...of nursing staff and what is being done now, and can be done in the future to enhance the quality and quantity of practicing registered nurses. In an article published in 2004 by the Agency for Healthcare Research and Quality, it was stated that “hospitals with low nurse staffing levels tend to have higher rates of poor patient outcomes such as pneumonia, shock, cardiac arrest, and urinary tract infections. Major factors contributing to lower staffing levels include the needs of today’s higher acuity patients for more care and a nationwide gap between the number of available positions and the number of registered nurses (RN’s) qualified and willing to fill them” ( www.ahrq.gov, 2004). It is interesting that the same issues that are being faced today were an issue in 2004. “A persistent shortage of nursing staff across the United States challenges the belief and values of the profession. Many nurses find it difficult to carry out their ethical obligations to patients due to the insufficiency in staffing. Because of this shortage, many nurses complain that they experience emotional distress and job dissatisfaction and end up not providing quality care to their patients. As such nurses end up in an ethical dilemma, whereby they must choose between caring for their own welfare or the needs of their patients” (Lowrie, 2013 p. 1). Registered nurses acknowledge that staffing issues are an ongoing concern, and that staffing...
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...RETENTION? Does Shared Governance Improve Nursing Retention? La Quinta Roberts Kaplan University NU499 Bachelor’s Capstone in Nursing Natasha Zurcher, MSN/ED, RN, CPN April 6, 2014 Abstract The global nursing shortage has prompted health care systems to seek new strategies to attract and retain nurses. The growing evidence points to the shared governance model of management are as a possible strategy to improve productivity, nurse job satisfaction and nurse retention. There are different models of shared governance, but a clear relationship exists between nurse practice environment and higher retention rates. Research found long hours, and unsupportive practice environments contribute to high turnover rates. Here is a look at the evidence which promote the creation of a shared governance model for a positive practice environment and better retention rates. Shared Governance and Nurse Retention Introduction Shared governance models are being promoted as a plan to decrease nurse turnover, but there are many variable elements to the Shared governance model. True shared governance characteristics are a practice environment that has a process by which nurses take an active participatory role in the decisions of the hospital nursing practice. Most shared governance models are associated with Magnet status hospitals, but more and more hospitals are adopting this style of management without the designation. This is a relatively new concept because nursing in hospitals...
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...Study Job satisfaction in registered nurses should be of great concern to any organization. Nurses hold the majority of positions in most health care settings, and replacement of licensed personnel is costly and time consuming. As newly graduated nurses, we have limited time but ample exposure to varying degrees of job satisfaction. What makes some so happy with their chosen profession, and others so unhappy? Aside from a change of career, is there a solution? With the current nursing shortage, and the anticipation of worsening conditions, we set out to investigate the sources of dissatisfaction in the health care setting. We reviewed several scholarly sources and withdrew pertinent information. Following the discussion of literature findings is a summary including suggestions for further research. In the article written by Fletcher, job satisfactions as well as dissatisfactions were investigated. Questionnaires were mailed to 5,192 registered nurses (RNs), 1,780 of which were returned and scored using several evaluation methods (Fletcher, 2001). Researchers looked at job satisfaction, patient satisfaction and safety, extrinsic work values, role of the immediate supervisor, and intent to stay in nursing. Job satisfaction was evaluated on several levels: Profits, Job performance, Intrinsic work values, and, Patient care issues. Profits referred not to personal financial gain, but to the organization’s profits. Many nurses responded feeling "devalued in their job" (Fletcher...
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...Application of Theory Neukenya Jokines Chamberlain College of Nursing Application of Theory The future of nursing is dependent upon nursing leadership that adheres to the professional standards in regards to education, research and practice. On a daily basis decisions are made by nurses that directly affect the lives of others. Nursing theory is a guide that has been set in place in order for nurses to look upon when it comes to daily healthcare decisions. It was stated by Cody (2003), that “one learns to practice nursing by studying nursing theories” (pg. 226). This statement can be applied to the problems of nursing leadership, problem solving and decision making. Cody (2003), also states that “nursing practice will be transformed to the betterment of humankind when all nursing practice is fully autonomous and guided predominantly by nursing theory” (pg. 230). For many years nursing practice has found its foundations from nursing theories. Understanding how nursing knowledge within healthcare organizations influence patient and organizational outcomes are discussed in the middle range theory of nursing intellectual capital (Covell, 2008). Intellectual capital is defined as the combination of collective knowledge of individuals and structures in an organization or society. The theory consists of two concepts of nursing which includes human capital and nursing structural capital. According to (Covell & Sidani, 2013) “Intellectual capital theory defines human capital...
