Nursing Administration Commons^™

Conflict Management And Team Building As Competencies For Nurse Managers To Improve Retention, Jeanette Black

DNP Qualifying Manuscripts

Abstract

Aim(s): To critically review and summarize evidence related to coaching and training nurse managers in conflict management and team building skills and to determine the relationship of these skills to retention.

Background: Retention of nurse managers is a significant challenge to healthcare organizations.

Evaluation: The databases searched were CINAHL, PubMed, evidence-based journals, JANE, Cochrane, SCOPUS and Joanna Briggs. The keywords searched were conflict management, team building, nurse manager retention, retention, teamwork, healthy work environment, conflict management theory, organizational culture, coaching nurse managers, and nursing. Articles with the strongest evidence were critically appraised using the Johns Hopkins Research and …

Nurse Expectations As Compared To Perceived Reality, Kathryn Mckelvy

Dissertations

Burnout and turnover in nursing have been well documented in nursing literature, but little is known about a nurse’s expectations of the profession compared to their perceived reality of the profession. Do these expectations meet the reality of the workplace, and does this cause the nurse to make a career change? What factors influence a nurse to leave the profession, job-hop, or return to school to further their education? The rate of nurse turnover is an ongoing issue with a lack of research regarding the foundation of nurse expectations compared to the realities of the profession.

The purpose of this …

Scientific Proceedings Of The Texas Children’S Hospital’S 17th Session Of The Advanced Quality Improvement And Patient Safety Program, Arjun M. Dangre Bds Mph, Kelly Wallin Ms Rn Chse, Gertrude A. Leidich Mba, Rn, Angelo P. Giardino Md, Phd

Journal of Nursing & Interprofessional Leadership in Quality & Safety

The Texas Children’s Hospital’s Advanced Quality Improvement and Patient Safety (AQI) Program is a six month mixed didactic and experiential learning experience designed to improve patient care, lower costs, change the culture, and develop quality leaders. As a part of AQI program participants are grouped into teams and each team completes a healthcare related Quality Improvement (QI) project. Each project demonstrates use of various QI tools including process maps, fishbone diagrams, and key driver diagrams. The projects use ‘Model for Improvement’ as the primary QI methodology to achieve their aim. Three or more Plan-do-study-act (PDSA) cycles are required for each …

Scientific Proceedings Of The Texas Children’S Hospital’S 16th Session Of The Advanced Quality Improvement And Patient Safety Program, Arjun M. Dangre Bds, Mph, Kelly Wallin Ms, Rn, Chse, Gertrude A. Leidich Mba, Rn, Angelo P. Giardino Md, Phd

Journal of Nursing & Interprofessional Leadership in Quality & Safety

The Texas Children’s Hospital’s Advanced Quality Improvement and Patient Safety (AQI) Program is a six month mixed didactic and experiential learning experience designed to improve patient care, lower costs, change the culture, and develop quality leaders. As a part of AQI program participants are grouped into teams and each team completes a healthcare related Quality Improvement (QI) project. Each project demonstrates use of various QI tools including process maps, fishbone diagrams, and key driver diagrams. The projects use the IHI ‘Model for Improvement’ as the primary QI methodology to achieve their aim. Three or more Plan-do-study-act (PDSA) cycles are required …

Improving Communication To Reduce Patient Falls In A 48-Bed Medical-Surgical Unit, Christian Gella

Nursing and Health Professions Faculty Research and Publications

Abstract

Problem: Patient falls has been associated with increased morbidity, mortality and decreased quality of life. The increase in total patient falls for 2018 relative to 2017, and a spike of 10 patient falls for the month of June 2018 from a baseline of 5.3 falls per month has gained greater attention to reduce patient harm from falls while hospitalized. Prevention of falls minimizes patient exposure to the possibility of being injured. Despite efforts to curtail patient falls, improvement in communication is essential to address the safety issues surrounding improving quality of care practices, and consequentially reduce un-reimbursable hospital costs …

Nur 3110 The Nurse Leader Within, Syllabus, Linda Ann Paradiso

Open Educational Resources

Syllabus for NUR 3110 The Nurse Leader Within - a 15 week semester course for pre-licensure nursing students or nurses earning their baccalaureate degree. Every nurse is a leader, regardless of title or position within an organization. In this course you will learn to develop your voice and skills in order to lead teams of people who care for persons in need of any type of medical care.

