...Running head: DOES SHARED GOVERNANCE IMPROVE NURSING RETENTION? Does Shared Governance Improve Nursing Retention? La Quinta Roberts Kaplan University NU499 Bachelor’s Capstone in Nursing Natasha Zurcher, MSN/ED, RN, CPN April 6, 2014 Abstract The global nursing shortage has prompted health care systems to seek new strategies to attract and retain nurses. The growing evidence points to the shared governance model of management are as a possible strategy to improve productivity, nurse job satisfaction and nurse retention. There are different models of shared governance, but a clear relationship exists between nurse practice environment and higher retention rates. Research found long hours, and unsupportive practice environments contribute to high turnover rates. Here is a look at the evidence which promote the creation of a shared governance model for a positive practice environment and better retention rates. Shared Governance and Nurse Retention Introduction Shared governance models are being promoted as a plan to decrease nurse turnover, but there are many variable elements to the Shared governance model. True shared governance characteristics are a practice environment that has a process by which nurses take an active participatory role in the decisions of the hospital nursing practice. Most shared governance models are associated with Magnet status hospitals, but more and more hospitals are adopting this style of management without the designation...
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...The Future of Nurse Leadership A paper submitted in partial fulfillment of the course MHST/NURS 604 Leadership Roles in Health XXXXX February 28, 2013 Abstract Canada’s healthcare environment faces dynamics of change and elements of uncertainly. However, change and uncertainty need not be met with prospects of a dismal future. The framework of healthcare faces distinct challenges, potentially providing the opportunity for nurse leadership to provide a pathway for the future. One concern is the capacity to prepare the next generation of nurse leaders, both formal and informal, to become effective leaders, contributing to the future health of the workplace. This study is an analysis pertaining to the development of future nurse leaders. The analysis seeks to uncover the challenges of developing nurse leaders, and the necessary requirements for the next generation of leaders within healthcare. The findings suggest that the development of nursing leadership is vital in relation to healthy workplace environments, and quality patient care. Furthermore, a new paradigm and set of competencies necessary to lead nursing into the future. Keywords: leadership, nursing, development...
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...Abstract This paper will explore the topic of nursing overtime and its effect on adverse events and errors in the workplace. The prevalence of mandatory and voluntary overtime is high. Nursing shortages combined with the aging baby boomer population means more work for health care workers, and nurses bear the brunt of this reality. There is some legislation in place to restrict mandatory overtime, but research suggests that overtime hours have not decreased since those policies were created. Furthermore, voluntary overtime is unregulated, with many nurses exceeding the recommended 40-hour workweek. Studies have shown that exceeding recommended hours results in workplace injuries to nurses, increased burnout and lower retention of nurses, and poorer outcomes for patients, including early readmission, medication errors, falls and nosocomial infections. More regulation may be necessary to reduce the hours worked by nurses. Advanced practice registered nurses are in a position to advocate for stricter policies in their facilities, and to implement strategies that would reduce overtime hours worked in their facilities, for example by increasing staffing. Nurse managers can ensure that their nurses doing overtime take the recommended breaks and do not exceed the recommended number of hours worked per week. Nursing Overtime and Adverse Effects Mandatory overtime is defined as employer-imposed work time in excess of one’s assigned schedule. Voluntary overtime is time worked at the employee’s...
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...Organizational analysis Hospital AB and Health Center is a community based acute care general hospital. The hospital is proactive in seeking methods to identify and provide all sources of community benefit and charity care. The mission of the hospital as stated in administrative service manual policy 726 (2005) is “With caring and compassion, we will improve the health and quality of life of the people we service.” The purpose of existence of the hospital is the commitment to patients and community to first understand their needs, second to provide services that meet these needs; and third, the recognition that service and clinical excellence are only achieved if they are delivered with caring and compassion. The strategies developed for achieving these purpose are invest in high performing people, innovation and implementation, superior quality and service, know patient and customer needs, and meet budgets. Hospital AB integrates the values such as dignity, collaboration, justice, stewardship and excellence into all the services being delivered. The key behaviors identified are honor commitments, take ownership, value individual differences, help others succeed, exceed customer expectations and inspire others to do their best (unknown author, 2005). The 347 bed hospital is an affiliate of Catholic Healthcare. For over 80 years, hospital AB and Health Center has grown along with the community and has evolved into one of the region's major healthcare...
