Nursing Administration Commons^™

Developing A Nursing Peer Review Program For Nurse Leaders, Holli D. Roberts

Graduate Theses, Dissertations, and Capstones

Abstract

Peer review is described as a best practice in assessing professional competence for all levels of nurses. However, barriers exist in implementing peer review among nurses in leadership roles. Nurse leaders have limited interactions to observe how others manage their units making assessment of professional competence difficult. A gap analysis of peer review in an acute care hospital revealed a need to revise the peer review program for nurse leaders. The American Organization of Nurse Executives list of leadership competencies was used as a framework to revise peer review instruments for the nurse leaders. Each instrument included a self-assessment …

Compassion Satisfaction And Compassion Fatigue Among Pediatric Nurses And The Impact On Patient Satisfaction, Maribeth Thornton

Nursing ETDs

Compassion fatigue and compassion satisfaction are two inter-related concepts. Individuals in helping professions may occasionally face compassion fatigue from giving so much of themselves to others. Compassion fatigue has been studied in a variety of settings: medical, social work, nursing, law enforcement, and fire departments, to name a few. While some researchers have studied nurses, little published work has focused exclusively on nurses who care for specialty pediatric populations. Additionally, there is scant research on whether compassion satisfaction and compassion fatigue are associated with patient satisfaction. The purpose of this study was to determine the level of compassion satisfaction and …

An Assessment Of Errors And Near-Misses From Pre-Licensure Student Nurses, Megan Wolfe, Dnp, Fnp-C, Ms Ed., Rd, Rn, Cne

Doctor of Nursing Practice Projects

Background: Approximately one-half of new nurses with less than one year of experience who were involved in adverse patient events identified that their formal education preparation was a causal factor in their error (Saintsing, Gibson & Pennington, 2011). An examination of quality and safety measures of a current hospital based associate degree nursing (ADN) educational program provided data regarding errors committed by prelicensure students. Tracking and analysis of frequency and type of student clinical errors provided for identification of similarities and an opportunity for system evaluation and improvements.

Objectives: To identify the number, types and categories of Student …

Screening, Brief Intervention And Referral To Treatment Implementation In The Emergency Department, Arvind Venkat Md, Gary Shank Phd, Sherry Rickard-Aasen, Janice Pringle Phd, William Johnjulio Md

The Qualitative Report

We sought to qualitatively evaluate impediments in implementing a novel Screening, Brief Intervention and Referral to Treatment (SBIRT) protocol into normal emergency department (ED) workflow for patients with at-risk drug/alcohol behavior. From 2010, administrative and nursing champions trained nurses at a single ED (census: 50,000 visits/yr) in SBIRT and incorporated SBIRT into normal ED nursing workflow in 2012. To qualitatively analyze impediments in SBIRT implementation, we created a semi-structured questionnaire for protocol champions with subsequent follow-up. Investigators analyzed responses using qualitative methodology based on a modified grounded theory framework. In 2012, 47693 visits by 31525 patients met SBIRT protocol initiation …

Communicative Behaviors Elicited By Leisure Activities In Memory Care Units, Tarynn Clune

Honors Projects

A wide variety of leisure activities used in reminiscence care have been studied for their merits in terms of preventing cognitive decline, and increasing quality of life; however, little is known about what different types have to offer in terms of communicative opportunities. Communication with peers is imperative for quality of life, and is crucial for maintenance of relationships between the person with dementia (PWD) and their loved ones. As a result of this importance, an exploration of communication elicited by different activities facilitated in a unit was conducted. The communication explored in this study was solely vocal, and included …

Improving Patient Safety Through High Reliability Organizations, Jared Padgett, Kenneth Gossett, Roger Mayer, Wen-Wen Chien, Freda Turner

The Qualitative Report

Preventable medical errors result in the loss of 200,000 lives per year with associated financial and operational burdens on organizations and society. Widespread preventable patient harm occurs despite increases in healthcare regulations. High reliability organization theory contributes to improved safety and may potentially reverse this trend. This single case study explored the introduction of a safety culture and subsequent improvements in patient safety in a reliability-seeking organization. Fourteen participants from a subacute nursing facility were selected using purposeful sampling criterion. Data were collected through participant interviews, document reviews, and group observation. Five themes emerged from an analysis of collected data …

Warmth And Competence Traits: Perceptions Of Female And Male Nurse Stereotypes, Randolph E. Gross

Dissertations, Theses, and Capstone Projects

A nursing shortage looms ahead; 1.03 million new nurses will be needed by 2022 to meet society's healthcare needs. A major barrier to recruitment of women and men are nurse stereotypes. The literature suggests four female and four male stereotypes exist; however, no quantitative research exists that explores perceptions of non-nursing undergraduate students. Approximately, 90% of college students do not consider nursing as a career option, and 72% have misconceptions of what nurses do in reality.

