Matching Items (10)
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- All Subjects: Nursing
- Creators: Hagler, Debra
Description
The healthcare system is plagued with increasing cost and poor quality outcomes. A major contributing factor for these issues is that outdated leadership practices, such as leader-centricity, linear thinking, and poor readiness for innovation, are being used in healthcare organizations. Through a qualitative case study analysis of innovation implementation, a new framework of leadership was uncovered. This framework presented new characteristics of leaders that led to the successful implementation of an innovation. Characteristics uncovered included boundary spanning, risk taking, visioning, leveraging opportunity, adaptation, coordination of information flow, and facilitation. These characteristics describe how leaders throughout the system were able to influence information flow, relationships, connections, and organizational context to implement innovation.
ContributorsWeberg, Daniel Robert (Author) / Fluery, Julie (Thesis advisor) / Malloch, Kathy (Thesis advisor) / Porter-O'Grady, Timothy (Committee member) / Hagler, Debra (Committee member) / Arizona State University (Publisher)
Created2013
Description
Nurses are ideally positioned to lead the transformation of healthcare delivery in the United States, however they must be prepared to do so. The Institute of Medicine has called for nurses to become change agents and assume leadership positions across all levels in order to become full partners with physicians and other health care providers. While clinical leadership is a responsibility for all nurses, expectations for new nurse clinical leadership have not been well studied.
This study sought to determine the nursing leadership competencies clinical managers expect of new nurses in an acute care setting and to identify gaps between end-of-program nursing leadership competencies, as outlined in The Essentials of Baccalaureate Education for Professional Nursing Practice, with leadership competencies identified by clinical managers in an acute-care setting.
A single, bounded case study approach was used to collect data from nurse managers and assistant nurse managers at one acute care hospital. Data from intensive interviews, focus groups, and archival records were analyzed. Seven major themes related to clinical leadership emerged, including intentional learning, communication, professional practice, advocacy, teamwork, influencing practice, and systems thinking. Traits, mentoring, and generational differences emerged as secondary themes.
Data from this study revealed a developmental sequence for clinical leadership. Certain expectations identified as antecedent to clinical leadership emerged initially, whereas other aspects of clinical leadership, developed later in the career trajectory. It was clear that accomplishing nursing care tasks was a fundamental expectation for professional nursing practice. Communication, teamwork and advocacy are crucial leadership competencies which help the new nurse to effectively manage time and provide safe, high-quality nursing care. As the new nurse continues to develop, systems thinking and influencing nursing practice emerge as significant expectations. Nurse managers have clear expectations for how new nurses should be prepared for clinical leadership. The degree to which clinical practice partners employing new nurses and academic nursing programs educating future nurses collaborate to establish expected outcomes is variable; however, academic-practice collaborations are crucial in developing educational standards for entry to practice in complex healthcare delivery systems.
This study sought to determine the nursing leadership competencies clinical managers expect of new nurses in an acute care setting and to identify gaps between end-of-program nursing leadership competencies, as outlined in The Essentials of Baccalaureate Education for Professional Nursing Practice, with leadership competencies identified by clinical managers in an acute-care setting.
A single, bounded case study approach was used to collect data from nurse managers and assistant nurse managers at one acute care hospital. Data from intensive interviews, focus groups, and archival records were analyzed. Seven major themes related to clinical leadership emerged, including intentional learning, communication, professional practice, advocacy, teamwork, influencing practice, and systems thinking. Traits, mentoring, and generational differences emerged as secondary themes.
Data from this study revealed a developmental sequence for clinical leadership. Certain expectations identified as antecedent to clinical leadership emerged initially, whereas other aspects of clinical leadership, developed later in the career trajectory. It was clear that accomplishing nursing care tasks was a fundamental expectation for professional nursing practice. Communication, teamwork and advocacy are crucial leadership competencies which help the new nurse to effectively manage time and provide safe, high-quality nursing care. As the new nurse continues to develop, systems thinking and influencing nursing practice emerge as significant expectations. Nurse managers have clear expectations for how new nurses should be prepared for clinical leadership. The degree to which clinical practice partners employing new nurses and academic nursing programs educating future nurses collaborate to establish expected outcomes is variable; however, academic-practice collaborations are crucial in developing educational standards for entry to practice in complex healthcare delivery systems.
ContributorsMiehl, Nickolaus (Author) / Komnenich, Pauline (Thesis advisor) / Hagler, Debra (Thesis advisor) / Lamb, Gerri (Committee member) / Arizona State University (Publisher)
Created2018
Description
I conducted a qualitative, comparative study on the nursing education systems in the United Kingdom and the United States, focusing on two universities—Arizona State University in Phoenix, Arizona and Leeds Beckett University in Leeds, England. The goals of my thesis included comparing the educational, economic, and cultural aspects of the countries and how those aspects impact nursing students on both sides of the pond. The educational and economic aspects were compared by utilizing existing literature and open data sources such as the university websites and publications from comparative education journals, while the cultural differences were evaluated by conducting short, one-on-one interviews with students enrolled in the Adult Health courses at both universities. The findings from the interviews were transcribed and coded, and findings from the sites were compared. While there is an extensive amount of research published regarding comparative education, there has not been much published comparing these developed countries. While there is a significant difference in the structure and cost of the nursing programs, there are more similarities than differences in culture between nursing students interviewed in the US and those interviewed in the UK.
