Nursing Administration Commons^™

Aspects Of The Physical Work Environment And Nursing Work, Yolanda Keys

Nursing Theses and Dissertations

Objective: The purpose of this body of work is to inform nurse leaders and design professionals of opportunities to leverage the physical environment to enhance the overall work environment for nurses.

Background: The environments in which nursing work takes place need to support the staff who work within them. Healthy work environments have been shown to improve outcomes for patients, nurses, and organizations; however, the contribution of the built environment to the overall work environment for nurses is not fully understood.

Methods: Included in this portfolio are three studies: 1) a descriptive study exploring the experiences of …

Dnp Final Report: Cultivating A Culture Of Civility In A Baccalaureate Nursing Program: A Doctor Of Nursing Practice Evidencebased Practice Project, Monica Sowell

DNP Final Reports

Incivility is a well-known issue in nursing, negatively impacting every aspect of the profession. In response to high incivility levels within a baccalaureate nursing program in central Texas, an incivility education module was created for use in adult medical-surgical courses. The module incorporated online preparatory learning followed by active classroom learning, roleplay practice, and faculty modeling to teach students to define, identify, and respond to incivility using evidence-based cognitive-behavioral strategies. Data was collected pre-education implementation and at three post-education time points to evaluate student self-efficacy changes in recognizing and responding to incivility. The COVID-19 pandemic necessitated changing the education delivery …

Implementing Modern Management In Nursing, Ashley E. Hall

MSN Capstone Projects

Throughout the recent years, there has been occurrence of massive nursing shortages across the country. While there are many explanations as to why these shortages could be occurring, one very common explanation is that of poor leadership. As it now stands, the training for new leaders is a “trial by fire” style of orientation. New leaders either have a short training period consisting of minor introductions and gathering of various system access, or no training for their new position whatsoever. This style of orientation leads to poor outcomes for the leader as well as the team they are put in …

Dnp Final Report: Practice Change Compliance, Laura Duran

DNP Final Reports

Healthcare professionals in acute care hospital settings at the frontline of patient care affect many aspects of the patient's hospital stay, including infection prevention. The wearing of artificial nails by healthcare professionals in direct patient care is against best practice, although it is often seen. Therefore, the following PICOT question arises: In direct patient care providers who fail to adhere to policy (e.g., artificial nail use per hand hygiene policy) (P), how does a multimodal approach (I) compared to a single approach (education) (C) affect compliance with policy (0) within six months (T)? A systematic review was conducted using CINAHL, …

Creating An Educational Intervention To Combat Nursing Incivility Benchmark Study, Kathleen P. Melancon

MSN Capstone Projects

When most people reflect on the nursing as a profession, the term compassionate typically comes to mind. The association with compassion is no surprise as nursing is considered to be the most compassionate profession in the world. Nurses, by trade and in all areas of practice, have an ethical and professional responsibility to create and uphold an environment of mutual respect and civility. However, the notion of “nurses eat their young” and the behaviors that stem from this mindset are causing detrimental effects not only to those organizations employing nurses but to patients and the nurses themselves.

Over the last …

Meaningful Recognition And The Effect On A Medical-Surgical Unit's Staff Satisfaction And Retention, Lindsey Greene

MSN Capstone Projects

The current state of the American healthcare system is riddled with challenges. Nurse administrators are faced with the formidable tasks of decreasing operating costs; improving the patient experience; delivering high-quality and safe patient care; and decreasing the mounting rates of nurse turnover. Nurse leaders must understand the complexities of their work environment, including the key drivers for nurse satisfaction and retention. In 2005, the American Association of Critical Nurses developed six standards for creating a healthy work environment. (American Association of Critical Care Nurses, 2016). An adult, medical-surgical unit at a South Texas hospital was faced with rising rates of …

Burnout And Fatigue: A Potential Downside Of The Critical Care Nursing Profession, Samantha L. Ford

MSN Capstone Projects

Studies show that burnout and fatigue increase healthcare cost and decreases organizational profit due to increased rates of employee turnover, decreased employee satisfaction, a decrease in the quality of care provided to patients, and the development of a toxic work environment. The three principal factors of job-related burnout and fatigue will be addressed within the context of this paper including emotional exhaustion, depersonalization, and personal accomplishment.