According to social cognitive theory's Stereotype Content Model (SCM), perceptions are viewed through a combination of two dimensions: warmth and competence. The author devised …

Transformational Leadership Assessment Of Nurse Managers And Assistant Nurse Managers, Susan Braun Duggar

Nursing Theses and Capstone Projects

Transformational Leadership behaviors are essential to build and sustain a healthy work environment in healthcare. Nurse Managers who possess transformational leadership behaviors lead nursing teams with a higher degree of engagement, work satisfaction, and retention. The purpose of this project was to perform an assessment of transformational leadership characteristics among nurse managers and assistant nurse managers, develop an educational program to teach transformational leadership behaviors, and incorporate a transformational leadership assessment into the orientation onboarding process of new nurse managers and assistant nurse managers. The Full Range Leadership Model (FRLM) asserts leaders should use multiple leadership characteristics or behaviors to …

Adult Qdts, Chinese, Marianne E. Weiss, Binghua Wang

Quality of Discharge Teaching Scale

The Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale, and Post-Discharge Coping Difficulty Scale were developed by Dr. Marianne Weiss to measure nurse-sensitive discharge care processes and patient outcomes. Three versions of the scales were developed concurrently for different patient populations – Adult medical-surgical patients, Parents of hospitalized children, and Postpartum Patient mothers (see Weiss & Piacentine, 2006, Weiss et al., 2007, and Bobay et al., 2018 for description of the development and initial testing). Additional scales and information about translation rights are located at Marquette Nursing.

PERMISSION TO USE

The Readiness for Discharge Scale, Quality of Discharge …

Risk Of Medication Errors In The Home: An Integrative Literature Review, Maria M. Crescenzi

Honors Undergraduate Theses

Regardless of the setting, medication errors are of great concern when associated with an individual’s health outcomes, along with the increased costs to society, healthcare institutions, and providers. Current research focuses on medication error data primarily in acute and extended care facilities. However, there is a paucity of research examining the causes of medication errors that occur post hospital discharge when individuals transition to the home. The purpose of this integrative literature review is to examine risk factors for medication errors outside of these settings, specifically in the home. A systematic literature search was conducted using multiple databases for relevant …

Defining A Person: The Nurse At Risk For Compassion Fatigue, Ellen Johnston

Honors Undergraduate Theses

The intent of this thesis was to examine compassion fatigue in nurses through analysis of research studies conducted within the past five years in an effort to identify predisposing factors to the experience of compassion fatigue. Individual and institutional factors were identified as well as current strategies to assist with management of compassion fatigue. Findings indicated that being new to practice, having a trait negative affect, being younger in age, having a history of exposure to trauma and working in high emotionally stressful units predisposed individuals to the experience of compassion fatigue. Institutional factors included a lack of managerial support, …

Nonprofit Pay In A Competitive Market: Wage Penalty Or Premium?, Christian King, Gregory B. Lewis

Department of Nutrition and Health Sciences: Faculty Publications

Two competing theories argue that the nonprofit sector pays differently: Nonprofit employees may accept lower pay to be able to do meaningful work for a good cause, or they may earn higher pay due to nonprofit organizations’ tax exemptions and weaker incentives to hold down wages. To test these opposing expectations, we use the 2005-2013 American Community Surveys to examine pay differences among registered nurses working for nonprofit, for-profit, and public hospitals. We also test hypotheses that public and nonprofit hospitals have smaller pay disparities by gender, race, and relationship status. We find that pay is highest in nonprofit hospitals, …

Evaluation Of A Nurse Navigator Program On The 30-Day Readmission Rate In Heart Failure Patients, Katie A. Winiger

DNP Projects

PURPOSE: The purpose of this study was to evaluate the impact of a registered Nurse Navigator (NN) on hospital 30-day readmissions for patients with heart failure at Norton Healthcare (NHC) in Louisville, Kentucky.

METHODS: This study involved two phases. Phase I was a retrospective descriptive design utilizing a medical record review of 159 patient charts. Group 1, 54 charts, included patients with heart failure who were discharged from NHC for heart failure related illnesses and were seen in a primary care clinic that utilized a NN after discharge from the hospital. Group 2, 105 charts, included patients with heart failure …

Assessment Of Horizontal Violence And Healthy Work Environments Of Two Nursing Units, Rebekah Dailey

DNP Projects

PURPOSE: Horizontal Violence plagues the health of nursing work environments. In order to diminish this phenomenon and establish healthy work environments as established by the AACN, assessments must be completed to identify strengths and weaknesses and determine the proper interventions to employ. However, there is a lack of evidence in actionable interventions. The purpose of this project was to assess healthy work environments of two nursing units by examining horizontal violence, civility, teamwork, and satisfaction, and identify interventions to strengthen the health of the work environment.

