Nursing Administration Commons^™

Use Of The Coleman Transition Model To Reduce Copd Readmissions, Sara Briggs

Doctor of Nursing Practice Projects

This paper explores the use of the Coleman Transition Model as an evidenced based intervention to reduce 30-day readmissions of Chronic Obstructive Pulmonary Disease (COPD) patients on a pulmonary unit. Nearly 20% of Medicare beneficiaries are re-hospitalized within 30 days after discharge, resulting in an annual cost of approximately $17 billion. Hospitals can engage in activities to lower their rate of readmissions. The evidenced based intervention includes robust case management using The Coleman Transition Model in hospitalized COPD patients to reduce readmissions. COPD is a prevalent, complex, and costly condition to manage. COPD is now the third leading cause of …

A Nurse Mentor Program In A Long Term Acute Care Hospital, Regina Masters

Doctor of Nursing Practice Projects

Nurse turnover is a national problem with the potential to affect quality of care and patient outcomes. A Long Term Acute Care Hospital (LTACH) with nurse turnover rates above the national average as high as 28% sought to address this problem. A review of the literature identified nurse mentor programs increasing registered nurse (RN) satisfaction and decreasing turnover. Therefore, the purpose of this project was to implement a mentor program for newly hired RNs. Mentors were paired with new RNs for a four-week program. Pre and post intervention data were collected via the McCloskey Mueller Nurse Satisfaction Survey (MMSS) and …

Implementation Of Shared Governance And Its Impact On Shared Decision Making, Jennifer Vigodsky

Nursing Theses and Capstone Projects

Shared governance is a management style where frontline nurses, nursing assistants, and unit secretaries share power, control, and responsibility in their work area. The primary purpose of the unit governance council is to evaluate their current practice for improvement as it correlates to patient care, patient satisfaction, and physician communication. A positive nursing work environment has been elevated as an essential component for improving nursing engagement and patient outcomes. The purpose of this study was to implement a unit-based shared governance council on two medical surgical units which share the same leadership team, staff, and have more than 85 employees. …

Nurse Manager Job Satisfaction And Retention, Ivy Renee Morton

Nursing Theses and Capstone Projects

The purpose of this study was to explore job satisfaction and retention of front line nurse managers. Retention of nurses in the workplace is a primary focus of health care systems. Helen Erickson, Evelyn Tomlin, and Mary Ann Swain’s Theory of Modeling and Role Modeling served as the theoretical framework for this study. The literature shows that there is prevalence of nurse manager job satisfaction and retention. A quantitative study was performed using 6-point Likert scale and the participants’ demographics to determine the level of job satisfaction, recommendation for nurse leadership as a career, and retention. Descriptive statistics were used …

Academic Incivility In Modern Generation Of Nursing Students, Laila Akber Cassum

School of Nursing & Midwifery

Incivility in nursing academia and workplace is one of the emerging and complex issues in recent years, and can have substantial consequences on the organizational benchmark as well as on the teaching and learning milieu of the institution. Growth of academic incivility among the modern and diversified generation of students can have a profound destructive impact on their academic life and professional career. Impolite and discourteous attitude and behavior in a classroom atmosphere can originate from the learners as well the teachers, which can significantly impact the critical thinking and learning outcomes of the learner. This matter needs to be …

Defining The Health Of A Work Environment: An Assessment And Evaluation, Jennifer Thornsberry

DNP Projects

PURPOSE: The purpose of this study was to ascertain nursing leaders and direct care nurses’ perceptions of the health of the work environment in medical-surgical, intermediate care, and progressive care units at an acute care hospital located in central Kentucky. METHODS: This study employed a descriptive, correlational design. Bivariate statistical procedures were utilized to determine the relationship between the perceptions of the health of the work environment and nursing turnover and engagement. RESULTS: Direct care nurses and nurse leaders both scored effective decision making/skilled communication as the healthiest attribute of the work environment, while genuine teamwork was scored as the …

Nurse Manager Span Of Control And The Impact On Employee Engagement, Jene' M. Kendall

DNP Projects

PURPOSE: The purpose of this study was to assess nurse manager span of control in medical- surgical, intermediate care, and progressive care units at Norton Healthcare and determine correlations between nurse manager span of control and employee engagement.

METHODS: For this descriptive, correlational study, the researcher analyzed data to identify relationships in span of control and employee engagement data for 19 nurse managers leading 23 inpatient care units. A survey to evaluate the role of the nurse manager and the assistant nurse manager also was done.

