Theses and Dissertations at Montana State University (MSU)
Permanent URI for this collectionhttps://scholarworks.montana.edu/handle/1/733
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Item Development of an acuity scale for the inpatient hospice setting: a quality improvemtent project(Montana State University - Bozeman, College of Nursing, 2023) Blake, Angela Lynn; Chairperson, Graduate Committee: Sandra Benavides-VaelloBackground: Nurse burnout and care fatigue are troubling, prevalent issue within our medical community. Research has shown that high acuity and inequitable staffing assignments contribute to the problem. No streamline solutions have been proposed in the literature. Patient safety events such as falls, and medication errors have been shown to be interrelated to nurse burnout. Balancing workload and patient demands are essential in promoting safe care environments. A 21-bed hospice unit in North Idaho recognized this correlation and requested help in developing an acuity scale to promote nurse to patient staffing equitability thus lessening care burden. Method: A literature review reviled numerous articles promoting staffing balance to stave off care fatigue. Acuity scales are an efficient, concise way to quantify workload and promote balanced staffing assignments. Staff surveys were conducted prior to and post implementation of the tool to measure staff assignment satisfaction. Data was collected on fall rates and medication errors to detect correlation between the two factors. Intervention: Only one published hospice specific acuity scale was identified in the literature review done for this project, Mary Potter Hospice Acuity Tool. A unit specific tool was developed based of the framework provided by this published scale. The acuity tool was trialed on fifty new admissions into the hospice unit between February and March 2023. Results: Limited data was collected as the implementation phase of the project was delayed due to IRB approval and facility specific setbacks. The marginal data collected demonstrates nurse assignment satisfaction improved post intervention while fall rates and medication errors actually increased. Conclusion: This projects objectives were not fully realized due to the previously mentioned delays. The data collected was minimal and greatly impacted. This project provides a solid framework for future developments in unit specific acuity tool development. Future projects such as this one would benefit from a larger timeframe in which to revise the tool being developed and facilitate better impact on the metrics being studied.Item Exploring the impact of a values-based reward system on engagement and perceptions of office culture in higher education(Montana State University - Bozeman, College of Education, Health & Human Development, 2020) Gresswell, Candice Marie; Chairperson, Graduate Committee: Sweeney WindchiefEmployee engagement and satisfaction may be telling indicators of employee health that can have rippling effects on the employee, university, and the student who interacts with the employee every day. Research has demonstrated a positive correlation between administrative styles and retention in the context of engagement, climate and culture (Farrell, 2009). Across industries and disciplines, employees who are engaged are more productive, creative, solve more problems, and more easily adapt to change (Craig & DeSimone, 2011; Flade, 2006; Holbeche & Matthews, 2012). Contrast to this research, in the higher education setting, employee engagement is measuring at an all-time low (Wasilowski, 2016). The purpose of this transformative, sequential, mixed-methods study is to examine how formalizing an engagement incentive program for higher education administrative staff in the Division of Student Success at a regionally accredited, land-grant institution impacts employee-reported engagement as measured by the Gallup Q12. The researcher collected qualitative data to help explain the quantitative Gallup Q12 survey scores to give individuals in leadership roles concrete information on how employees interpret Gallup Q12 and which, if any, actions they can take to improve employee engagement in their offices in the context of climate and culture. Wilcoxon Signed Rank test indicated significant change in the overall engagement score for the Division of Student Success (z = 2.79, p = .002), indicating the formalization of an engagement program does have a statistically significant effect on engagement as measured by the Gallup Q12. Major themes that emerged from the engaged offices in relation to climate were Relatedness and Care for the Student Experience. Major themes that emerged from the disengaged offices included Frustration, Stress, Turnover, Exclusivity, Not Being Able to Demonstrate Expertise or Improve Processes, Customer Service Focus, and Problem-Solving.Item Design of a primary care advanced practice nursing fellowship(Montana State University - Bozeman, College of Nursing, 2019) Weber, Anna Katherine; Chairperson, Graduate Committee: Jennifer SofieNew graduate nurse practitioners (NPs) can find the transition between student and independent practitioner to be difficult. Residency and fellowship programs are becoming a popular option to help support NPs with this transition. The Institute of Medicine has called for support through residency and fellowship programs. These programs have shown positive outcomes including increased job satisfaction, retention, positive patient outcomes, and increased