Critical care nurses suffer from feeling emotionally depleted to the point they feel as though they can no longer give anymore of themselves to the patients they care for, which is a result of …

Medication Error Prevention Strategies, Shana L. Brown

MSN Capstone Projects

The fundamental purpose of every healthcare organization is to enhance patient quality of life through the provision of superior healthcare to produce the best patient outcomes. In the pre-hospital practice setting of helicopter emergency medical service (HEMS) the desire of system leaders and medical staff is to be primarily patient-centered, focused on the safety and wellbeing of patients while at the same time managing the business finances and budget of the organization. Maintaining a healthy environment with safe patient practices is the responsibility of organization administrators, physicians, nurses, paramedics, and all healthcare providers.

One of the primary duties that healthcare …

Oral Care And Ventilator Associated Pneumonia Prevention, Rachel Baber

MSN Capstone Projects

With rising healthcare costs and increasing demands placed on healthcare workers, it is no wonder that decreasing hospital length of stay for patients is high priority for hospitals today. Hospital acquired infections are one of the culprits keeping so many patients hospitalized. Specifically, in intensive care units (ICU) and intermediate care (IMC) units that care for mechanically ventilated patients, ventilator associated pneumonia secondary to intubation is a complication and cost that is being sought to be avoided. Hospitals have been pro-active to prevent ventilator associated pneumonia from occurring by placing oral care bundles or protocols in place to care for …

Reducing Catheter Associated Urinary Tract Infection (Cauti) Rates Benchmark Study, Tendai B. Shambare

MSN Capstone Projects

Abstract

Urinary Tract Infections (UTIs) make up to about 40 % of all healthcare associated infections, and about 13,000 patients die yearly from Catheter Associated Urinary Tract Infections (CAUTI) complications. Urinary catheters at times maybe unjustified or inappropriate, which can potentially create increased hospital costs, patient discomfort and pain, length of hospital stay. And even death. The longer the catheter is left in place also increases the patient’s risk of developing a CAUTI. CAUTI bundle packages have been found to be effective in reducing CAUTI rates when used consistently. The bundle is a combination of evidence-based practice policies, nurse and …

Preventing Readmissions Through Community Health Nursing, Stephanie Dawson

MSN Capstone Projects

Incorporating community health nurses to follow patients with a moderate to high risk of readmission post-discharge could improve the risk of readmission for these patients. When a patient is discharged from the hospital, they can become overwhelmed and not be adequately prepared to go home despite the discharge education given (Kenney-Lueptow, 2020). Telephone follow up is a low-cost way to decrease readmissions and provide continued education to the patients (Heitkam, 2019). Utilizing the bedside nurses that have been caring for the patients in the hospital can create a greater sense of community for the hospital and its population. By connecting …

Reducing Readmissions In The Heart Failure Population, Yvette Castellanos

MSN Capstone Projects

This paper will explore the importance of preventing acute hospital readmissions in the heart failure adult population. Prevention of re-hospitalization is aimed at improving patient care and outcomes as well as reducing the financial stress caused by readmissions. Recurrent hospitalizations are expensive and unnecessarily overutilize resources (Donzé, Lipsitz, Bates, & Schnipper, 2013). Research shows that improving transitions of care during hospitalization and developing specific heart failure interventions healthcare providers can assist in reducing readmissions. For this project the Plan Do Check Act (PDCA) tool combined with the lean methodology. The PDCA cycle consist of planning, to identify the problems, do …

Bedside Shift Report Improves Patient Safety, Scott Meyers

MSN Capstone Projects

In the inpatient setting, Parkland Health & Hospital System has continued to have patient falls with injury above its target goal. This occurred every month throughout 2019. Additionally, multiple egregious IV medication administration errors occurred over the last year related to nurses bypassing established safety practices.