RESULTS: The average span of control for nurse managers was 52.2 full time equivalent …

The Evaluation Of Advanced Practice Providers Practice Patterns And Delivery Of Care Models In The Specialty Practice Environment, Katherine W. Rogers

DNP Projects

Background: Advanced Practice Providers (APPs), specifically Nurse Practitioners (NP) and Physician Assistants (PA), have been utilized in healthcare for decades to improve access to care for patients. Norton Healthcare’s largest population of APPs is in specialty practices. The expansion of APPs into the medical group has been rapid and without evaluation of value and role identification.

Purpose: The purpose of this study is to evaluate Advanced Practice Provider (APP) practice patterns and care delivery models within specialty practices in a large medical group. The outcome of the study will help to identify trends in practice and areas where …

Cynicism About Change, Work Engagement, And Job Satisfaction Of Public Sector Nurses, Diep T. N. Nguyen, Stephen T. Teo, David Pick

Research outputs 2014 to 2021

This paper uses the job demands‐resources theory to examine the consequences of changes on nursing work. Data were collected from 220 public sector nurses in Australia to test the model. We conducted a two‐wave data collection process where independent variables (organisational change, workload, job control, nursing administrative stressors, cynicism about organisational change, and demographic variables) were collected in Time 1. The dependent variables (nursing work engagement and job satisfaction) were collected 6 months later. Changes to nursing work were found to cause high workload and an increase of administrative stressors that leads to an increase in nurses’ change cynicism. Job …

Best Practices For Sepsis Patients: A Quality Improvement Project, Kevin Mark Smith Jr

Graduate Theses, Dissertations, and Problem Reports (ETD)

Sepsis is a complication caused by the overwhelming and life-threatening response of the body to an infection. Sepsis can lead to tissue damage, organ failure, and death (Center for Disease Control and Prevention, 2016). Sepsis is the leading cause of death in U.S. hospitals. Mortality from sepsis increases 8% for every hour that treatment is delayed. Each year, 258,000 people die from sepsis in the U.S. As many as 80% of sepsis deaths could be prevented with rapid diagnosis and treatment (Sepsis Alliance, 2016). This project seeks to improve the ability of the transfer unit to screen patients, improve early …

Impact Of A Leadership Development Program On Perceptions Of Structural Empowerment, Leadership Self-Efficacy, And Staff Nurse Clinical Leadership, Matthew E. Proud

DNP Projects

BACKGROUND: In order to serve as full partners on the interdisciplinary health care team: nurses at all levels must develop essential leadership competencies Organizations need to identify the essential leadership competencies required for bedside nursing staff and develop programs to enhance these competencies. Leadership competencies in areas such as managing change can help bedside nursing staff improve care delivery and quality outcomes.

PURPOSE: The purpose of this project was to evaluate the impact of an established leadership development program on participants’ perceptions of structural empowerment, leadership self-efficacy, and staff nurse clinical leadership in one university health system.

METHODS: The pilot …

The Evaluation Of A Multi-Hospital System Nurse Residency Program On New Graduate Nurse Retention And Engagement, Julie N. Wolford

DNP Projects

PURPOSE: The purpose of this evaluation project was to determine the effectiveness of the Norton Healthcare new graduate nurse residency program on retention and engagement of newly- licensed registered nurses.

METHODS: This study was a retrospective pre-test, post-test design of the impact of the nurse residency program on turnover and engagement for the participants in the first year of the Norton Healthcare Nurse Residency Program. Engagement was evaluated using the Utrecht Work & Well-being Survey (UWES). Return on investment was also evaluated for the first year of the program. The sample included 791 newly-licensed registered nurses hired between January 2014 …

Scheduling Practices Of Acute Care Rn’S And Nurse Fatigue: Assessment And Development Of An Educational Program For Nurse Managers, Miranda Adkins

DNP Projects

PURPOSE: The purpose of this project is to develop an evidence-based organizational fatigue climate assessment to understand the current culture as it relates to nurse fatigue. This study includes the use of a fatigue measurement scale and the development of a fatigue reduction educational program for nurse managers.

METHODS: Using a cross-sectional survey design, data assessing organizational climate and actual fatigue levels among nurses employed at Saint Joseph East Hospital was obtained through an electronic questionnaire. Results were used to create a workplace fatigue educational program for nurse managers. The target sample consisted of 361 acute-care registered nurses for a …

The Effects Of A Nurse Manager System Collaborative Council On Job Satisfaction, Intent To Leave, & Resilience, Heather Oliver

DNP Projects

Abstract

PURPOSE: The purpose of this project was to create a Nurse Manager System Collaborative Council (NMSCC) at Norton Healthcare and to determine the impact of participation in the NMSCC on job satisfaction, intent to leave, and resilience.

