Nursing Commons^™

Enhancing Newer Nicu Nurse Confidence With Resuscitation Through High-Fidelity, In-Situ Crisis Resource Management, Karen Rose

Doctor of Nursing Practice Final Manuscripts

Neonatal resuscitation is a low-volume, high-risk occurrence. Given the infrequency of resuscitation, newer neonatal intensive care unit (NICU) nurses may have little to no exposure to neonatal resuscitation events. This can lead to a lack of confidence in resuscitation skills, contributing to burnout, poor patient outcomes, and the potential for nursing turnover. This evidence-based practice project, guided by the Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care, focused on enhancing the perceived confidence in neonatal resuscitation skills among newer NICU nurses. To achieve this, multidisciplinary, high-fidelity, in-situ neonatal resuscitation crisis resource management (CRM) simulated events were implemented. …

Do More Than Train New Nurses...Retain Them! A Qualitative Research Study, Kerrin L. Hampton

Doctoral Dissertations and Projects

The purpose of this hermeneutic phenomenological study is to understand the orientation experiences of new graduate nurses and identify retention practices that are relevant and beneficial to the population of interest. Study participants were new graduate nurses employed at a five-hospital healthcare system. Using social constructivism as the theoretical framework, the study sought to answer the research question of what are the lived experiences of new graduate nurses during orientation? Ten new graduate nurses participated in individual interviews to discuss their personal orientation experiences. The interviews informed the researcher regarding the meaning and value new graduates place on their orientation …

The Effect Of Formal Mentorship Programs On Nurse Faculty Retention: An Integrative Review, Lisa Livingston

Doctoral Dissertations and Projects

The nursing shortage has been a hot topic for decades, and literature supports a need to address this issue. Although faculty are critical to educating the nurses of the future, the shortage has impacted nurse faculty numbers as well. Nursing shortages are predicted to increase over the next decade. Evidenced-based interventions are critical to help sustain the nursing workforce. This integrative review highlights the importance of formal mentorship programs for new nurse faculty as a retention strategy for use by administrators of schools of nursing.

Fostering Relationships Between New Graduate Nurses And Leadership To Increase Retention, Michelle Cotton

Doctor of Nursing Practice Projects

Objective: To implement weekly one-on-one touch bases between nursing leaders, such as managers and directors, with newly hired, new graduate nurses, up to 1 year after graduation to improve retention of those employees. The intent is to improve retention from a baseline of 23% in 2022.

Results: 35.8% of the newly hired nurses plan to remain in their current role for the next 2-3 years.

Conclusions: Almost 55% said that they strongly agreed with the touch base contributing to development/growth. This was the lowest scoring question and the most concerning related to retention. An overwhelming majority felt …

New Crew Nights: The Impact Of A Nurse Leader Led Mentorship Series On Perceived Competency In The Novice Nurse, Taylor C. Bergman

DNP Projects

Abstract

Background and Purpose: Nursing leaders across the United States are seeking to recruit and retain new graduate nurses as a national nursing shortage widens at an alarming pace. Healthcare systems are tasked to strengthen the skill set of novice nurses as they seek to meet the care needs of acutely ill patients and rebuild a skilled workforce for future years. This study evaluated the impact of a four-part mentorship series for novice nurses on perceived strengths in competency, communication, wellbeing, and teamwork.

Methods: In this quality improvement project with pre-intervention/post-intervention assessment, a sample (n=14) of medical surgical nurses with …

The Effect Of An Employee Recognition Program For Clinical Registered Nurse Retention At Eastern State Hospital, Kristi Richmond

DNP Projects

Abstract

Background: Nurse executives want to build and retain teams capable of delivering high quality care. However, registered nurse (RN) turnover continues to jeopardize this goal. RN satisfaction has been associated with reduced turnover in the nursing field. Adequate staffing levels are linked to better patient outcomes, and employee recognition is a key factor in RN retention.

