction. All nursing and …

Medication Safety: Improving Faculty Knowledge And Confidence, Sharon S. Cherry

Nursing Theses and Capstone Projects

The purpose of this capstone project was to increase knowledge and confidence among nursing faculty assisting pre-licensure nursing students with the medication administration process. The project administrator designed a one day Safe Medication Practices seminar that included a Medication Administration Toolkit to increase knowledge and confidence in faculty members about safety and efficiency in giving medications with multiple students on any clinical day. This toolkit included high-fidelity simulation medication scenario case examples as a teaching pedagogy, as well as other teaching strategies to utilize in the clinical environment. Bandura's Social Learning theory provided the framework for this capstone project. The …

Patient-Family Centered Advisory Council For The Emergency Department, Kelly Sanocki

Theses and Graduate Projects

Issues such as overcrowding and long wait times in the ED cause an increase in patient frustration and dissatisfaction, which may lower hospital satisfaction scores,, and reimbursement. This project proposes the implementation of a Patient-Family Advisory Council (PFAC) in the Emergency Department (ED) setting in a large urban hospital. The addition of a PFAC will offer patients and family members a voice in their care, as they work collaboratively with various healthcare providers to improve patient care, patient safety, and overall satisfaction. The addition of Watson's Caring theory will serve as the theoretical framework for the PFAC since it is …

Nursing Leadership Team Orientation Program, Sheryl Capelle

Theses and Graduate Projects

Nursing is a dynamic profession. Throughout the history of nursing, leaders have emerged. Some leaders have joined a nursing leadership team to provide care and support to the unit staff and patients. Developing a highly functioning leadership team comes through having a well-developed orientation plan. The nursing leadership team must learn, their roles and expectations from each other. This project explains nursing leadership teams and discusses the development of a new orientation program for the nursing leadership team. A conceptual model of a puzzle is used to describe how nursing leaders bring the ptzzle pieces of leading, caring and relationships …

Who Do You Think You Are? And Who Would You Like To Become?, Sandra Koeller

Theses and Graduate Projects

Ultimately -y goal would be to enhance staff satisfaction to the point of better retention of nursing assistants on my floor. I thought this would also assist in improving RN satisfaction, as there would be solid, reliable assistive staff on the floor. Research of the literature shows staff retention has a direct impact on patient satisfaction as well. The constant cycle of replacing staff is costly to the organization and diminishes satisfaction to all staff as they become trapped in the endless cycle of training new staff in. Patient quality of care suffers, as newly trained staff needs time to …

Floattng Through Uncharted Waters, Amanda Moscatelli

Theses and Graduate Projects

The act of floating or flexible staffing is a cost effective way to maintain nursing staffing levels through times of shortages and surplus. While the financial and patient care benefits are abundant, the culture of floating tends to be negative. Nurses cite difficulty adapting to a changed environment, caring for different patient populations, and working with different staff members as the most difficult and anxiety provoking aspects of floating. Although nurses at a large Midwest medical center frequently float across a number of nursing units, they receive no formal education on the practice of floating. Introduction of an online floating …

The Influence Of Emergency Rns' Characteristics And Readiness For Change On Their Intention To Implement Evidence-Based Practice, Mary Kathryn Naccarato

MUSC Theses and Dissertations

Emergency departments are a major source of hospital admissions with patients at risk for pressure ulcer development. Yet, there is a paucity of literature in two key areas: emergency RNs' role in PU prevention and their knowledge, skills, attitudes and intentions toward implementation of PU prevention guidelines. Manuscript 1 was an integrative review that found multiple factors--knowledge, attitudes, and environmental--that affect nurses' use of PU prevention. Manuscript 2 was an integrative review that found the readiness for change construct as a precursor to implementing an organizational or individual change. Some nurse researchers suggest a readiness assessment as the first step …

The Effect Of Coaching On Nurse Manager Leadership Of Unit Based Performance Improvement: Exploratory Case Studies, Cynthia A. Baxter

DNP Projects

The nurse manager role has experienced an explosion of responsibilities and expectations over the last decade. As a result, competency and skill acquisition for the successful nurse manager has become the focus of many nurse managers, nurse executives, researchers and organizations. The three manuscripts contained in this final capstone report will explore the acquisition of nurse manager competency, propose coaching as a methodology for acceleration and improvement of nurse manager skill acquisition and describe the results of three case studies using coaching as an intervention to improve the performance improvement skill acquisition of nurse managers.