An evaluation of evidence-based literature reveals that the practice of bedside shift report (BSR) leads to a reduction in both patient falls and medication administration errors. Indeed, BSR is evidence-based practice (EBP) that promotes an overall environment of safety, quality care, and improved communication between nurses and patients. Additionally, there is virtually no risk …

Benchmark Nurse Leader Mentorship Program, Ijeoma Anyanwu

MSN Capstone Projects

“Historically, promotion to management positions has been a key pathway by which hospital staff nurses advance their careers, and these promotions typically occur before the nurse has acquired any formal management training” (Weisman, Minnick, Dienemann & Cassard, 1995, p. 296). Nurse managers are often driven to their roles due to sudden vacancies as a result of promotions, resignations, transfers or layoffs. Though willing to take on these challenges, these nurses are nevertheless inadequately prepared. “Nurse leaders are ill-equipped in terms of knowledge and may lack support and guidance to manage the challenges inherent in the role, such as productivity, job …

Official Mentor Program Benchmark Project, Gabriela O'Hara

MSN Capstone Projects

Nursing shortage, turnover, and low job satisfaction are constant issues that often trouble healthcare organizations. These issues have led organizations to implement programs, such as externship, internship, and preceptor programs to strengthen new nurses’ professional practice and skills. However, these issues continue to be organizational challenges. Considering the need for new nurses to have a supportive foundation for their career and to further encourage workplace satisfaction and retention, the following PICOT question was developed: In a healthcare organization, how does an official mentor program, compared with not having a mentor program, influence nursing retention and nursing job satisfaction over 2 …

Dnp Final Report: Changing Admission Criteria In A Vocational Nursing Program To Decrease Attrition, Gabrielle O. Davis

DNP Final Reports

By the year 2030 Texas will have a shortage of 33,500 Licensed Vocational Nurses (LVN). The LVN is responsible for providing safe, compassionate and focused nursing care to assigned patients with predictable health care needs. Most LVNS work in settings caring for our ever increasing and aged population. To combat the coming shortage VN programs need to graduate safe, competent, and compassionate nurses, but programs across the state are experiencing high student attrition rates. Admission criteria is a common method to determine student success in nursing programs. This evidence-based practice improvement project synthesized evidence and integrated best practices along with …

High-Risk Pregnant Patients In The Third Trimester: Comparing Mental And Physical Health, Megan Maxwell

MSN Capstone Projects

The purpose of the paper is to compare physical and mental health in high-risk pregnant patients in their third trimester who are managed in an inpatient setting compared to an outpatient setting. This paper looks at specific high-risk pregnancy diagnoses.

Controlled Donation After Circulatory Death: Benchmark Study, Marilyn R. Strait

MSN Capstone Projects

Abstract

In potential organ donors after circulatory death (P), does the utilization of an evidence-based critical pathway from identification of potential donor to organ donation (I) versus no utilization of an evidence-based critical pathway (C) increase the rate of organ procurement and the satisfaction of donor families with the donation process (O)? A benchmark study was conducted to answer this question, and in short, yes, it does. The utilization of a critical pathway, when individualized to a local population and hospital’s organization increases the organ procurement rate, the donor family satisfaction with the process, and increases staff satisfaction with the …

Emergency Department Homeless And At Risk Homeless Screening Benchmark Study, Emily Mulder

MSN Capstone Projects

Individuals experiencing homelessness drastically overutilize emergency department (ED) services compared to non-homeless individuals (Ku et al., 2014). Many unhoused individuals have serious medical and psychosocial needs, which are chronic in nature, and become exacerbated due to poor management while living on the streets (Ku et al., 2014). The health needs of such individuals would be best managed through primary care continuity. However, care coordination becomes complex when a patient does not have a physical address or knowledge of available community resources (Mitchell, León, Byrne, Lin, & Bharel, 2017). By understanding the unique barriers that homeless and at risk homeless patients …

Implementation Of A Patient Acuity Tool And The Impact On Nurse Satisfaction, Amber M. Denson

MSN Capstone Projects

Increased workloads contribute to nurse stress, affect nurse-patient relationships, and can ultimately lead to nurse turnover (O’Connell, Nettleton, Bunting, & Eichar, 2020). Nurse satisfaction can also be influenced by nurse-patient assignments (Allen, 2019). Implementation of a patient acuity tool (PAT) to balance workload and evenly distribute patient acuity in nurse-patient assignments can improve nurse job satisfaction, quality of care, and nurse retention (Firestone-Howard, Gonzalez, Dudjak, & Rader, 2017; Al-Dweik & Ahmad, 2019).

