Theses and Dissertations at Montana State University (MSU)
Permanent URI for this communityhttps://scholarworks.montana.edu/handle/1/732
Browse
9 results
Search Results
Item Perceptions of nurse practitioners among Montana critical access hospital leadership(Montana State University - Bozeman, College of Nursing, 2018) Deffinbaugh, Zachary Lee; Chairperson, Graduate Committee: Polly PetersenChallenges associated with provider recruitment, as well as rural populations' access to healthcare, are well-documented in the literature. While primary care physician numbers continue to fall behind demand, nurse practitioners (NPs) are forecasted to drastically increase in numbers in upcoming years. Montana is a full-practice state for advanced practice registered nurses (APRNs), and critical access hospitals (CAHs) commonly employ APRNs, including NPs. Little is known regarding perceptions of NPs among CAH boards of directors, chief executive officers, or other senior-management officials. It is important to understand how leadership teams perceive NPs, as these are the individuals who will collectively make decisions affecting the number and type of providers employed within their respective facilities. This study employed focus-group methodology to interview four CAH leadership teams spanning the entire state of Montana. Focus-group analysis suggests CAH leadership teams have primarily positive perceptions of NPs. There is a lack of consistency regarding comprehension of the NP's scope, role, and autonomy. Lastly, the challenges of provider recruitment were affirmed. However, it was noted that a number of NPs currently employed at CAHs previously worked as registered nurses within the facility, suggesting a potential provider recruitment advantage with regard to hiring NPs. Future implications include expanding research to include larger health systems within Montana, in addition to studying CAHs in states with restricted NP practice. Finally, more work should be done to raise CAH leadership awareness of the NP's role, scope, and autonomy.Item A study of the common task requirements of the head nurse position in one Montana hospital(Montana State University - Bozeman, 1965) Cic, Mary Vianney, Sister; Chairperson, Graduate Committee: Laura WalkerItem The nurse consultant role as identified by directors of nursing in selected Montana nursing homes(Montana State University - Bozeman, College of Professional Schools, 1975) Williams, Arthur Clayton; Chairperson, Graduate Committee: Laura WalkerItem An analysis of the nursing and non-nursing functions performed by evening supervisors in intermediate general Montana hospitals(Montana State University - Bozeman, 1960) Jacobsen, Helen ChristineItem The relative importance of communication areas as rated by evening and night staff nurses and nursing supervisors in a federal hospital(Montana State University - Bozeman, 1962) DeLia, MichaelItem A survey of the nonsupervisory tasks being performed by nursing supervisory personnel in Montana hospitals(Montana State University - Bozeman, College of Professional Schools, 1972) Davies, Griffith HowellItem Sources of influence : nursing service administrators in Montana(Montana State University - Bozeman, College of Nursing, 1984) Peterson, Avis RuthItem Design rules, metaroutines, and boundary objects : a framework for improving healthcare delivery systems(Montana State University - Bozeman, College of Engineering, 2006) Ghosh, Manimay; Chairperson, Graduate Committee: Durward K. Sobek IIThe healthcare industry in the United States has been fraught with medical errors, rising costs, and wastes for many years. Despite widespread adoption of Total Quality Management and Six Sigma programs, healthcare's woes continue unabated. The Toyota Production System (TPS), progenitor of lean manufacturing, is widely regarded as the most effective production system ever devised. It has been successfully adopted by manufacturing firms worldwide resulting in significant gains in efficiency and quality in companies of all sizes. The goal of this research is to determine whether principles from the Toyota Production System could be applied to a healthcare environment to improve its delivery systems. Following an action research methodology, the work reported here describes how TPS principles were adapted and applied to generate sustainable improvements to hospital work processes. Using a combination of qualitative and quantitative research methods, the results of the intervention were scrutinized, resulting in several important contributions to the existing body of knowledge on TPS and organizational problem solving.Item The study of errors, expectations and skills for medication delivery systems improvement(Montana State University - Bozeman, College of Engineering, 2008) Mazur, Lukasz Maciej; Chairperson, Graduate Committee: Shi-Jie (Gary) Chen; Edward L. Mooney (co-chair)Medication errors occurring in hospitals are a growing national concern. The enormous gaps in knowledge related to medication errors are often seen as major reasons for increased patient safety risks and increased waste in the hospital setting. However, little research effort in industrial and management engineering has been devoted specifically to medication delivery systems to improve or optimize their operations in terms of patient safety and systems efficiency and productivity. As a result, the current literature does not offer integrated solutions to overcome the workflow and management difficulties with medication delivery. Therefore, a better understanding of workflow and management sources of medication errors is needed to help support decisions about investing in strategies to reduce medication errors. Using qualitative and quantitative research methods the work reported in this dissertation makes several contributions to the existing body of knowledge. First, using healthcare professionals' perceptions of medication delivery system, a set of simple and logical workflow design rules are proposed. If properly implemented, the proposed rules are capable of eliminating the unnecessary variations in the process of medication delivery which cause medication errors and waste. Second, a theoretical model of 'expectations' for effective management of medication error reporting, analysis and improvement is provided. The practical implication of this theoretical model extends to effective management strategies that can increase feelings of competence and help create a culture that values improvement efforts. Third, eight propositions for effective use of a systems engineering method (in this research the "Map-to-Improve" (M2I) method) for medication delivery improvement are offered. Finally, a set of skills needed for future healthcare professionals to effectively use systems engineering methods is provided. The proposed insights into these areas can result in improved pedagogy for professional development of healthcare professionals. The practical implication extends to the development of better methods for healthcare systems analysis. In summary, the author of this research work hopes that the findings and discussions will help healthcare organizations to achieve satisfactory improvement in medication delivery.