Purpose: The purpose of this study was to evaluate the effectiveness of utilizing an existing recognition tool for RNs at an inpatient state psychiatric hospital in the southeastern United States to determine level of job satisfaction, level of job loyalty, level of engagement, …

Mentorships For New Graduate Nurses, Taylor Leigh Bailey

Doctor of Nursing Practice Projects

New graduate registered nurses (NGRNs) represent a crucial segment of the nursing workforce, embodying the future of the profession. Thus, it is imperative that we utilize our resources, knowledge, and experiences to continuously strengthen and grow this generation of nurses. Mentorship is one key method that can be used to support NGRNs. This DNP project aimed to evaluate the effectiveness of mentorship for NGRNs within their first year of nursing practice and was implemented within an existing residency program at a Level I trauma facility. Experienced nurse volunteers received mentor education, and 40 NGRNs were individually paired with these volunteer …

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

Master of Science in Nursing Family Nurse Practitioner

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

Leadership Style And Nursing Retention, Brenae J. Reason

MSN Capstone Projects

Nursing is the heart of healthcare, for decades we have been the drivers of innovation and have contributed to so many advancements in the profession. Even with nursing being a sincere passion amongst many nurses, there is an alarming trend of nurses who are faced with burnout (Brusie, C., n.d.). It has been reported that 1 in 5 nurses left their position in one particular health system (Andreyeva et al., 2023). It is also noted that turnover can be costly for organizations (Zuniga et al., 2019). While there are a multitude of reasons nurses could be leaving their companies, one …

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

MSN Capstone Projects

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

The Impact Of Self-Compassion Strategies To Reduce Stress And Support The Transition To Practice For New Graduate Nurses: A Pilot Project, Charity Michelle Ballmann

Electronic Theses and Dissertations

Abstract The purpose of the study was to analyze the impact of self-compassion exercises to reduce stress and support the transition to practice for new graduate nurses. As the years pass, one thing remains a consistent topic in healthcare, and the need for nurses remains constant. The nursing staffing shortage gap seemingly widened further as the COVID-19 pandemic created additional challenges for healthcare systems, patient care, and employees. Retention of the workforce and an intentional focus on new graduate nurses' well-being have become increasingly important. New graduate nurses are a pipeline for the nursing workforce. Supporting the transition to practice …

Improving New Nurse Manager Orientation And Onboarding Program, Leanne E. Deegenaars

Doctor of Nursing Practice (DNP) Projects

ABSTRACT

Purpose: Identify and adapt the best evidence for nurse manager orientation and onboarding programs into practice. Assess the program's impact on job satisfaction and retention of new Nurse Managers (NMs) and Assistant Nurse Managers (ANMs).

Background: Constant turnover of ANMs and NMs within local and regional facilities is expensive and negatively impacts nursing leaders' work environment, job satisfaction, and patient outcomes.

Local Problem: The lack of formal orientation and onboarding at the focus facility impacts the retention and job satisfaction of NMs. The sunsetting of a regional hub model of new NM orientation and onboarding led to a just-in-time …

Transformational Leadership And Structural Empowerment For Nurse Managers To Improve Nursing Job Satisfaction, Engagement, And Retention, Leah M. Gehri

Doctor of Nursing Practice Projects

Problem Description

Low nurse job satisfaction and engagement have historically been associated with high attrition. While it is too soon to fully quantify the impact of Covid-19 on nurse satisfaction, engagement, and turnover, evidence is emerging that high chronic fatigue and persistent feelings of being overwhelmed are causing nurses to either leave the bedside or quit nursing altogether, exacerbating existing nurse staffing challenges caused by a decades long nursing shortage that, pre-pandemic, predicted a national deficit of over one-half million nurses by 2030. The financial impact of competing for experienced nurses, and recruiting, hiring, and training new nurses to replace …

Application Of Preceptorship Bundle To Enhance New Graduate Rn Success, Joann R. Nardoni