METHODS: This study was a descriptive study using an electronic survey of two nursing …

Nursing Skill Mix, Nurse Staffing Level, And Physical Restraint Use In Us Hospitals: A Longitudinal Study., Vincent S. Staggs, Danielle M. Olds, Emily Cramer, Ronald I. Shorr

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Although it is plausible that nurse staffing is associated with use of physical restraints in hospitals, this has not been well established. This may be due to limitations in previous cross-sectional analyses lacking adequate control for unmeasured differences in patient-level variables among nursing units.

OBJECTIVE: To conduct a longitudinal study, with units serving as their own control, examining whether nurse staffing relative to a unit's long-term average is associated with restraint use.

DESIGN: We analyzed 17 quarters of longitudinal data using mixed logistic regression, modeling quarterly odds of unit restraint use as a function of quarterly staffing relative to …

A Systems Approach To Moral Distress In Long Term Care, Margaret Lemley

Electronic Theses and Dissertations

Abstract: The question that this dissertation seeks to answer is whether or not a Systems Approach to Moral Distress can serve to positively address issues of moral distress within the Long-Term Care setting. Because moral distress has largely been understood as a phenomenon of the individual, efforts to address and reduce incidents of moral distress have focused almost entirely on the individual and his or her reaction to specific triggers. Building upon the existing literature this dissertation argues that previous efforts to understand moral distress within the healthcare setting have been limiting in two very important aspects. The first …

Safety Culture And Fall Prevention: A Collaborative Effort, Cecilia Cortina

Seton Hall University DNP Final Projects

Patient falls in the United States (US) range from 700,000 to one million annually and one third of those falls can be prevented (Du Pree, Fritz-Campiz & Musbeno, 2014). Twenty to 30% of falls are moderate to severe (Schimke & Schimke, 2014). As of 2009, The Joint Commission’s (TJC) (2015) Sentinel Event databank held 465 reports of hospital falls with injury; deaths that resulted in those injuries were reported as 63 percent. Common denominators resulting in patient falls with injury are poor assessment, lack of communication, failure to follow protocols, insufficient training and supervision, staffing levels, unsafe environments and lack …

Developing An Electronic Health Record Training Program For New Employees, Crystal D. Figlietti

Doctor of Nursing Practice (DNP) Projects

In May 2015, an electronic health record (EHR) was implemented at an urban, long-term care facility. This facility is part of the county Department of Public Health (DPH) and was one of the last locations to implement the designated EHR system. The unique nature of the facility compared to the smaller, health care centers within the DPH network necessitated development of a customized training and onboarding program for new employees. It was not possible to duplicate an existing training program. The registered nurse (RN) informaticist assigned to the EHR used data from nursing staff surveys and information collected through a …

Patient Care Sitter Reduction And Fall Safety Improvement, Timothy J. Bock

Doctor of Nursing Practice (DNP) Projects

The financial constraints imposed upon operational budgets by the frequent use of patient care sitters is well known among hospital leadership. Despite the high labor costs associated with direct and continuous observation, this intervention is routinely deployed by frontline care teams in an effort to preserve patients from harm, particularly from accidental falls. This reality creates an opportunity where significant budget savings can be achieved by supplanting the use of patient care sitters with more effective fall prevention strategies. This quality improvement (QI) project implemented a non-psychiatric sitter reduction and fall prevention initiative in two high volume adult acute care …

Innovation Through An Academic Practice Partnership: A New Clinical Nurse Leader (Cnl) Implementation Model, Nancy P. Taquino

Doctor of Nursing Practice (DNP) Projects

Problem

The IOM reports (1999, 2001) were catalysts for development of a new nursing role - the Clinical Nurse Leader (CNL). Academic practice partnership models are needed to integrate the CNL role in health care systems.

Context

A large integrated health care system in Northern California and a university Clinical Nurse Leader (CNL) program initiated a formal academic practice partnership, establishing a hospital based MSN CNL program.

Intervention

A CNL implementation model was developed that includes (a) academic practice partnership advisory charter; (b) academic practice partnership roles (MSN CNL program director, MSN CNL faculty liaison, and hospital-based CNL …