Nursing Administration Commons^™

Sustainability In Quality Improvement And Patient Safety Initiatives, Angelo P. Giardino, Eileen R. Giardino

Journal of Nursing & Interprofessional Leadership in Quality & Safety

The question often asked of a quality improvement initiative is whether the improvement process has been sustained within the organization. Rarely is the question answered satisfactorily. The sustainability of an improvement process is important as it justifies the investment of human and financial capital. The term 'evaporation of improvements' addresses the dilemma that between 33% to 70% of all innovations are reportedly not sustained (Fleiszer, Semenic, Ritchie, Richer, & Denis, 2015) . This evaporation of improvement captures the frustrating inability of many institutions to maintain the achieved improvement after the newness of the initial effort wears off (Buchanan, Fitzgerald, & …

Going For Gold With The Perioperative Olympics, Hope L. Johnson Msn, Rn, Cnor

Patient Care Services / Nursing

No abstract provided.

Use Of Workplace Incentive Programs To Increase Health Behaviors In Nurses, Sydney Harris, Barbara Mcclaskey

Posters

As the frontline and most visual health promoters in a hospital setting, nurses are to be at the top of their game in terms of their health behaviors. Unfortunately, several studies show that nurses tend to follow the trend of the general population in poor eating habits, physical inactivity, sleep habits, and smoking and alcohol consump­tion. The purpose of this study is to unveil the benefits of Workplace Health Incentive Programs in an effort to increase the overall health of those who are to be considered role models for a healthy lifestyle, the nurses who hold the seat for the …

Improving Nursing Staffing Methodology And Nursing Sensitive Outcomes With The Addition Of A Patient Centered Acuity Measure, Douglas C. Howard Rn, Ms, Ne-Bc

Doctor of Nursing Practice Projects

Background: Assigning the correct nursing resources to hospitalized patients positively impacts patient outcomes. The current process for matching nurses to patients is highly variable and involves a combination of simple ratios, historical workload data, and expert opinion but lacks objective measurement of the patient’s condition.

Objectives: This project evaluated change in selected quality indicators and the daily unit-level management of nursing resources after implementing the Troubled Outcome Risk (TOR) into existing nursing staffing methodology in a Department of Veterans Affairs hospital.

Methods: TOR provides objective measurement of individual patient allostatic load. Daily calculation of TOR scores for each patient on …

Nurse Managers: An Association Between Empowerment And Burnout, Sonja Lynn Avery

Doctoral Projects

The purpose of the study is to ascertain the presence of an inverse relationship between nurse managers’ feelings of structural empowerment and self-perception of burnout. Although research is available studying the effects of staff nurse empowerment and burnout, literature is sparse relative to evaluation of nurse manager empowerment and burnout. Of the studies available, there is supportive evidence pertaining to the negative implications associated with nurse manager burnout such as reduced staff nurse retention and morale, decrease in quality of patient care, and financial impact on organizational success. With such negative implications associated with a lack of empowerment and burnout, …

Improving Patient Handover From The Pediatric Emergency Department To The Pediatric Intensive Care Unit, Kathryn Devinney

Doctoral Projects

Patient safety can be at risk during registered nurse handover, particularly when transitioning between high risk areas. According to The Joint Commission (2017), a standardized transition process should be implemented during patient handover. The purpose of this paper was to evaluate the effect of a standardized process with a cognitive aid on handover between a pediatric emergency department and an intensive care unit. Objectives of the project were to decrease conversion time in the emergency department, increase standardized process utilization, and improve patient outcomes, registered nurse perception and satisfaction, and patient proxy satisfaction. This evidence-based quality improvement project took place …

Interprofessional Collaboration To Improve Discharge Planning, Erica L. Spalding

Doctoral Projects

Historically, health care professionals collaborated solely with other professionals within the same discipline. However, evidence shows collaboration between all disciplines involved in patient care leads to improved patient outcomes. Interprofessional collaboration can reduce costs and improve patient care, yet is used inconsistently in health care systems. Interprofessional collaboration was not fully used on two medical-surgical units in a large health system in the Midwest, particularly during the discharge planning process. This project aimed to standardize rounds on two units as part of a larger initiative to standardize rounds across all units within the system. The clinical question to be answered …

Development Of A Process For Adoption And Attainment Of Pcmh Recognition Requirements For An Urban Primary Care Clinic, Jamie L. Hendricks

Doctoral Projects

The Centers for Disease Control and Prevention (2017) reported that in 2016, healthcare expenditures in the United States totaled 17.9% of the gross domestic product. Unfortunately, care quality is not reflective of the high costs of care. Models of care delivery like the patient centered medical home (PCMH) have shown promise in addressing these concerns.