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...Adn vs Bsn: Differences Rachel McAdams Phoenix University September 2, 2010 Adn vs Bsn: Differences may be a Matter of Degree In the late 1850s Florence Nightingale started her own school to train nurses and developed standards by which nurses performed their duties. She may never have envisioned that one day there would be different educational tracks resulting in multiple degrees and disciplines in nursing, each having their own set of criteria for excellence. Associate degree nurse (ADN) and baccalaureate degree nurse (BSN) are the two most common entry level nursing positions. An ADN can be obtained in two or three years whereas the BSN takes four years of education to complete due to additional courses. Differences between the degrees begin with education and mature as the nurse gains experience. Raines and Taglaireni’s (2008) article states ADN and BSN nurses attend the same basic liberal arts and general education courses such as English, literature, history, math, humanities, and arts. Both have basic nursing courses, the same technical skill sets are taught, and nurses must pass the same National Council Licensing Examination for RNs (NCLEX-RN©) which measures minimum technical competency for entry-level nursing practice. Colleges will differ in the exact requirements for each degree but the community college ADN program consists of approximately 75 course credits of which 38 are science and liberal arts prerequisites, and 37 credits are in the...
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...Challenges of New Graduate Nurses: Transition to Practice Job retention rates amongst newly graduate nurses tend to fluctuate widely. These fluctuations have many possible and combined explanations including orientation quality, level of confidence, residency programs, pay rates, mentoring programs, management support, and countless views of job satisfaction. My concept will focus on transition to practice success of new graduate nurses in relationship to their organization’s orientation process, job satisfaction, and the effects of job retention rates. Identifying these challenges are significant noting that low retention rates are costly for health care facilities as well as for the economy. According to Gemberling, Tretter-Long, Reiner, Potylycki, and Davidson in their article Clinical Support for the Off-Shift Nurse and the Graduate Nurse: The Clinical Rock Stars, “Depending on the specialty, estimated replacement costs for an RN were $42,000-$64,000 [in 2005]” Gemberling et al. (2011). This topic is especially important for new graduate nurses when considering a first place of employment. Nursing educators and health care managers have been analyzing and designing new ways to combat low retention rates specifically for newly graduated nurses. Review of Literature Several factors influence job satisfaction, which is a key characteristic that effects job retention rates. Gemberling et al. (2011) found that most new nurses leave their first job because of stress related...
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...Looking at the future of nursing throughout the 21st century seems exhilarating but on the other hand challenging. With the frequent expansion of the function of nurses, the current healthcare climate, education, and research, nurses will play a key role in the transformation of the world’s health and healthcare as a whole. The patient care delivery systems of the future will be significantly influenced by the industry trends that are impacting the healthcare industry today. Nursing as a profession will continue to evolve pass the year 2025. Since the inception of a college education for introductory nursing, advanced degrees are now required for specialized practice and there is a push for more doctoral educated nurses. Moreover, hospitals in their effort to acquire magnet status are requiring their nurses to possess a minimum of a Bachelor’s degree to be employed. This trend is mentioned in the article –Visioning the Future of Nursing: Analysis of the IOM/RWJ Foundation Report which made recommendations for an 80 percent increase in nurses with a baccalaureate degree by 2020 ("Visioning the future of nursing," 2011). Master’s and doctoral educated nurses have specialized knowledge and skills to make not only a significant impact on the profession of nursing, but also on the discipline and science of nursing. Nurses continue to engage in research and incorporate theory into their models so that new insights can be gained from ideas which leads to improved practice and patient...