Implementing Strategies To Reduce Central Line-Associated Blood Stream Infections On An Inpatient Pediatric Unit, Sherryann St. Pierre, Nicole Manchester, Jessica Howe, Melanie Lord, Mark Parker, Suneela Nayak, Ruth Hanselman, Stephen Tyzik, Amy Sparks, Barbara Bush Children's Hospital

Operations Transformation

STRATEGIES TO REDUCE CENTRAL LINE ASSOCIATED BLOODSTREAM INFECTIONS

Every central line associated bloodstream infection (CLABSI) leads to poor outcomes, increased mortality and increased healthcare costs. A pediatric care team in an academic tertiary medical center set a goal to reduce the number of these infections on their unit.

The team’s research showed that daily bathing greatly decreases CLABSI. Their baseline metrics demonstrated an unacceptable level of those with central lines being bathed. A root cause analysis revealed that patient and family refusal was the leading cause for those who did not bathe.

A performance improvement plan was initiated that consisted …

Increasing Bedside Medication Safety In An Intensive Care Setting, Natasha Stankiewicz, Jonathan Archibald, Scu 2, Mark Parker, Stephen Tyzik, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operations Transformation

A PERFORMANCE IMPROVEMENT PROJECT FOR INCREASED BEDSIDE MEDICATION SAFETY

The convenience of having certain medications directly available at bedside has long been a priority for a medical intensive care nursing team in an academic tertiary medical center.

However, it was apparent to new staff and leadership that there was a lack of awareness and interest in securing medications within the department. This posed a risk to patients, families, visitors and colleagues.

Baseline metrics on patient safety were collected and a root cause analysis was conducted. Countermeasures included increased education of medication safety as well as a instituting a KPI which …

Improving Revenue Capture And Patient Safety In An Icu Setting, Natasha Stankiewicz, Laura Lewis, Jonathan Archibald, Mark Parker, Suneela Nayak, Stephen Tyzik, Ruth Hanselman, Amy Sparks

Operations Transformation

IMPROVING REVENUE CAPTURE AND PATIENT SAEFTY IN AN INTENSIVE CARE SETTING

Materials management department is responsible for restocking chargeable supplies in an intensive care unit (ICU) at an academic tertiary medical center. Staff confusion as to what items were considered chargeable often led to low supply par levels resulting in delays of critical patient care.

Using baseline metrics, a team of caregivers created several performance improvement goals to increase nursing compliance with appropriate supply charging. The results of a root cause analysis spearheaded the development of a KPI that encompassed staff education, lost charge tracking and charge supply labeling.

Post …

Sustaining Daily Management With Gemba Walks: A Scheduling Model, Suneela Nayak, Ruth Hanselman, Stephen Tyzik, Amy Sparks

Operations Transformation

SUSTAINING DAILY MANAGEMENT WITH GEMBA WALKS: A SCHEDULING MODEL

At an academic tertiary care medical center, there are 110 Operational Excellence teams across 4 campuses. Every weekday, 10 GEMBA walks occur with the 11^th on Wednesdays. The expanding program has made daily leadership visits to all KPIs challenging. As a result, consideration of reduced gemba walks to departments who have met specific maturity/performance criteria.

The scope of the eight-week pilot consisted of 13 pre-identified teams that have weekly workflows. The teams must have met a baseline level of performance. Performance was scored for 9 variables measuring engagement, PDSA, use …

Improving The Practice Model In A Military Clinic, Kristina Marie Zuccarelli

Doctoral Dissertations and Projects

Military members and their families face numerous stressors due to the unique lifestyle of this career (Lester, 2011). The occupational impact on these members creates a highly stressful and physically demanding environment with low morale, chronic medical complaints, and poor mental health for these individuals. This project incorporated the current patient-centered medical home (PCMH) model and fused it with the operational medical model for all the active duty members in this unit. The combination of models allowed the provider to have a better understanding of the population’s needs. By embedding in the units, the provider developed a team approach to …

Pain Management: A Flowsheet For Providers, Lisa Swezey

Doctoral Dissertations and Projects

Many different factors led to the trend of providers prescribing opioids for chronic pain. However, the misuse of and many deaths related to opioid prescriptions have caused the trend to reverse its direction. National organizations call for providers to stay clear of opioid medication and increase the use of nonpharmacological pain management, but also to treat pain adequately. There are still many barriers to decreasing the use of opioids and increasing the use of nonpharmacological methods. This scholarly project hoped to use an educational flowsheet to assist providers in meeting the demands from national organizations to decrease the use of …