Discussions were held on a 20-bed medical-surgical unit in an acute care hospital with stakeholders that included the nurse manager, charge nurses and bedside nurses at staff meetings …

The Effectiveness Of A Robotic Seal On Compassion Satisfaction In Acute Care Nurses: A Mixed Methods Approach, Jo S. Henson

Nursing Theses and Dissertations

Problem: Nurses face a variety of stressors that can result in decreased levels of compassion satisfaction. The purpose of this study was to investigate the efficacy of a computerized interactive social assist robot (PARO) to decrease stressors and increase compassion levels of acute care nurses in an inpatient setting.

Theory: The Professional Quality of Life Model posits that low Compassion Satisfaction, Burnout, and Secondary Traumatic Stress leads to Compassion Fatigue.

Hypotheses: It was hypothesized that interaction with a social assist robot with artificial intelligence will result in decreasing levels of stress therefore increasing levels of compassion satisfaction in nurses working …

Nurses Role In Health Home Mixed Methods Study, Jacqueline S. Prokop

Nursing Theses and Dissertations

Managing individuals with chronic health conditions in the primary care setting continues to be a significant challenge in the U.S. health care system. This issue is further compounded for low-income individuals with both mental health and physical health chronic conditions. With the enactment of the Affordable Care Act (ACA), new chronic disease health home opportunities have emerged to address the existing structural and process gaps found in primary healthcare. The nurse’s role is integral to health homes as they empower nurses to play a greater role in improving patient experiences, population health, and lowering healthcare costs. Three research manuscripts presented …

Examining The Relationship Between Registered Nurses’ Turnover And The Benefits Of An Affirming Climate Of Diversity As Mediated By Workplace Outcomes, James Mark Clardy

Human Resource Development Theses and Dissertations

The Affordable Care Act has created within health care a growing demand for primary care services in both the inpatient and outpatient settings. The anticipated growth in need for registered nurses (RN) of 19% by 2020 is compounded by a current estimated national turnover rate greater than 17%. Human Resource Development (HRD) practitioners in health care are challenged to develop and implement interventions that can influence turnover in RNs despite identifying variables that effect turnover. This research explored how RN turnover can be positively affected by a government mandated requirement that health care create a diverse workforce and cultural competency. …

Analyzing Organizational Commitment And The Effect On Job Turnover In Nurse Residents, Cory D. Church

Nursing Theses and Dissertations

This dissertation is an exploration of psychosocial concepts related to the experiences of a vital health human resource, newly licensed registered nurses. Newly licensed registered nurses are at risk for leaving their first job within the first year due to the difficulty of transitioning to practice. The pressure to gain competence and deliver quality care, all while navigating the workplace environment, can impact their commitment to an organization and the profession. The reader will notice these concepts threaded throughout the dissertation. While these concepts are explored in other nursing workforce populations, the researcher determined a gap in the research on …

A Follower - Centric Model: Predictors Of Job Satisfaction And Perception Of Leader Effectiveness In Lebanese Registered Nurses, Rana S. Abdel Malak

Nursing Theses and Dissertations

Leaders and their followers share the work environment; they live the same challenges, and face the same problems (Baker, 2007; Uhl-Bien et al., 2014). However, in nursing little is known about the effect of the quality of the manager – follower relationship and work engagement in formulating a follower’s perception of leadership and its impact on job satisfaction. In a country such as Lebanon that has the eighth lowest nurse density in the Eastern Mediterranean Region (EMR) and suffers from excessive nurse migration and low nurse satisfaction and retention rates (El-Jardali, Dimassi, Dumit, Jamal, & Mouro, 2009) understanding the factors …