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...Mariani, B. (n.d.). The Effect of Mentoring on Career Satisfaction of Registered Nurses and Intent to Stay in the Nursing Profession. Nursing Research and Practice, 1-9. Mentoring plays a crucial role in the growth and development of novice nurses. It provides a way for the experienced nurses to give back to the profession and helps them play a significant role in the formulation of a new nurses’ career. Mentors offer knowledge, encouragement, support, guidance, and friendship to the next generation of caregivers. In her study, Marian wanted to see if there was a connection between mentoring, job satisfaction, and retention. Practicing nurses were selected randomly to be mailed surveys to complete regarding mentoring and its’ effect on job satisfaction and nursing retention. There were limitations and flaws in this study making it difficult to determine its validity. For one, the rate of returned surveys did not reach the study’s target goal of 60%. The responses were uneven between nurses who had participated in mentoring and those who did not. Also nurses dissatisfied with their careers may not have responded, and even with defined terms included, participants may have been confused with precepting, mentoring, and protégé. Although this survey study did not show any relationship between mentoring, job satisfaction, and retention, it did establish that mentoring continues throughout the profession on a routine basis. Mariani thinks this suggests that future studies should...
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...beneficial to new graduate registered nurses? Nursing residency program is a program designed to increase retention and provide essential tools to promote graduate nurse success and productivity. (Welding, 2011). Nurse Residency program gives the nurse who is a novice the learning base and expertise set required to move to clinical nursing practice competence while giving the skills required to meet the mission and objectives of the organization, the program gives nurses the administration abilities to work cooperatively within a multidisciplinary team. The nurse residency program bridges the gap between...
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...Quantitative Research Article Critique Frances Vitek Winston-Salem State University NUR 3303 Nursing Research Introduction Nurse residency programs are important in the desire for nursing recruitment and retention. New graduate hires face many stressful challenges transitioning from student to professional RN in the workforce. Loss of a new graduate nurse leads to a great financial loss and ultimately increase in the shortage that in turn can lead to patient safety issues. The leaders of the nurse residency programs need to be vested and continue to follow and mentor these new professionals well into their second or third year of hire. The purpose if this paper is to critique the research article “Are rural and urban newly licensed nurses different? A longitudinal study of a nurse residency programme” by Marilyn Meyer Bratt, Marianne Baernholdt, and Jessica Pruszynski. My examination focuses on specific aspects of the article in terms of process and validity of research methods and results. According to Burns and Grove (2012) the purpose of reviewing literature provides us with evidence in theory and science about a specific problem, alloying is to decipher information about what is known to us and not. The key concept covered in Bratt, Baernholdt and Pruszynski’s article is to determine if there is a difference among rural and urban nurse residency programs that lead to a higher retention rate? The key points of this review is to assess the two different...
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...made available for no longer than five years and that student would be able to print off copies or download. The authorship would remain anonymous. (4) I agree to my Project being submitted to a plagiarism detection service, where it will be stored in a database and compared against work submitted from this or any other School or from other institutions using the service. In the event of the service detecting a high degree of similarity between content within the service this will be reported back to my supervisor an second marker, who may decide to undertake further investigation which may ultimately lead to disciplinary actions, should instances of plagiarism be detected. (5) I have read the University Policy Statement on Ethics in Research and...
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...influencing job satisfaction Nowadays, being a professional is byzantine complex journey universally. In most of the profession, the “next gen” is increasingly hunting for a technology-focused globe and constantly transforming. Trede (2012) mention besides being knowledgeable and skillful, the individual must also trait sense of responsibility towards themselves, others and organization. Today for a nurse to hold on and work blissfully in one work place is challenging due to dissatisfaction of their job. Tang and Ghani (2012) argued nowadays, even though there are abundant opportunities available in Malaysia, nursing is no longer popular as it used to be. Chaulagain and Khadka (2012) stated one of the issue raise in quality improvement program is job gratification among nurses as it is a crucial issue being faced by most healthcare organization. The efficiency of healthcare services is affected due to increase rates of nurse’s turnover and absenteeism resulting from low job satisfaction. Understanding the factors that nurses are satisfied and dissatisfied will enable interventional measures be taken to improve the working conditions. Whereas such understanding will not improve the retention rate, it will improve the nurses’ work performance leading to better quality care to the patient (Newman et al, 2002). Judge et al (2002) assert the most widely investigated in the history of healthcare organization psychology, job satisfaction is the most widespread research topic. This...
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...Effects of Nursing Rounds: on patients’ Call Light Use, Satisfaction and Safety. Introduction: The findings of this article will critically review the methods of research, population, systems and data used to obtain results regarding this study. This evaluation of the outcome would determine whether or not there was a need to change the nursing management of patient care. The study would determine if patients were happy with their care and if the rate of falls were minimised. In the health care setting, the call light is an important communication tool for the nursing staff and patients especially in an emergency situation. Title: The title clearly summarises the content of this Journal article which suggests there was either a qualitative or quantitative designed research data used to conclude the findings. There was limited context which was not clearly defined (Meade et al.2006, p 58). Abstract: This is succinct, meaning the writer has been brief and precise with the back ground information about the research article. This covered the objectives, methods, results...