ContributorsTahiliani, Shreja (Author) / Hagler, Debra (Thesis director) / Allen, Angela (Committee member) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
Hematopoietic stem cell transplantation (HCT), a common treatment for various hematopoietic cancers, involves lengthy hospital stays as well as intensive chemotherapy prior to the transplant. Many patients exhibit clinically significant symptoms of depression, anxiety, or post-traumatic stress disorder (PTSD) after transplant, due to the demanding nature of the treatment process and the associated risks. However, little research has been done concerning how nurses' actions impact the emotional well-being of these patients; most studies lack evidence related to the nursing staff's precise role in this distressing situation. The purpose of this study was to explore, using a qualitative approach, participants' personal experiences with their nurses throughout all phases of treatment, focusing on interventions and actions nurses took to ease the participants' reported anxiety, depression, or PTSD symptoms. A convenience sampling method was used to recruit participants. Nine English-speaking individuals (M age = 55 years; 78% female; 67% allogeneic) from around the US were invited to participate in semi-structured in-depth interviews. Seven major themes emerged from the interviews: (1) support from nurse, (2) physical symptoms, (3) emotional/cognitive distress, (4) open/honest communication, (5) coping, (6) continuity of nurses, and (7) anticipatory guidance. Results indicated the need for heavy psychosocial support, informational support, and active listening from nurses. Implications for nursing practice included an increased need for education on the best timing for implementation of nurse-led interventions, as well as further investigation into strategies for nurses to provide optimal psychosocial care for HCT patients.
ContributorsGaney, Nicole Isabel (Author) / Kim, Sunny (Thesis director) / Hagler, Debra (Committee member) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
Description
This cross-sectional descriptive study was designed to examine critical care registered nurses’ perceptions of nurse-to-nurse incivility and professional comportment, and the extent to which education, nurses’ age, nursing degree, and years of nursing experience is related to their perceptions on these topics. Professional comportment is comprised of nurses’ mutual respect, harmony in beliefs and actions, commitment, and collaboration. Yet, it was unknown whether a relationship existed between a civil or uncivil environment in the nursing profession and nurses’ professional comportment. Correlational analyses were conducted to explore the relationship between perceptions of nurse-nurse incivility and professional comportment, and the relationships between incivility and professional comportment education and perceptions of nurse-nurse incivility and professional comportment. Multiple linear regression analyses were conducted to identify predictors of perceptions of nurse-nurse incivility and professional comportment. Results indicated statistically significant relationships between perceptions of nurse-nurse incivility and professional comportment, and between professional comportment education and perceptions of professional comportment. Professional comportment education was identified as a statistically significant predictor of increased perceptions of professional comportment. Findings of the current study may assist in establishing more targeted and innovative educational interventions to prevent, or better address, nurse-nurse incivility. Future research should more clearly define professional comportment education, test educational interventions that promote professional comportment in nurses, and further validate the Nurse-Nurse Collaboration Scale as a measure of nurses' professional comportment.
ContributorsOja, Kenneth John (Author) / Komnenich, Pauline (Thesis advisor) / Hagler, Debra (Thesis advisor) / Kelly, Lesly (Committee member) / Arizona State University (Publisher)
Created2015
Description
The purpose of this study was to investigate the use of the design characteristics component of the Jeffries/National League for Nursing Framework for Designing, Implementing, and Evaluating Simulations when developing a simulation-based approach to teaching structured communication to new graduate nurses. The setting for the study was a medium sized tertiary care hospital located in the southwestern United States. Participants in the study were an instructional designer (who also served as the researcher), two graduate nursing education specialists, one unit based educator, and 27 new graduate nurses and registered nurses who had been in practice for less than six months. Design and development research was employed to examine the processes used to design the simulation, implementation of the simulation by faculty, and course evaluation data from both students and faculty. Data collected from the designer, faculty and student participants were analyzed for evidence on how the design characteristics informed the design and implementation of the course, student achievement of course goals, as well as student and faculty evaluation of the course. These data were used to identify the strengths and weaknesses of the model in this context as well as suggestions for strengthening the model. Findings revealed that the model generally functioned well in this context. Particular strengths of the model were its emphasis on problem-solving and recommendations for attending to fidelity of clinical scenarios. Weaknesses of the model were inadequate guidance for designing student preparation, student support, and debriefing. Additionally, the model does not address the role of observers or others who are not assigned the role of primary nurse during simulations. Recommendations for strengthening the model include addressing these weaknesses by incorporating existing evidence in the instructional design of experiential learning and by scaffolding students during problem-solving. The results of the study also suggested interrelationships among the design characteristics that were not previously described; further exploration of this finding may strengthen the model. Faculty and instructional designers creating clinical simulations in this context would benefit from using the Jeffries/National League for Nursing Model, adding external resources to supplement in areas where the model does not currently provide adequate guidance.