Nurse Manager Caring And Workplace Bullying In Nursing : The Relationship Between Staff Nurses' Perceptions Of Nurse Manager Caring Behaviors And Their Perception Of Exposure To Workplace Bullying Within Multiple Healthcare Settings, Lynda Diana Olender

Seton Hall University Dissertations and Theses (ETDs)

This study examined the relationship between staff nurses’ perception of nurse manager caring behaviors and their perceived exposure to workplace bullying within multiple healthcare settings. It was based on the theoretical position that caring promotes reciprocal caring and healing for each other and for the larger universe as informed by Watson’s theory of human caring (1979, 2006, 2008). Results indicated a statistically significant, negative, linear relationship between the CFS-CM and the NAQ-R (r = -.534, p < .001), meaning that as staff nurses’ perceptions of their nurse manager caring increased, their perception of exposure to negative acts (meeting the definition of workplace bullying) significantly decreased. The sample consisted of primarily older, more experienced, staff nurses who worked 10 years or longer within their work environment. Data analysis also revealed that staff nurses who were females and those who worked in Medical/Surgical settings were significantly more likely to perceive their managers as caring (p < .05 respectively) and that a high workload significantly influenced the staff nurses perception of exposure to workplace bullying (p < .05). In view of the predicted nursing shortages as baby-boomer nurses retire at the same time the demand for health care is rising (AACN, 2009), these findings highlight the importance of caring leadership for the health and availability of nurses at the bedside, and may lead to shifting work priorities for nurse managers. Study findings may also foster the design and implementation of a caring curriculum and caring competencies applicable for the nurse managers’ role either within nursing academic or clinical settings.

Developing Ambulatory Care Registered Nurse Competencies For Care Coordination And Transition Management, Sheila Haas, Beth Ann Swan, Traci Haynes

College of Nursing Faculty Papers & Presentations

The need for care coordination and management of transitions between Patient-Centered Medical Home providers, outpatient and community settings, including the Accountable Care Organization is often overlooked, episodic, and accountability for coordinating care and managing transitions between providers and services is lacking.

Advancing The Future Of Nursing: A Report By The Building Academic Geriatric Nursing, Jennifer L. Bellot, Dana Carthron, Melissa O'Connor, Karen Rose, Casey Shillam, Janet Van Cleave, Amy Vogelsmeier

College of Nursing Faculty Papers & Presentations

In the United States, the number of older adults will double during the next 25 years (United States Census Bureau, 2008). This dramatic demographic shift is changing the landscape of health care practice as more people live longer with multiple chronic conditions. To better prepare nurses to care for this future population, the John A. Hartford Foundation partnered with the American Academy of Nursing in 2000 to launch the Building Academic Geriatric Nursing Capacity (BAGNC) program. Since that time, 251 scholarships and fellowships have been awarded to nurses to advance geriatric nursing education, research, and practice. In 2009, …

The Impact Of The Clinical Nurse Leader/Navigator On Clinical Outcomes And Patient Satisfaction, Diane Smith Raines

UNF Graduate Theses and Dissertations

In an era of value based purchasing and healthcare reform, hospitals face the challenge of delivering high quality care in an environment of diminishing resources. This performance improvement project describes the use of master’s prepared nurses on medical surgical units to improve quality and patient satisfaction. The setting was five medical surgical units in a 200+ bed hospital in the southeastern United States. Declining resources necessitated an increase in the nurse to patient ratios on the units (from 5:1 to 6:1). The project involved the modification of the model of care through the change in nurse/patient ratios and the addition …

The Economic Benefits Of Increased Levels Of Nursing Care In The Hospital Setting, Diane E. Twigg, Elizabeth Geelhoed, Alexandra Bremner, Christine M. Duffield

Research outputs 2013

Aim: To assess the economic impact of increased nursing hours of care on health outcomes in adult teaching hospitals in Perth, Western Australia.

Background: Advancing technology and increased availability of treatment interventions are increasing demand for health care while the downturn in world economies has increased demand for greater efficiency. Nurse managers must balance nurse staffing to optimize care and provide efficiencies.

Design: This longitudinal study involved the retrospective analysis of a cohort of multi-day stay patients admitted to adult teaching hospitals.

Methods: Hospital morbidity and staffing data from September 2000 until June 2004, obtained in 2010 from a previous …

The Role Of Internal Communication And The Effect On Employee Engagement, Cherie Gaither

Graduate Theses, Dissertations, and Capstones

The purpose of this project was to build and evaluate internal communication interventions that would enhance employee engagement. The desired outcome of the communication team’s efforts was to show a significant increase in employee engagement, as compared to peer institutions.

