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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