Scholarship & Research
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Item Program evaluation of a nurse-residency program(Montana State University - Bozeman, College of Nursing, 2018) Hastings, Deanna Dawn; Chairperson, Graduate Committee: Susan LuparellWhile the number of graduates from schools of nursing is increasing, there is a national trend that shows they are leaving the profession at alarming rates. This problem could potentially contribute to decreased patient outcomes and increased costs to facilities as they are continuously recruiting and training new nurses. Furthermore, research suggests that the transition to practice is a stressful period, and new graduates who receive support and guidance through nurse-residency programs tend to have higher satisfaction rates, deliver better patient care, and have lower turnover rates. Therefore, the purpose of this project was to evaluate the nurse-residency program in a local, level-two trauma center in rural central Montana that can serve up to 34,000 patients a year. A convenience sample of 13 registered nurses who completed the nurse-residency program or who were currently enrolled in the program and graduated within a year of beginning the residency program were surveyed using the Casey-Fink Graduate Nurse Experience Survey (New Graduate Survey). Also, a convenience sample of 41 staff members of the local emergency department, which included registered nursing staff who didn't participate in the nurse-residency program, operations specialists, physicians, and paramedics, were given an adapted Casey-Fink Graduate Nurse Experience Survey to evaluate their perception of the new graduates' readiness to practice. Project results indicate that new graduates who participated in the program tend to be more confident, the nurse-residency program is meeting the needs of the new graduates, and retention rates of the new graduates has increased since the inception of the program. Facilities and management can incorporate these findings into developing and maintaining nurse-residency programs in order to improve patient outcomes and new-graduate satisfaction and retention rates.Item Best practice components for nursing new graduate residency programs: an integrative review of the literature(Montana State University - Bozeman, College of Nursing, 2018) Wacker Happel, Amanda May; Chairperson, Graduate Committee: Susan LuparellThe need for an effective transition to practice program, such as nurse residency programs (NRPs), has been documented for over 80 years (Townsend, 1931 as cited in Spector et al., 2015). Anderson, Hair, and Todero (2012) stress how new graduate registered nurses (RNs) face high patient acuity and complex situations, nursing shortages, high turnover, burnout, excessive overtime demands, reduced new RN orientations, and heavy use of agency/traveling nurses to fill gaps (Joint Commission on Accreditation of Healthcare Organization, 2002; Jones & Gates, 2007 as cited by Anderson et al., 2012). Not only does this turnover negatively affect morale and job satisfaction, it's also very expensive with the estimated cost to replace these nurses ranging from $49,000 to $92,000 per nurse (Kram & Wilson, 2016). NRPs have been recommended to combat turnover and provide support during the transition into professional practice (Benner, Sutphen, Leonard, & Day, 2010; IOM 2011; The Joint Commission, 2002 as cited by Spector et al., 2015; Cochran, 2017). However, despite these recommendations, there continues to be a lack of comprehensive, evidence-based NRPs offered by employers (Spector, et al., 2015). The purpose of this integrative review of literature was to explore the best practice components of NRPs. This integrative review was performed by mining relevant literature from predetermined databases and all reference lists of the selected literature. A total of 13 publications met the predetermined inclusion criteria. After reviewing how different factors affect the transition of new graduates, it was concluded that an NRP that was based on a national model or developed internally in congruence with national models would provide best chance for a successful transition for new graduates. This model would include an adaptive, evidence-based curriculum that is customized to the patient populations and unit specifics, a program length of at least 12 months, and training and careful selection of preceptors and mentors. Additionally, it is recommended to that NRP staff have an awareness of differences in new graduate ADN and BSN preparedness and skill sets and adapt the NRP as needed to accommodate both cohorts.Item Cardiac services nurse residency(Montana State University - Bozeman, College of Nursing, 2016) Kennedy-Collins, Kamera Machel; Chairperson, Graduate Committee: Alice RunningThis professional project was born out of a specific need within the cardiac services department at Kalispell Regional Medical Center. In order to describe, and best determine the exact needs of the cardiac services department, a clinical microsystem assessment was completed for the department focusing on the 'five P's' of the assessment process; Purpose, Patients, Processes, Professionals, Patterns. Information obtained from the microsystem assessment highlighted the need for additional staffing. Factors such as retirement, department growth, and turnover have left the department chronically short staffed. Chronic short staffing has resulted in long work hours and routine overtime. Attempts at hiring experienced nurses have not been successful enough to meet the