interprofessional collaboration. A hospital located in the northwestern United States is struggling with NP satisfaction and retention. Purpose: A graduate scholarly project was initiated to design a fellowship for NPs in the primary care setting in response to this problem. Methods: The American Nurses Credentialing Center Standards, National Nurse Practitioner Residency and Fellowship Training Consortium Standards, a current program at the Carolinas HealthCare System, and the National Organization of Nurse Practitioner Faculties Competency areas was used as a foundation to the design. Guidance used was Benner's Novice to Expert Theory. Results: A twelve-month program was designed that includes didactic learning sessions, primary care clinical experience, specialty area clinical experience, interprofessional teamwork, and structured evaluation. Intended outcomes of the project for the sponsoring organization are 1) retention of NPs for twelve months after completion of the program and 2) increased employee satisfaction. The graduate nursing student concluded that more input from current programs and increased participation from the sponsoring organization would have made this project more successful. Further research into the best practice for evaluation tools for personnel and participants in these types of programs would also strengthen the design. Foundation based on current accreditation standards helps to strengthen this design.Item Teacher self-efficacy development in an international school in the Dominican Republic(Montana State University - Bozeman, College of Education, Health & Human Development, 2018) Zerbe, Robin Joy; Chairperson, Graduate Committee: Tena VerslandAs the teaching profession becomes increasingly challenging and teachers leave the profession at an alarming rate, school leaders need to understand the factors that influence teacher resiliency and longevity. A teacher's self-efficacy beliefs have been found to affect teacher's emotional and physiological well being (Bandura & Locke, 2003), job satisfaction (Caprara, Barbaranelli, Steck, & Malone, 2006, Hoigaard, Giske, & Sundsli, 2012), and stress management (Bandura, 1997). Self-efficacy also impacts effort and performance (Tschannen-Moran & Woolfolk Hoy, 2001), professional commitment (Coladarci, 1992; Ware & Kitsantas, 2007, 2011; Klassen et al., 2013), and longevity in the profession (Wentzel & Wigfield, 2009). In consideration of the value of teacher self-efficacy, there is a lack of qualitative research explaining how self-efficacy develops in teachers. The present study used a qualitative phenomenology methodology to explore beliefs, factors, and experiences that influence the development and strengthening of self-efficacy in teachers. The choice of a phenomenological study reflected my belief that the best way to grasp the very essence of individual teacher beliefs was to dialogue with teachers about their lived experiences in the context of a particular situation (Moustakas, 1994; Creswell, 2013). The present study utilized focus groups and individual conversations with teachers in a K-12 international school in the Dominican Republic. This study also embedded a quantitative teacher self-efficacy survey instrument to select participants and to describe their perceived self-efficacy levels. The results indicated emerging themes of Connection, Support, Knowledge and Growth, Balance, and Gratification as factors shaping self-efficacy beliefs. This study contributes to our understanding of how self-efficacy develops by illuminating a self-efficacy growth cycle with eight stages: The Gold Standard, Teaching Challenges, Dissonance, Perspective, Teacher Behavior Change, Intentional Practice, Equilibrium, and Self-Efficacy Growth. The study also revealed cognitive processes of self-reflection, self-regulation, cognitive flexibility, growth mindset, intentional positivity, reminding oneself of calling/commitment and mental models of prior success and growth as catalysts to develop, change, and strengthen self-efficacy. In conclusion, the results from this study may inform administrators, teachers, mentors, instructional coaches and university programs about intentional, proactive ways to guide teacher self-efficacy growth.Item Job satisfaction of selected student affairs administrators at four units of the Montana University System as assessed by Herzberg's motivator-hygiene theory(Montana State University - Bozeman, 1979) Ralph, Mark AlexanderItem An examination of some of the factors which lead to job satisfaction among hospital supervisory personnel(Montana State University - Bozeman, College of Professional Schools, 1968) Newstrom, Phyllis Marie ShankItem A survey to determine if job satisfaction was related to expressions of satisfaction of selected needs among Army Nurse Corps officers(Montana State University - Bozeman, College of Professional Schools, 1969) LaRock, Ethel BarbaraItem A survey of factors relating to job-satisfaction among operating room nurses in selected hospitals in Montana(Montana State University - Bozeman, 1961) Bender, Ruth ElaineItem Perceived autonomy and job satisfaction among rural home care nurses(Montana State University - Bozeman, College of Nursing, 1998) Iverson, Mary LouiseItem The effect of years of experience and other selected variables on attitudes of teachers toward aspects of the teaching profession(Montana State University - Bozeman, College of Education, Health & Human Development, 1988) Hollensteiner, Beverly June Rada