Implementation Of Shared Governance, Sheryl Glasscock

Graduate Theses, Dissertations, and Capstones

Implementation of shared governance in any facility presents challenges for leadership as well as the nursing staff. The implementation of shared governance for this organization yielded positive results operationally, and for the development of nursing overall.

Value Based Purchasing: Positioning A Healthcare Organization For The Future, James Dale Heard

Doctoral Projects

In 2005, the Deficit Reduction Act introduced Value Based Purchasing (VBP) into the healthcare system as a means of hospital reimbursement for acute care hospitals receiving reimbursements from the Centers of Medicare and Medicaid (CMS). The purpose of this Capstone Project was to increase the knowledge of healthcare executives concerning Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and VBP and the effect it will place on the organization though the utilization of a consultant program. The role of the consultant in this project is to provide expert advice to healthcare executives about the impacts of HCAHPS and provide …

Exploration Of Self-Care Following Distribution Of Acute Management Tool For Elder Heart Failure Patients In Clinic Setting, Sharon Elaine Vincent

Doctoral Projects

The aim of this study was to develop a broad understanding of heart failure patients’ perceptions about their lived experiences. An acute symptom management tool, Red Flags I Need to Know: Heart Failure Action Plan (Health Net Federal Services, 2011), was distributed to the patients prior to initiation of the project.

The problem of heart failure rehospitalization is significant. Cost of treatment for heart disease in the United States exceeds all other conditions. The national excessive 30-day readmission rate in elders post-discharge is 24.8%. Pay-for-performance initiatives will reduce reimbursement for excessive readmissions beginning FY 2013.

The project was a mixed …

Vertical Violence And The Student Nurse: Is This Toxic For Professional Identity Development?, Sherri Williams Cantey

Dissertations

This narrative inquiry centers on student nurses’ stories of vertical violence perpetuated by clinical registered nursing staff and the meaning that students associate with this phenomenon. Student nurses are the very young and potentially impressionable members of our profession; therefore, a concern of this study was if vertical violence affects professional identity development for the student nurse. Additionally through stories revealed by these participants, this study attempted to explore whether perceptions of violence are believed to be a rite of passage into the profession. Students are the future of our profession, and it is important that this phenomenon be understood …

Improving Outcomes Of Acute Coronary Syndrome Patients Through Disease Specific Care Certification, Terri Ginn Lemon

Doctoral Projects

Cardiovascular disease remains the number one killer of Americans, accounting for over 800,000 deaths in 2008. Improving a hospital’s performance by obtaining and maintaining The Joint Commission Disease-Specific Care Certification is one method of impacting acute coronary syndrome patient outcomes. The purpose of this capstone project was to provide consultation services to ready the cardiology division of a large community hospital in south Mississippi for the process of obtaining Joint Commission Disease-Specific Care Certification in the area of acute coronary syndrome. The activities of the consultation included facilitating an examination of the current organization of ACS patient care; reviewing core …

Creating An Interactive Dnp Project Repository:A Model For Change, Sara D. Guido Dr.

Doctor of Nursing Practice (DNP) Projects

The creation of systems that can provide bridges to information technology requires rethinking old ways of doing business. In the past, individual universities and colleges would accommodate theses and dissertations on their library sites. Some of these sites are public and can be accessed by everyone, while some require university-specific affiliation.

This project aims to apply knowledge and skills related to information systems and technology. With the growth of the DNP clinical doctorate programs, and final outcome projects there is a need for specialized DNP database for a new method of data entry and retrieval for DNP’s. The creation of …

Using Structural Equation Model To Study The Impact Of Organization Culture And Nursing Work Environment In Nursing And Patient Satisfaction, Taher Giaedi

MUSC Theses and Dissertations

No abstract provided.

Nurses' Perception Of Clinical Ladder Programs, Bobbie Baucom

Nursing Theses and Capstone Projects

The purpose of this study was to measure registered nurses' perceptions of clinical ladder programs and to determine what registered nurses consider to be satisfiers in order to keep them at the bedside. Clinical ladder programs reward registered nurses for their advancement in nursing education, nursing research, expert clinical skills, and leadership skills. This study was conducted on 68 post-licensed registered nurses from the ADN to BSN program at Gardner-Webb University. A quantitative descriptive study using an instrument which items measured perceptions of registered nurses' regarding clinical ladder programs was utilized. The results concluded that registered nurses thought autonomy and …

Medication Errors: It's A Matter Of Time, Thomas D. Smith Jr.

Nursing Theses and Capstone Projects

A retrospective review of medication errors is presented as a measurement tool. Times of medication errors are separated into categories. The numbers of errors are associated with the numbers of medication administrations. The first data set contains errors that occurred within the first 8 hours of a 12-hour shift and the second data set contains errors that occurred during the last 4 hours of a 12-hour shift.