ContributorsWilson, Rebecca D (Author) / Klein, James D. (Thesis advisor) / Hagler, Debra (Committee member) / Savenye, Wilhelmina (Committee member) / Arizona State University (Publisher)
Created2011
Description
Minority mental health patients face many health inequities and inequalities that may stem from implicit bias and a lack of cultural awareness from their healthcare providers. I analyzed the current literature evaluating implicit bias among healthcare providers and culturally specific life traumas that Latinos and African Americans face that can impact their mental health. Additionally, I researched a current mental health assessments tool, the Child and Adolescent Trauma Survey (CATS), and evaluated it for the use on Latino and African American patients. Face-to-face interviews with two healthcare providers were also used to analyze the CATS for its’ applicability to Latino and African American patients. Results showed that these assessments were not sufficient in capturing culturally specific life traumas of minority patients. Based on the literature review and analysis of the interviews with healthcare providers, a novel assessment tool, the Culturally Traumatic Events Questionnaire (CTEQ), was created to address the gaps that currently make up other mental health assessment tools used on minority patients.
ContributorsAldana, Lauren Michelle (Author) / Sullivan-Detheridge, Julie (Thesis director) / Allen, Angela (Committee member) / Edson College of Nursing and Health Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
Description
The aim of this thesis is to provide prelicensure nursing faculty at Arizona State University with a supplemental resource and presentation on inclusivity, with specific respect to the Lesbian, Gay, Bisexual, Transexual, Queer (LGBTQ+) demographic. Background research posits that prelicensure nursing faculty possess limited information about how to teach students to provide inclusive care and communicate respectfully with patients in the LGBTQ+ population group. This project synthesizes current research pertaining to health inequities within this demographic, and summarizes reported patient care experiences to illustrate a need for prelicensure faculty education in this area. Information from this research was extrapolated, and a supplemental resource regarding inclusivity created, which was presented to prelicensure nursing faculty at a staff meeting using an in-person modality. A survey was conducted at the conclusion of this educational presentation, gathering anonymous demographic data, as well as opinions as to the usefulness of the presentation in the setting of prelicensure nursing education. Results were then analyzed thematically, with 70% of those surveyed currently incorporating some form of LGBTQ+ education within their curriculum. These results suggest the majority of surveyed prelicensure faculty found the educational presentation and accompanying resource both useful and informative, and intend to apply information learned to their future practice as a nursing educator. These findings provide justification for continuing education and additional learning experiences in this area.
ContributorsArmendariz, Ethan (Author) / Cruz, Elizabeth (Co-author) / Hagler, Debra (Thesis director) / Shepherd, Allegra (Committee member) / Barrett, The Honors College (Contributor) / Edson College of Nursing and Health Innovation (Contributor)
Created2023-05
Description
The purpose of the integrative review was to analyze published research on the experiences of individuals aged 15 to 24 years within two years of a type 1 diabetes mellitus (T1DM) diagnosis, with the intention of understanding their potential challenges and ensuring best practice by healthcare professionals when caring for and supporting these individuals. With T1DM being a chronic disease with no known cure, this diagnosis greatly impacts one’s life, making understanding of the experiences of individuals with diabetes essential. Individuals aged 15 to 24 years were studied as this age group craves autonomy while potentially facing multiple life transitions simultaneously. They may make risky decisions that can threaten their health, and are at an increased risk for suicide. After completing a systematic literature search, two studies that met the set criteria were analyzed. One found that T1DM adds challenges to college living, while the other study discussed management of exercise with T1DM. Both studies emphasized the importance of education and how T1DM affects all parts of one’s life. While they provided a glimpse of the daily challenges individuals with T1DM face, there are still many gaps in T1DM diagnosis experience research. Health professionals need additional credible research in order to conduct evidence-based practice that improves the lives of these young individuals coping with a serious chronic disease. If further research is not conducted, individuals aged 15 to 24 years are at a severe disadvantage in navigating a new T1DM diagnosis and could easily become overwhelmed due to their developing brains and additional lifestyle changes that come with being an emerging adult.
ContributorsNelson, Shelby Marcelle (Author) / Rascón, Aliria (Thesis director) / Hagler, Debra (Committee member) / Edson College of Nursing and Health Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
Description
Bleeding control education has taken a much more prominent focus in saving lives over the past decade. While many non-medically trained civilians are receiving Stop the Bleed training, throughout their time as students, baccalaureate nursing students prominently struggle in pre-hospital emergencies. Not only would the implementation of Stop the Bleed education into baccalaureate nursing improve client outcomes, it can further spread and share the message of bleeding control, as well as enhance the student experience.
ContributorsMcDonald, Matthew (Author) / Hagler, Debra (Thesis director) / May, Jennifer (Committee member) / Barrett, The Honors College (Contributor) / College of Health Solutions (Contributor) / Edson College of Nursing and Health Innovation (Contributor)
Created2022-05