Doctor of Nursing Practice Projects

New graduate Registered Nurses (RN) are experiencing a difficult transition to practice. In turn it causes increased stress and job dissatisfaction. The quality improvement project focused on a bundled intervention to bridge this gap. It involved a preceptorship enhancement bundle to improve training with an emphasis on intentional pairing of preceptor/preceptee and use of the One-Minute Preceptor Model. People of like temperament were paired using the Ntrinsx personality profile to enhance the learning relationship. The One-Minute Preceptor Model was used to train preceptors how to engage critical thinking and clinical reasoning in the new RN. The actions of intentionally pairing …

The Relationship Between Perceived Stress And Academic Self-Efficacy To The Academic Performance Of Undergraduate Nursing Students, Ashley J. Pierre

Nursing Theses and Dissertations

When nursing students fail and are required to repeat a course in a pre-licensure nursing program, they are at risk for attrition. While nursing student attrition is a problem with recognized consequences to the student, school, and profession, the incidence of students who fail a required course and need to repeat it has had little attention. Despite research addressing students' experiences with course failure, little describes strategies and interventions to support the retention and success of these students. The first manuscript, Student Repeaters in Baccalaureate Nursing Programs: A Concept Analysis, provided a foundation that enhanced the conceptual understanding of nursing …

The Effect Of Mentorship And Social Events On Job Embeddedness And Intent To Stay In Emergency Department Nurses, Kacie L. Albertsen

DNP Projects

Background and Purpose: The COVID-19 pandemic has drastically impacted nurse retention. According to the Kentucky Nurses Association, 57% of surveyed Kentucky nurses are considering leaving their jobs. Best retention strategies are unclear. Job embeddedness (JE) and Intent to stay (ITS) are factors that influence retention. The purpose of this project is to increase JE and ITS at a level one emergency department (ED) by implementing evidence-based mentorship and social event interventions.

Methods: This study utilized a mixed-methods, one group pretest-posttest design. Mentorship pairs were matched by personality type using the Big Five Personality Test. Four mentorship discussion meetings and two …

The Heart And Soul Of Engagement In The Float Pool Team, Kymberly Dexter

Master's Projects and Capstones

Problem: The assistant nurse manager (ANM) role is considered an entry-level management position and is not intended as a permanent career role. The unintended consequence is that there is a high rate of organizational turnover, making it challenging to build and retain a solid, cohesive, and productive team.

Context: A new manager of a float pool team in a 166-bed community hospital found that with little financial investment, a significant impact is made by holding a safe space for listening to the ANM team and designing education and training around what is most important to frontline managers.

Interventions: A baseline …

Retention Of New Nurses In The Cardiovascular Operating Room, Hannah Shufeldt

Doctor of Nursing Practice Projects

Background

In January of 2020, a hospital in Springfield, Illinois started the year with seven full-time circulating nurses in the cardiovascular operating room (CVOR). Three of those nurses left before the end of the year and an additional four nurses were hired. In January of 2021, the CVOR began the year with eight nurses. Five of these nurses left by the end of the year and seven more were hired, one of which left before the end of 2021. This department has struggled to retain nurses, with a turnover rate of 42.9% in 2020 and 62.5% in 2021.

Purpose

The …

Effects Of Resilience Coaching On Behavioral Health Nurse Burnout, Dalila Franklin

Dissertations

Abstract

Background: Inpatient, staff nurse burnout negatively impacts nurses’ mental and physical health, hospital nurse retention and turnover, and patient care. The Stress First Aid for Health Workers program attempts to bolster resilience and subsequently reduce burnout among mental health nurses in this project.

