Theses and Dissertations at Montana State University (MSU)
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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 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 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 Rural nurses' perception of job satisfaction(Montana State University - Bozeman, College of Nursing, 1990) Nilan, LynnetteItem Determinants of intended job turnover in rural nurses(Montana State University - Bozeman, College of Nursing, 1988) Ballantyne, Jean ElizabethItem Nurses' perceptions of the utility of patient scripting with regards to patient satisfaction(Montana State University - Bozeman, College of Nursing, 2012) Hasenkrug, Kally Marie; Chairperson, Graduate Committee: Susan LuparellThis research study was intended to determine the perceptions of nurses' regarding the utility of patient scripting with regards to patient satisfaction. Patient scripting refers to a script used by nurses while speaking to patients and/or their families to convey a consistent message from all nurses and employees. Hard copy surveys were delivered into the work mailboxes of 95 part-time and full-time nurses on the maternal child department of a local community hospital. It was found that nurses find patient scripting important to patient satisfaction, easy to use, and easy to incorporate. However, some nurses felt that it was awkward and not words they would generally use in conversations with patients or families. The nurses did not feel it increased their job satisfaction or hospital revenue. It appears that if the nurses were to develop a script that was easier to use or made up of words they would use more easily, they would utilize patient scripting more frequently.