This project focused on program development for PCMH adoption at an urban clinic in an effort to improve financial stability and remain competitive. The purpose was to propose a plan for adoption and attainment of PCMH recognition requirements for an urban primary care office.

The …

Factors Affecting Nurses’ Job Satisfaction In Rural And Urban Acute Care Settings: A Prisma Systematic Review, Yasin Yasin, Mickey Kerr, Carol A Wong, Charles H. Bélanger

Western Research Forum

This review aims to systemically describe the findings of primary studies in order to identify the intrinsic and extrinsic factors that affect nurses’ job satisfaction using PRISMA guidelines. It also aims to analyze the finding according to the two-factor theory; and compare studies based on rural and urban settings.

Two reviewers completed study selection, screening, and quality assessment. After data extraction, content analysis was used to categorize identified factors into themes.

Thirty-eight studies were selected for this review. Extrinsic factors reported in the findings were: work conditions (n=17), monetary benefits (n=5), hospital policies (n=6), supervision (n=7), interpersonal relationships (n=8), organization …

Nurses’ Cyberloafing And Its Relationship To Procrastination And Conscientiousness In Damanhour National Medical Institute, Yaldez Zeineldin Prof, Fatma Baddar Prof

Nursing

Cyber-loafing involves an unproductive use of time in the workplace and distracts employees from their responsibilities and duties. This study was conducted because there is a risk posed on patient's safety if nurses are cyberloafing and if this behavior has a direct relation with procrastination and lack of conscientiousness. Aim of the study: to determine the relationship between cyberloafing, procrastination and conscientiousness among staff nurses working in Damanhour National Medical Institute. Research Design: A cross-sectional descriptive correlational design with a self-reporting questionnaire was used to obtain data. Setting: The study was conducted in all inpatients units except Intensive Care Units …

Improving Nurse-To-Nurse Handoff Communication At The Bedside Through Simulation-Based, Lisa Thornsberry Mrs.

Doctor of Nursing Practice Projects

Communication among nursing staff is crucial to the outcome of patient care. Poor handoff and communication among professionals can have a negative impact on the safety of patients. The systemic nature of the problem with miscommunication among healthcare clinicians supports the necessity of standardization of communication among nursing as a handoff of care.

Change of shift report, or nurse-to-nurse report ensures the transfer of critical information to promote patient safety and best practices. Transferring and communicating pertinent information from one shift to the next is one factor in providing continuity of care. Bedside Shift Report (BSR) is an opportunity to …

Nurse Manager Leadership Styles, Tristy Morrison

Nursing Theses and Capstone Projects

Strong leadership skills are crucial to establish, grow, and sustain a healthy work environment in healthcare. Transformational leadership behaviors drive nursing teams to achieve higher levels of engagement, increased nursing satisfaction, increased retention rates, and higher commitment levels to the organization. The purpose of this research was to assess the transformational leadership characteristics among assistant nurse managers, managers, and directors, in a southeastern hospital in the United States. The Multifactor Leadership Questionnaire (MLQ-5X) was administered to evaluate the leadership characteristics. A convenience sample of 14 nurse leaders rated themselves as more transformational than the norm with an average score of …

Mobile Video Monitoring To Reduce Falls And Sitter Usage, Jennifer L. Forman

Doctor of Nursing Practice Projects

In the United States between 700,000 to 1,000,000 people fall in hospitals each year. Reducing patient falls in the inpatient setting remains a challenge for many acute care hospitals. Inpatient falls can lead to serious injuries such as fractures and internal bleeding. Fall-related complications can lead to increased hospital stay, prolonged rehabilitation, and increased healthcare costs. Inpatient falls are considered preventable. One intervention commonly used to prevent falls and keep patients safe is the use of an in-person sitter or a patient safety companion (PSC). However, sitters are very costly and considered a variable staffing resource. The need for a …

An Evaluation Of A Pilot Inpatient Hospice Unit And The Impact It Has On End-Of-Life Care At An Academic Medical Center, Cynthia Minetree

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Background: Research shows that acute care hospitals with inpatient hospice units have an increase in hospice resource utilization and provide end-of-life care that is more aligned with patients’ end-of-life goals compared to hospitals that do not have inpatient hospice units.