Method: This quality improvement (QI) project was an observational pre-post survey design and was conducted on a cohort sample of inpatient, behavioral health nurses at an urban, mid-sized, Midwestern hospital psychiatric unit to assess personal, work-related, client-related, and overall burnout utilizing the Copenhagen Burnout Inventory (CBI) tool to quantitatively measure burnout pre- and three months post-implementation …

Predictors Of Engagement In Nursing Professional Practice: Transforming Organizational Culture In The Post-Covid Healthcare Environment, Jennifer Garnand

Dissertations

Cultivating the shared belief that individuals matter within an organization enhances the empowerment of staff and supports enthusiastic engagement in organizational efforts aimed toward a common mission, vision, and goals (McShane & Von Glinow, 2019). The nursing profession has been plagued by an unprecedented decrease in engagement and diminished job satisfaction, particularly following the prolonged tenure of the COVID-19 pandemic, leading to subsequent attrition amidst a staffing crisis. This quantitative predictive correlational study seeks to determine whether proactive and persevering characteristics, professional identity, and passion of nurses are predictors of engagement in a post-COVID healthcare environment. The research was based …

Computer-Based Learning For Opioid Use Disorder, Jordan Taylor Bentz, April Snell

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

Over the last several decades, the prevalence of Opioid Use Disorder (OUD) has escalated in the U.S., leading to an opioid epidemic that ravages the wellbeing of the nation. Despite all alleviating efforts, opioid-related morbidity and mortality continue to rise across most states, including Tennessee. Currently, medication-assisted treatment (MAT) is the most highly regarded method of treatment for OUD; however, MAT programs differ significantly on the pharmaceutical agent of use, adjuncts to treatment, and philosophy of care. Unfortunately, this inconsistency often leads to poor treatment retention in MAT programs. This project aimed to improve MAT retention for patients with OUD …

Retention Strategies For The Current Nursing Workforce, Jennifer Higgins

Walden Dissertations and Doctoral Studies

Retaining a robust nursing workforce is essential to care delivery. As the generation gap in the nursing field widens, retention strategies that align with the current nursing workforce must be considered. Rapid turnover is a looming concern as baby boomers retire and millennials become the leading generation in the nursing workforce. Nurse leaders must identify and deploy strategies that will provide a meaningful work environment to retain nurses in this majority group. The purpose of this project was to address the gap in practice of rising turnover, low nurse engagement, and reliance on premium labor to deliver care. The sources …

Role Of Intravenous Access Support In Novice Nurses’ Job Satisfaction And Intent To Stay, Shaji Kurian

Walden Dissertations and Doctoral Studies

The nursing shortage is a growing concern across the country, especially due to the Covid-19 pandemic. Novice nurse retention is essential to solving this national problem. The purpose of this study was to examine whether intravenous (IV) access support influences job satisfaction and retention among novice nurses to improve their retention. Herzberg’s two-factor theory guided this research; IV access support acts as the hygiene factor. The absence of IV access support can result in dissatisfaction among novice nurses, contributing to higher turnover rates. This quantitative nonexperimental causal-comparative research design utilized a nurse work satisfaction questionnaire and intent to stay scale …

Evaluation Of An Orientation Program For Graduate Nurses Transitioning Into Professional Practice, Kristy Patrick-Lewis

Walden Dissertations and Doctoral Studies

The transition from student nurse to practicing professional is extremely challenging. The local organization experienced increases in turnover among new graduate hires and determined that adjustments to their orientation program to better meet the needs of new graduates were warranted. The problem that this doctoral project addressed is the lack of evaluation of the effectiveness of the new orientation program. The practice-focused question examined the effectiveness of the new orientation program at reducing turnover and improving satisfaction with the quality of the orientation program among new graduate nurses. The framework used to guide this study was Patricia Benner’s novice to …

Nurse Manager’S Leadership And Communication Skills And A Registered Nurse’S Organizational Citizenship Behavior, Satisfaction, And Intent To Leave, Emmitte J. Hall

