Matching Items (4)
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- All Subjects: Communication in nursing
- All Subjects: Innovation
- Creators: Lamb, Gerri
Description
The goal of this research was to contribute to the understanding of how the physical design of Intensive Care Unit (ICU) environments may be improved to enhance nursing communication, and in turn, the quality and safety of patient outcomes. This study was guided by two research questions: (1) What are the major characteristics of nurse communication in a hybrid ICU nurse station design? (2) What are the factors in the built environment that enhance or hinder nurse communication in a hybrid ICU nurse station design? The research design was exploratory and qualitative. Observations were conducted in two ICUs with hybrid nurse station layouts. Participant observation was used to systematically observe and document nurse communication and the physical attributes of the ICU nurse work environment that affect communication. Literature, observations, and information regarding staffing and design about the selected ICUs were analyzed for the generation of concepts and the exploration of significant themes. Results show that nurse interactions with other staff members varied within the different zones of the ICU pod. A biaxial map illustrates four key types of core nurse communication interactions: At ease, On guard, In motion, and On the edge. The quadrants representing barriers to nurse communication are On guard and On the edge, and included interactions with other staff members in the pod. The quadrants representing facilitators to nurse communication are At ease and In motion. The hybrid nurse station layout supported nurse-nurse communication, but not communication interactions with other staff members present on the pod. The results provide a broad understanding of how nurse communication is affected by the environment in which nurses work, and allows for the emergence of design opportunities to enhance nurse communication.
ContributorsNewcomb, Emily Michelle Darling (Author) / Lamb, Gerri (Thesis advisor) / Stein, Morris (Thesis advisor) / Wolf, Peter (Committee member) / Arizona State University (Publisher)
Created2011
Description
ABSTRACT The catalyst for this research was rooted in a patient satisfaction survey reported the need for an ambient quiet setting. This study used a descriptive comparative design augmented with qualitative data. The sample consisted of 54 participants came from one of three primary care clinics listened to 22 minutes of existing natural clinical sounds while the others listened to therapeutic sound hertz in a treatment room. The survey data correlated identify if an association existed or not to add therapeutic soundscape hertz back into a clinical ambient setting could affect the patient experience and wellness. Rather than, continue with abatement program efforts to remove unwanted sounds or mask the noise. Quantitative data were collected on mood states and biometric measures consisted of respiratory, heart, pulse systolic, and diastolic blood pressure rates. Qualitative data 5-Point Likert scale and open-ended questions determined participants' awareness of ambient sounds within the clinical setting. Data from participants were analyzed and compared separately for each clinic. The metrics were found to be statistically correlated (p<0.05) for the POMS-A survey and biometric measures using a Chi-square test. After the intervention, two clinics reported a 60%, and the third clinic an 80% mood state changes. Clinic 2-M reported the greatest significant mood state change. The t-Test validation biometric measures showed no significant evidence among the test and control groups for Clinic 1-L (396, 417, 444 Hz). Clinics 2-M (528, 639 Hz) and Clinic 3-H (714, 852 Hz) did share significant evidence to respiratory, heart, and systolic blood pressure rates. The respondents revealed 27% had a positive opinion of the therapeutic sound hertz perceived as silent or quiet, 59% had a negative opinion of unwanted sounds included communication as disruptive, and 16% felt the clinic’s physical design was poor. As a whole, this study indicates exposing patients to therapeutic sound hertz had a positive impact on their biopsychosocial wellness states. The value and novelty of this study show by adding selective distinct therapeutic sound hertz levels back into the clinic setting have profound implications for future researchers to build upon how the quality soundscape performance effects on the patient.