METHODS: This study employed a quasi-experimental, pre-test, post-test design to assess the effectiveness of the NMSCC at Norton Healthcare. Job Satisfaction was measured using the Warshawsky scale, Intent to Leave was evaluated using the Houser scale, and resilience was assessed using the Connor-Davidson CD-RISC scale.

RESULTS: Resilience increased after participation in the NMSCC for 6 months. Job satisfaction and intent to leave …

Methods To Improve Interprofessional Collaboration In Administrative Dyads, Julie Lee Hudson

DNP Projects

Abstract

PURPOSE: The primary objective of this project was to determine if specific interventions, to include education, rounding, and regular meetings, improved collaboration and communication for nurse/physician dyads working in acute care hospital administrative roles.

METHODS: The study employed a prospective pre-test and post-test comparison of participants’ scores on a validated survey tool. This tool (JeffSATIC) measured perception of collaboration between nurses and physicians. The objective was to evaluate the differences in these scores in participants before and after an intervention.

RESULTS: This study sought to discover if specific interventions impacted scores on a tool measuring collaboration among dyad pairs. …

How To Prepare Interprofessional Teams In Two Weeks: An Innovative Education Program Nested In Telehealth, Tina S. Haney, Karen Kott, Carolyn M. Rutledge, Bruce Britton, Christianne N. Fowler, Rebecca D. Poston

Ellmer School of Nursing Faculty Publications

PROBLEM:

Preparing health professional students for interprofessional collaborative practice, especially at a distance where provider shortages prevail remains difficult.

APPROACH:

A two-week interprofessional education (IPE) immersion experience preparing students from 11 disciplines and four universities was implemented. Week-one, using online technology, students develop/present an interprofessional careplan for a complex patient. Students then meet face-to-face to conduct group interviews with two standardized patient dyads. Week-two, students develop a website for use of the patient dyads. Websites are presented to faculty and fellow students via an online virtual meeting space.

OUTCOMES:

To date, 594 students have participated demonstrating capacity to: 1.effectively engage …

Decreasing Duration Of Mechanical Restraint Episodes By Increasing Registered Nurse Assessment And Surveillance In An Acute Psychiatric Hospital, Diane Allen

DNP Scholarly Projects

Background

Application of mechanical restraints is a high-risk emergency measure that requires psychiatric intensive care in order to assure patient safety and expedite release at the earliest opportunity. While current regulations require that trained staff continuously observe restrained individuals, assessment by a registered nurse is required only once an hour. This project builds on research that demonstrated a regulatory change requiring more frequent registered nurse assessments led to decreased duration of mechanical restraint episodes in an acute psychiatric hospital.

Purpose

The purpose of this project was to implement and evaluate a practice change that required increased frequency of registered nurse …

A Program To Prepare Frontline Nurse Leaders For Peer Review, Suzanne K. Murdock

DNP Scholarly Projects

Introduction: The purpose of nursing peer review is to assess the quality of nursing care against established standards, identify strengths and weaknesses in practice, and identify knowledge gaps. Studies of nurse peer review predominantly focuse on staff nurse attitudes and knowledge after an educational intervention and barriers to implementation. Frontline nurse leaders (FLNL) can influence adoption of new practices such as peer review.

Purpose: The purpose of this project was to engage frontline nurse leaders in a role specific peer review program, preparing them to support their staff in the implementation of peer review in the future and providing an …

Preventing Emergency Department Overutilization For Florida’S Seasonal Resident Population, Amanda Garcia

DNP Scholarly Projects

Background/Local Problem: Seasonal migration of elderly patients to Lee County, Florida result in overcrowding and prolonged wait times in emergency departments. Many of these seasonal residents dissociate the management of their chronic health conditions with a local provider, therefore utilizing the emergency department for non-urgent needs. Purpose: The Seasonal Resident Navigator Program was intended to enhance the coordination of primary care services for elderly seasonal residents by establishing appointments with local primary care providers (PCP) in order to reduce the overutilization of emergency services and improve patient throughput. Methods: A residency and provider assessment tool was incorporated into the Healthpark …

Identifying Ways That Institutional Staffing And Scheduling Committees Engage Nursing Staff In Resource Allocation At The Unit And Institutional Levels, Kevin M. Shimp

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

The American Nurses Association (ANA) recommends that at least fifty percent direct care providers are involved in staffing and scheduling decisions at the institutional level (ANA Staffing, 2015). This recommendation coincides with Magnet recommendations for the staff most impacted by staffing levels. Magnet organizations are recognized for superior nursing processes and quality patient care, which lead to the highest levels of safety, quality, and patient satisfaction (ANCC, 2015). Existing research, largely at the unit level, shows that registered nurses in acute care environments have higher general work satisfaction and morale when they are engaged in decision making around staffing (Ellerbe …