Methods: A pilot six-bed General Inpatient (GIP) hospice unit was implemented at an acute care hospital, located in Washington, D.C., to provide hospice care for patients that were not able to transfer to another inpatient setting for hospice care. A six-month evaluation of the pilot GIP hospice unit was done to evaluate the feasibility of the unit and the impact …

Implementing A Discharge Navigator Reducing 30-Day Readmissions For Heart Failure And Sepsis Populations, Karen Weeks

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

A national focus for healthcare reform is preventing hospital readmissions. Thirty-day unplanned hospital readmissions impact patient outcomes and are costly to the healthcare system. This project explored the impact between the discharge navigator and 30-day unplanned readmissions for heart failure and sepsis populations in a 238-bed community hospital located in central Virginia. The primary aim of this discharge navigator project was to reduce 30-day readmissions for the heart failure and sepsis populations to meet the goals of the top quartile for like hospitals and the evaluation of cost avoidance for these readmissions. Heart failure and sepsis populations are high risks …

The Impact Of A Revised Discharge Process From Acute Care To Home Care On Hospital Utilization In Children With Single Ventricle Heart Disease, Brian M. Stahulak

Doctor of Nursing Practice Projects

Problem Description: It is estimated that approximately ~0.5%, or ~400,000, of all U.S. children, are identified as having complex chronic conditions (CCC) and account for as much as one-third, or ~$100 billion, of health care spending for all children. The goal of this quality improvement (QI) project was to identify the impact of a revised discharge process for children with Single Ventricle Heart Disease (SVHD) on hospital utilization rates and the parent’s perception of discharge readiness during the interstage period. The QI project was conducted in a 44-bed cardiac care unit within a 336-bed freestanding pediatric, academic medical center in …

Mentorship Through Storytelling Program, Debra Marie Perry

Theses and Graduate Projects

The Mentorship Through Storytelling Program began in response to an urgent need to reduce registered nurse (RN) turnover rates and improve nurses’ satisfaction on a medical surgical unit in a Midwestern Hospital. The unit was challenged to hire, integrate, and retain a multigenerational team of RNs. Guided by Jean Watson’s Theory of Human Caring, the Mentorship Through Storytelling Program was initiated in the fall of 2018 after doing a broad literature review and adapting the Academy of Medical Surgical Nurses’ Mentorship Program to include the concepts of storytelling, mentoring, and caring. Digital recordings of five expert nurses’ oral histories (stories) …

Implementation Of Safe Patient Toileting To Decrease Patient Falls On Medical-Surgical Unit, Kimberly A. Goldsborough

DNP Scholarly Projects

BACKGROUND: Patient falls are a serious safety concern in the hospital setting throughout the country. Falls are one of the most challenging patient safety events to prevent, as there are many contributing factors with toileting activities producing the highest incidence. Fall prevention bundles are used to minimize and reduce these such events although multifaceted. The project was conducted with an academic medical center on an acute inpatient medical-surgical unit primarily housing burn wound patients. Nursing leaders and front-line nursing staff participated.

METHODS: Literature review to determine the gap in knowledge of interventions to prevent acute inpatient falls was completed. Concepts …

Evaluation Of The Effectiveness Of A System Based Nurse Manager Collaborative Council On Work Engagement, Psychological Empowerment, And Value, Stacy Colligan

DNP Projects

BACKGROUND: Nurse Managers often do not receive direct acknowledgment for their accomplishments or have input into the facility wide decisions which directly impact them. Currently there are no known shared governance programs tailored to the nurse manager level.

PURPOSE: To determine the impact of a system shared governance model on nurse manager’s work engagement, psychological empowerment, and inclusion.

METHOD: A pretest and posttest design was utilized to determine the impact of shared governance participation for nurse managers. Spreitzer’s psychological empowerment scale and the Ultrech “Work and Well-being” instrument, in addition to some Likert scale and open-ended descriptive questions, were included …

Just Culture: It's More Than Policy, Linda Paradiso, Nancy Sweeney

Ellmer School of Nursing Faculty Publications

[Description] Paradiso and Sweeney discuss the relationship between trust, just culture, and error reporting in medical care. Errors rarely occur in a vacuum, rather they're a sequence of events with multiple opportunities for correction. Clinical nurses can have a significant impact on reducing errors due to their proximity to patients. Just culture is a safe haven that supports reporting. In a just culture environment, organizations are accountable for systems they design and analysis of the incident, not the individual. The shift to a just culture is a slow process that takes years to develop and hardwire. Hospital-wide policies that incorporate …