Walden Dissertations and Doctoral Studies

The Veteran’s Health Administration (VHA) is the largest employer of registered nurses in the United States. The American Association of Colleges of Nursing predicts there will be a nursing shortage through the year 2030 and replacing and training each nurse is expensive and negatively impacts patient care. A review of the literature showed organizations with high levels of organizational citizenship behavior (OCB) had high levels of job satisfaction, which reduces turnover, but there was no research on the existence and impact of OCB in a federal health care facility, specifically the VHA. The purpose of this quantitative, correlational research was …

Manager Onboarding To Improve Knowledge And Confidence To Lead, Christine (Tina) K. Asiimwe

Doctor of Nursing Practice (DNP) Projects

Background: Primary care (PC) is increasingly the setting for affordable, coordinated, end-to-end patient care, with PC managers in charge of organizational performance. While PC managers are central to high-functioning teams, they often receive inadequate onboarding.

Local Problem: Primary care onboarding competes with other operational priorities and faces time constraints, lack of mentorship, and cost.

Context: At an integrated healthcare system, a need was identified to develop structured, role-specific onboarding for newly hired PC managers to improve knowledge and confidence to lead.

Interventions: Bauer’s Four Cs framework for onboarding guided the development of a manager onboarding program for 12 new PC …

The Art Of Nurse Mentoring: A Framework Of Support, Diane S. Kramer, Victoria Y. Mccue, Eve Butler, Andrea S. Prentiss, Maria M. Ojeda, Kayce K. Tugg, Vivian Fuentes, Sally Bonet

Nursing & Health Sciences Research Journal

Introduction: Nursing mentoring relationships are vital to the advancement of personal and professional growth in nursing. Mentoring has been identified as an effective method to decrease turnover resulting in retention of experienced nurses. Despite the benefits of a mentoring relationship, barriers exist in creating and cultivating a formal mentoring program in the hospital setting.

Methods: A qualitative descriptive study approach that explored nurses’ perceptions of a mentoring culture within a hospital environment. Open-ended, conversational-style interviewing techniques with a semi-structured interview guide were utilized to gain a full description of nurses’ perceptions of a mentoring culture within a hospital environment.

Results: …

Mentoring New Nurses To Increase Retention: A Benchmark Study, Maria J.V Hartnauer

MSN Capstone Projects

New nurse retention and nurse satisfaction are two significant areas of concern for healthcare organizations. The financial burden that results from decreased retention and increased turnover rates can create severe distress for the hiring facility. Organizations struggle to retain new graduate nurses beyond the first year of practice. The transition to practice for many new nurses is often complex, challenging, and stressful. New nurses need multiple interventions to provide physical, spiritual, and moral support to adapt to their new role. Many hospitals have implemented new nurse orientation, educational opportunities, and preceptor programs. However, there is still room for improvement. This …

Benchmark Study On The Impact Of Nurse Managers’ Leadership Style On Job Satisfaction And Retention Of Nurses, Khatrina Swarup

MSN Capstone Projects

Nurse managers play a crucial role in the healthcare system as they ensure that quality care is maintained and provide the necessary support for the nursing staff to perform their responsibilities well, amongst other duties. Nurses want patients to receive quality, cost-effective care, and these patients want the same. If nurses are happy with their jobs, they provide quality patient care, improving overall patient outcomes. Also, job dissatisfaction predicts how individuals perform at work and whether they intend to leave their position or not.

The current standard of practice does not specify what leadership styles nurse managers or leaders should …

The Effect Of Authentic Leadership And New Graduate Support On New Graduate Nurses' Job Satisfaction, Stephanie H. Prtenjaca

Electronic Thesis and Dissertation Repository

The purpose of this study was to test a theoretical model linking authentic leadership to new graduate nurses’ job satisfaction through its effect on new graduate support. This study was a secondary analysis of Time 1 baseline data collected in a two-wave national study of Canadian new graduate nurses, which used a non-experimental, predictive survey design. A convenience sample of 215 new graduate nurses with less than two years of experience, working in direct care, was obtained through The College of Nurses of Ontario. Hayes’ PROCESS macro for SPSS, version 3 was used to test the hypothesized simple mediation model. …