department demand. Evidence would support nursing residency programs as one solution to staffing shortages. Therefore, a literature review was completed regarding the design and success of nurse residency programs. Given the issues of persistent short staffing, and the subsequent increased work load for staff, a proposal for the development of a unit specific nurse residency program was made. This professional project proposes a 16 week unit specific nurse residency program designed to be integrated into the existing organizational program. The programs includes components of preceptorship, mentoring, and didactics. The goal of the proposed nurse residency program would be to provide education, professional support, and mentoring to new graduate nurses interested in cardiac care in order to satisfy long term staffing needs within the department.Item Sex knowledge of freshmen and senior nursing students(Montana State University - Bozeman, College of Professional Schools, 1970) Wheeler, Lois Mary KocherItem A survey of career motivational factors which influence nursing students in Montana(Montana State University - Bozeman, College of Professional Schools, 1972) Sokoloski, James LeRoy; Chairperson, Graduate Committee: Virginia Ellen FeltonItem Institutional support of on-campus and off-campus nursing students(Montana State University - Bozeman, College of Nursing, 1995) Wankel, Kathleen KarenItem The relationship between critical thinking and learning styles in nursing students(Montana State University - Bozeman, College of Nursing, 1997) Wilson, Patricia WamsleyItem A comparison of younger and older students graduated from the baccalaureate nursing program at Montana State University in 1973, 1974, and 1975(Montana State University - Bozeman, College of Nursing, 1976) Johnson, Karen Elaine SolstadItem Male students' experiences with faculty incivility(Montana State University - Bozeman, College of Nursing, 2014) Larson, Amy Charlotte; Chairperson, Graduate Committee: Susan LuparellAcademic incivility can cause strain in the teaching learning environment. The problem of academic incivility from the male nursing student perspective has not been previously studied. The purpose of this study was to explore male students' perspectives of faculty incivility and compare male nursing students' perspectives to that of non-nursing male students. Twenty-five non-nursing male students and twenty-seven male nursing students completed a questionnaire about faculty incivility. A majority (92 %) of non-nursing students perceived that ineffective teaching is the most disruptive behavior and 56% have experienced or seen this behavior occur in the last 12 months. While 100% of nursing students perceived that making condescending remarks or putdowns is the most disruptive behavior, the top disruptive behavior experienced or seen in the last 12 months was ineffective teaching (67%). The most frequent threatening faculty behavior perceived by nursing students was general taunts or disrespect to other students (33%), whereas the most frequent threatening faculty behaviors perceived by the non-nursing students was challenges to other faculty knowledge or credibility (24%). Additionally, many male nursing students (89%) perceived academic incivility a mild to serious problem, while only 64% of their male non-nursing student colleagues did. Recommendations for nursing education based on the study findings include: faculty development, communication, setting goals and expectations, diversity awareness and change, and the ability for students to report incivility. Recommendations for nursing practice include recognizing the link of incivility in the workplace and the impact on new graduate nurses, particularly in the areas of retention and patient safety. Addressing incivility in academia could afford the opportunity to break the cycle of incivility before it reaches the nursing environment, mitigating the loss of qualified male nurses or deleterious impacts on patient care.Item Nursing students' perceptions of working with staff nurses(Montana State University - Bozeman, College of Nursing, 2010) Jones, Sharon Holly; Chairperson, Graduate Committee: Carolyn Hamlin WengerThe purpose of this project was to examine the perceptions of nursing students working with staff nurses during their clinical experiences. Based on this information, a resource for staff nurses was developed to assist them in mentoring students. A limited review of the literature identified helpful and hindering practices in the education of nursing students. Nursing schools and faculty are charged with theoretical and clinical education of nursing students so they may enter into the nursing profession as competent and safe nurses. Staff nurses play integral roles in the formative development of students. Data from a previous study were examined. The variables of friendliness, approachability, availability and willingness of staff nurses were evaluated. Students consistently ranked the ability of nurses to teach lowest and friendliness of nurses highest. Student comments were organized qualitatively utilizing retrospective analysis. Two themes were identified from the qualitative data which added to the veracity of the research. Positive reported nurse behaviors towards students were then utilized as a basis for a mentoring guide. Limitations for this project, as well as implications and topics of future research were identified and discussed. A resource guide was developed for distribution to staff nurses to assist them when mentoring nursing students.