Increasing Hcahps Scores By Scripting Of Hourly Rounding, Katherine Rivera

Doctoral Dissertations and Projects

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a standardized national report on patient perceptions of care and is now linked to hospital reimbursement by both government and now some independent insurance companies. Healthcare systems are therefore very interested in ways to increase patient satisfaction within their facilities. This evidence-based practice pilot project was based on the Iowa Model of Evidence and used a quasi-experimental process to ascertain if adding scripting to the hourly rounding process was able to increase patient satisfaction scores on the HCAHPS. The increase in patient satisfaction, in the area of perceived responsiveness …

1600 Rn, Jonathan Archibald, Natasha Stankiewicz, Mark Parker, Elizabeth Ridel-Dermanelian, Sandy Ridel-Dermanelian, Amy Stafford, Shawn Taylor, Deb Jackson, Alana Trottier, Roger Maynard, Bonnie Boivin

MaineHealth Maine Medical Center

Due to a changing employment arena, healthcare organizations are hiring more new graduate RNs into acute care units. MMC’s usual process is to put new hires into night shift. Historically, night shifts have less resource availability. These combined factors left staff feeling unsupported; patient care could be compromised when less support is available to those in the beginning of their careers.

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 …

Improving Communication: Huddling For Change, Harnoor Chahal

Master's Theses

The purpose of this communication improvement project is to incorporate huddles between interdisciplinary departments within a microsystem in order to improve customer satisfaction by decreasing the number of grievances. Based on the increasing number of grievances due to delayed hospital discharge, which results from a lack of communication between team members, there is an increased need for communication between the microsystem. By implementing weekly huddles between the Inpatient and Outpatient nurses, not only will there be increased care-coordination, but there will also be a decreased delay in discharge from the hospital caused by missed or no communication. Evidence-based practice indicates …

Workplace Bullying, Nurse Practice Environment, Patient Outcomes: A Descriptive Study, Noreen Houck

Electronic Theses and Dissertations

Better nursing practice environments are associated with improved patient safety, yet little is known about the nurse’s experiences of bullying or flourishing within the practice environment. This study described nurses’ experiences of workplace bullying and flourishing and identified associations with patient outcomes.

The study used an exploratory cross-sectional survey design following Donabedian’s Quality Framework of structure-process-outcome and informed through critical feminist theory. The study took place at a large medical facility in the northeastern United States. A multi-instrument survey included four sections. The demographic section and the Practice Environment Scale of the Nurse Work Index (PES-NWI) were used to measure …

Standardizing The Palliative Care Referral Process, Ronaviv M. Garcia

Master's Projects and Capstones

Standardizing the Palliative Care Referral Process

Problem: Heart failure (HF) is one of the most common causes of hospital admissions and emergency department visits in the United States. HF patients are at high risk for hospital readmission: 25% of HF patients discharged from the hospital are readmitted within 30 days of discharge, and 50% are readmitted within 6 months (Vedel & Khanossov, 2015).

Context: Palliative Care (PC) has been shown to be an effective way of managing distressing HF symptoms and thus of reducing hospital readmissions, yet patients are infrequently referred to PC services during their transition from hospital to …

Uams Summer Health Literacy Study, Merritt Osment

Health, Human Performance and Recreation Undergraduate Honors Theses

Background: Health Literacy is a barrier to self-care; patients often lack the skills to understand complicated instructions that deal with medications, wound care, follow up schedules, and preventative care. Patients who undergo hip and knee replacements are often older adults, a population that normally struggles with various aspects of health literacy. Patient education materials are a common means of communicating with these individuals. However, if the patient does not understand the materials that they are given, they are more likely to experience negative side effects after their operation. Purpose: The purpose of this study is to compare the health literacy …

Failure-To-Rescue Simulations As A Risk Management Strategy For Registered Nurses, Trena K. Seago

Graduate Theses, Dissertations, and Capstones

In the hospital setting, prevention of failure-to-rescue (FTR) events is an important aspect of patient safety. The use of patient simulation as a strategy to educate nurses on the prevention of these events offers two modes of learning: 1) experiential learning through simulation and 2) reflection through debriefing. The act of practicing to recognize a deteriorating patient through experiential learning and reflection may help increase nurses’ self-efficacy in recognizing a similar situation in their future practice. This quasi-experimental, one-group, pretest-posttest pilot study investigated the use of patient simulation among registered nurses (RNs) in the hospital setting as an anticipatory educational …