Contributorstate, angela diane (Author) / Bender, Diane (Thesis advisor) / Takamura, John (Committee member) / Lamb, Gerri (Committee member) / Arizona State University (Publisher)
Created2022
Description
Harm to patients remains high in US hospitals despite significant progress to improve the quality of care in our health systems. Leadership, a culture of patient safety, and a climate conducive to innovation in patient care are necessary to advance positive patient safety outcomes. Yet, little is known about how leadership can impact patient safety within a climate of innovation. This study examines the effects of transformational and transactional leadership (singularly and with transactional augmenting transformational leadership) as related to nurses’ perception of patient safety, how communication elements of a culture of patient safety may strengthen that relationship, and how the mediating role of team innovation climate may help explain the relationship between transformational and transactional leadership and nurses’ perception of patient safety. The variables were measured using three validated and reliable survey instruments: The Multifactor Leadership Questionnaire (MLQ Form 5X), the Team Climate Inventory-short (TCI), the Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture. A convenience sample of all staff registered nurses (N=952) from the single academic medical center with direct patient care responsibility was surveyed via e-mail for this research. A total of 210 surveys were returned, 157 met inclusion criteria for a response rate of 16%. Transformational leadership had a statistically significant relationship with patient safety perception, while the relationship of transactional leadership with patient safety perceptions was not significant. The results of the regression analysis that tested the effect of communication elements of a culture of patient safety on the relationship between transactional and transformational leadership and patient safety perception were not significant. Transformational leadership was significantly related with team innovation climate after controlling the effect of transactional leadership supporting the augmentation effect. Mediation analysis showed that team innovation climate had a significant mediating effect on the relationship between transformational leadership and patient safety perception. Team innovation climate had a significant mediating effect on the relationship between managers’ transformational leadership and patient safety perception after controlling for transactional leadership supporting the augmentation effect. This is the first study known to test the augmentation of transformational leadership related to patient safety and the role of team innovation climate.
ContributorsYounger, Samuel (Author) / Larkey, Linda (Thesis advisor) / Porter O'Grady, Timothy (Committee member) / Lamb, Gerri (Committee member) / Arizona State University (Publisher)
Created2019
Description
This descriptive research used social network analysis to explore the influence of relationships and communication among hospital nursing (RN, LPN, CNA) and discharge planning staff on adherence to evidence-based practices (EBP) for reducing preventable hospital readmissions. Although previous studies have shown that nurses are a valued source of research information for each other, there have been few studies concerning the role that staff relationships and communication play in adherence to evidence-based practice. The investigator developed the Relational Model of Communication and Adherence to EBP from diffusion of innovation theory, social network theories, relational coordination theory, and quality improvement literature.
The study sample consisted of 10 adult-medical surgical units, five home care agencies and six long-term care facilities. A total of 273 hospital nursing and discharge planning staff and 69 post-acute staff participated. Hospital staff completed a survey about communication patterns for patient care and patient discharge and about communication quality on the unit. Hospital and post-acute care staff completed surveys about relationship quality and demographic characteristics. Evidence-based practice adherence rates for risk assessment, medication reconciliation, and discharge summary were measured as documented in the electronic medical record.
Social network analysis was used to analyze the communication patterns for patient care communication at the unit. These findings were correlated with (1) aggregate responses for communication quality, (2) aggregate responses for relationship quality, and (3) EBP adherence. Statistically significant relationships were found between communication patterns, and communication quality and relationship quality. There were
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two significant relationships between communication quality, and EBP adherence. Limitations in response rates and missing data prevented the analysis of all of the hypothesized relationships.
The findings from this study provide empirical support for the role of social networks and relationships among staff in adoption of, and adherence to, EBP. Social network theory and social network analysis, especially the concept of knowledge sharing, provide ways to understand and leverage the influence of peer relationships. Future studies are needed to better understand the contribution that relationships among staff (social networks) have in the adoption of and adherence to EBP among nursing staff. Further model development and multilevel studies are
The study sample consisted of 10 adult-medical surgical units, five home care agencies and six long-term care facilities. A total of 273 hospital nursing and discharge planning staff and 69 post-acute staff participated. Hospital staff completed a survey about communication patterns for patient care and patient discharge and about communication quality on the unit. Hospital and post-acute care staff completed surveys about relationship quality and demographic characteristics. Evidence-based practice adherence rates for risk assessment, medication reconciliation, and discharge summary were measured as documented in the electronic medical record.
Social network analysis was used to analyze the communication patterns for patient care communication at the unit. These findings were correlated with (1) aggregate responses for communication quality, (2) aggregate responses for relationship quality, and (3) EBP adherence. Statistically significant relationships were found between communication patterns, and communication quality and relationship quality. There were
ii
two significant relationships between communication quality, and EBP adherence. Limitations in response rates and missing data prevented the analysis of all of the hypothesized relationships.
The findings from this study provide empirical support for the role of social networks and relationships among staff in adoption of, and adherence to, EBP. Social network theory and social network analysis, especially the concept of knowledge sharing, provide ways to understand and leverage the influence of peer relationships. Future studies are needed to better understand the contribution that relationships among staff (social networks) have in the adoption of and adherence to EBP among nursing staff. Further model development and multilevel studies are
ContributorsSolomons, Nan M (Author) / Lamb, Gerri (Thesis advisor) / Verran, Joyce (Committee member) / Marek, Karen (Committee member) / Arizona State University (Publisher)
Created2016