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...organizing factors of inpatient psychiatric care environments were associated with the occurrence of these events. The events examined were wrong medication, patient falls with injuries, complaints from patients and families, work-related staff injuries, and verbal abuse directed toward nurses. Methods: This cross-sectional study used data from a 1999 nurse survey linked with hospital data. Nurse surveys from 353 psychiatric registered nurses working in 67 Pennsylvania general hospitals provided information on nurse characteristics, organizational factors, and the occurrence of adverse events. Linear regression models and robust clustering methods at the hospital level were used to study the relationship of organizational factors of psychiatric care environments and adverse event outcomes. Results: Verbal abuse toward registered nurses (79%), complaints (61%), patient falls with injuries (44%), and work-related injuries (39%) were frequent occurrences. Better management skill was associated with fewer patient falls and fewer work-related injuries to staff. In addition, fewer occurrences of staff injuries were associated with better nurse-physician relationship and lower patient-to-nurse staffing ratios. Conclusions: Adverse events are frequent for inpatient psychiatric care in general hospitals, and organizational factors of care environments are associated with adverse event...
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...more recent concern are disruptive behaviors by physicians and other healthcare workers. In an effort to reduce the frequency of these incidents of disruptive behavior mandates have been issued regarding the implementation of policies and procedures which specifically address disruptive behavior among healthcare workers. The aim of this paper is to review research relevant to frequency of disruptive behavior among healthcare workers, the effect of this type of behavior on clinical outcomes, and efforts to decrease its incidence. Disruptive Behavior is a Cause of Poor Patient Outcomes Disruptive behavior has been recently defined by the American Medical Association, and The Joint Commission now requires the facilities they accredit to create a plan to outline acceptable behaviors, unacceptable behaviors and how they will address the latter (Rosenstein & O’Daniel, 2005.) Members of the healthcare team should receive training in regards to an organization’s Code of Conduct. Causes of disruptive behavior may include a culture of power among physicians, a culture of oppression among nurses (especially female nurses when dealing with male physicians), and conflict in regard to how a patients should be treated clinically. When disruptive behavior among healthcare workers is present, it can have a negative effect on the patient’s clinical outcome and could pose a possible safety risk to the patient. Disruptive behavior often leads to breakdowns in communication, and communication...
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...Nurse Burnout and Its Impact on Patient Safety Georgetown University Foundations of Health Systems and Policy NURO-624 September 12, 2013 Nurse Burnout and Its Impact on Patient Safety Patient safety encompasses the application of best practices that are geared towards achieving positive outcomes and promoting safety, and can serve as an indicator of quality in healthcare institutions; sustainable nursing workloads improve the quality of health care by reducing unsafe conditions, as well as reducing mortality and morbidity. Several literature reviews have clearly identified the consequences for patients when nurses are overtaxed or over utilized to bridge the gap of nursing shortages. According to Mckee et al, each patient added to nurses’ workloads (beyond four patients) is associated with a seven percent increase in mortality following common surgical procedures (McKee, M. 1999). Recent health reform legislation has further stimulated increased awareness and focuses on patient centered care, and emphasizes on the importance of the patients’ experience. Moreover, patients’ expectations of their caregivers to be positively engaged in their work and performing efficiently and effectively in a supportive environment are prudent. However, several challenges are being encountered by nurses, as they strive to meet the mandates of the aforementioned health care reform. Challenges resulting from unfavorable working conditions that are not conducive to the provision of patient...
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...Research Summary and Ethical Considerations: Support for Hospital Patients & Supported Factors Patient Support is a significant phase in delivering the care. This support should be tailored to each patients in their life situations and individual needs to bring out better outcomes. The article by E. Mattila et al in 2010, is a study of patient support especially emotional and informational support given by the nurses to their patients (Mattila, 2010). The patients need support in the hospital environment to reduce stress and anxiety that in turn, promote the healing and recovery. The article by E. Mattila et al. 2010, support works as a shield for the patients when they are stressed (Mattila, 2010). Access to support is very important through hospitalization as illness and hospitalization are very stressful. Emotional support is essential in providing the quality patient care. Based on patient's age, sex, background and education support will vary. Patients with shorter hospital stays are receiving less support. The article says about named nurse system. It is a system that each patient has a primary nurse who is in charge of planning, coordinating, and providing the care daily. This strengthens nurse-patient relationship, and let them explore their fears and concerns which reduces stress and make them feel comfortable in asking questions and gain confidence and also the support they want. Short staffing and increased workload on units decreases the access to support for...
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...profession, but the nature of advocacy in the nursing practice remains ambiguous. Nurses are obligated to act as an advocate for their patients, but there is lack of clarity on how to perform this role. The purpose of this paper is to better understand nursing advocacy and to explore ways it is practiced across all fields of nursing in order to promote improved patient care. Advocacy is an essential role for the nursing profession; however, it can be affected by many factors. The goal of advocacy is to balance the relationship between the healthcare system and the patients who are served by evaluating patient/family needs, providing information and education, ensuring access to proper care and supporting the patient and family’s decision within the structure of a multidisciplinary team. This paper will explore the following research question: What are the variables that affect the role of nursing advocacy and in what ways is it practiced across all fields of nursing? Review of Literature Introduction The general topic of the review of literature is nursing advocacy. We are examining and exploring a clearer definition of nursing advocacy and how it is practiced across all fields of nursing. The studies were retrieved through searches on the CINAHL, Medline, AcademicOne, and Sage Premier for the years 2006 - 2011. The key words used for the literature searches were nursing advocacy definition, nurses role, nursing ethics, dignity, code of conduct, barriers, nursing methodology...
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