Data was obtained from a 108 bed critical care hospital in the southeastern United States. A time period will be reviewed between the months of September 2010 until August 2011. All reports of …

Staff Nurse Perception Of Leadership Styles Among Nurse Managers, Robert A. Jaffe

Nursing Theses and Capstone Projects

This project examined if transformational nurse managers were perceived by their nursing staff as more effective leaders than transactional or passive/avoidant leaders using the Transformational Theory of Leadership through administration of the Multifactor Leadership Questionnaire (Form 5X) to nurse unit managers and staff nurses. 80 staff nurses and seven unit nurse managers participated in the study. Unit nurse managers completed the MLQ (Form 5X) about themselves and nursing staff completed the MLQ (Form 5X) about their unit nurse manager. Using descriptive statistics unit nurse manager results were compared with nursing staff results. The goal was for unit nurse managers to …

Second-Year Associate Degree Nursing (Adn) Self-Efficacy In Relation To Simulation Lab Experiences, Sarah W. Tate

Nursing Theses and Capstone Projects

Second-Year Associate Degree Nursing (ADN) Self-Efficacy in Relation to Simulation Lab Experiences utilized a convenience sample of second-year associate degree nursing students to conduct a survey of their perceptions of an increase in self-efficacy or self confidence in relation to their simulation lab experiences. Albert Bandura's theory of self-efficacy was the theoretical framework for the study. Students who have high levels of self-efficacy have been shown to handle obstacles with less stress, perseverance, and success. In this study, 85% of the students agreed that simulation lab experiences were beneficial in increasing their confidence to perform safely in their preceptorship and …

Transforming A Rn To Bsn Program To An On-Line Delivery Format, Cathy H. Abell, Deborah Williams, M. Susan Jones

Nursing Faculty Publications

No abstract provided.

Bridging The Gap: Nurse Mentorship Program, Jacqueline J. Johnson

Theses and Graduate Projects

High-quality, effective mentorship can be a crucial and valuable tool in recruiting, retaining, and supporting nurses' success, especially novice registered nurses. In the current healthcare environment, growth and development of nursing staff is essential to maintain quality outcomes. Mentorship programs can create a unique environment that facilitates educational opportunities for both the novice and expert registered nurse. Nursing leaders and organizations can make lasting impacts through mentoring relationships. Through effective mentorship, nurses can positively impact healthcare organization, improve job satisfaction, promote professional development, and empower themselves. Even more important is that mentoring can result in improved nursing care, high-quality healthcare, …

The Health Impacts Of Nursing Shift Work, Amanda Maria Cason Shandor

All Graduate Theses, Dissertations, and Other Capstone Projects

This descriptive pilot study was intended to evaluate negative outcomes of shift work stress in nursing. Objective analysis of waist-hip-circumference ratios (WHR) and subjective survey reports were utilized to assess whether differences existed in expressed stress, stress related health disorders, and stress associated behaviors among day shift, night shift, and rotating shift registered nurses (RNs). Statistical analysis of the WHRs indicates that no statistical difference exists in the results from this study across the three nursing shifts. Nonetheless, survey reports do suggest that variance exists between nursing shifts. For example, stress related health problems appear to be most prevalent with …

Nurses' Knowledge Of Heart Failure Education Topics At A Regional Midwestern Hospital, Catherine Joy Standfuss

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this capstone project was to better understand Registered Nurses' knowledge level of commonly taught heart failure education topics. Heart failure is a large reason for hospital readmissions, and subsequently, a major contributor to rising health care costs. Research for this project was completed at a Regional Midwestern hospital using a questionnaire consisting of 20 knowledge questions. Registered nurses working on three separate units with high volumes of heart failure patients were invited to participate. Sixty-nine nurses responded to the survey and obtained an average score of 16.67 out of a possible 20, or 83%. Nurses work in …

Re-Envisioning Nurse Faculty Mentoring: Developmental Network Connections That Count, Margaret Babb Kennedy

MUSC Theses and Dissertations

Fears surrounding the nurse faculty shortage in the United States have prompted significant emphasis on supporting novice educators and those in transition to new roles within academia through mentoring. Yet a continued focus on traditionally held notions of a hierarchical dyad limits possibilities for facilitating rich, diverse, mentoring relationships. A novel theoretical framework incorporating social network perspective is used to conceptualize the dynamic, multilevel reality of mentoring in examination of nurse faculty mentoring. This dissertation presents the results of an integrative review and qualitative study that explore evidence and experiences of nurse faculty mentoring using the unique developmental network lens, …