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...organization. Today for a nurse to hold on and work blissfully in one work place is challenging due to dissatisfaction of their job. Tang and Ghani (2012) argued nowadays, even though there are abundant opportunities available in Malaysia, nursing is no longer popular as it used to be. Chaulagain and Khadka (2012) stated one of the issue raise in quality improvement program is job gratification among nurses as it is a crucial issue being faced by most healthcare organization. The efficiency of healthcare services is affected due to increase rates of nurse’s turnover and absenteeism resulting from low job satisfaction. Understanding the factors that nurses are satisfied and dissatisfied will enable interventional measures be taken to improve the working conditions. Whereas such understanding will not improve the retention rate, it will improve the nurses’ work performance leading to better quality care to the patient (Newman et al, 2002). Judge et al (2002) assert the most widely investigated in the history of healthcare organization psychology, job satisfaction is the most widespread research topic. This module required us to identify and debate on a contemporary issue. Hence, factors influencing job satisfaction among Malaysian nurses will be explore through reflection on experience and the literatures I retrieve using database. Reflective practice is an important aspect of nursing management and in this essay discussion on implications of job satisfaction among nurses affecting...
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...Examine Nurse-to-Patient Ratios Primary health care organizations such as New York Presbyterian (NYP) are impacted by low nurse-to-patient ratios. The recent implementation of the Patient Protection and Affordable Care Act (ACA) has required organizations such as NYP to explore many approaches to improve quality and patient outcomes that contain costs. “Numerous studies reveal an association between higher levels of experienced RN staffing and lower rates of adverse patient outcomes” (www.nursingworld.org, 2015, para. 1). For this reason, nurse-to-patient ratios is an issue that needs to be addressed at NYP in order to improve quality healthcare within their organization. The acuity of the unit in which patient care is being provided, should determine the acceptable nurse-to-patient ratio. According to the American Nurses Association (ANA), factors that influence the nurse staffing needs include: patient complexity, acuity, or stability; number of admissions, discharges, and transfers; professional nursing and other staff skill level and expertise; physical space and layout of the nursing unit; availability of or proximity to technological support or other resources ("Optimal Nurse Staffing," 2015). Currently, New York is one of only fourteen states that addresses the nurse staffing issue in hospitals. New York State requires organizations such as NYP to disclose their nurse-to-patient staffing ratios to the public; however the state does not require a minimum nurse-to-patient...
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...Transformational leadership in nursing practice Owen Doody and Catriona M Doody Traditionally, nurses have been over-managed and led inadequately, yet today they face unprecedented challenges and opportunities. Organisations constantly face changes that require an increasingly adaptive and flexible leadership. This type of adaptive leadership is referred to as ‘transformational’; under it, environments of shared responsibilities that influence new ways of knowing are created. Transformational leadership motivates followers by appealing to higher ideas and moral values, where the leader has a deep set of internal values and ideas. This leads to followers acting to sustain the greater good, rather than their own interests, and supportive environments where responsibility is shared. This article focuses on transformational leadership and its application to nursing through the four components of transformational leadership. These are: idealised influence; inspirational motivation; intellectual stimulation; and individual consideration. Key words: Transformational leadership n Nursing n Motivation n Staff support n Personal qualities ffectivenursingleadershipisavehiclethroughwhich healthcare delivery and consumer demands can be fulfilled. Traditionally, nurses were over-managed andinadequatelyled;theynowfaceunprecedented challengesandopportunities(BowlesandBowles,2000). Thenotionofleadershipisconstantlychanging,withmany theoriesandframeworksavailable...
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...Transformational leadership in nursing practice Owen Doody and Catriona M Doody Traditionally, nurses have been over-managed and led inadequately, yet today they face unprecedented challenges and opportunities. Organisations constantly face changes that require an increasingly adaptive and flexible leadership. This type of adaptive leadership is referred to as ‘transformational’; under it, environments of shared responsibilities that influence new ways of knowing are created. Transformational leadership motivates followers by appealing to higher ideas and moral values, where the leader has a deep set of internal values and ideas. This leads to followers acting to sustain the greater good, rather than their own interests, and supportive environments where responsibility is shared. This article focuses on transformational leadership and its application to nursing through the four components of transformational leadership. These are: idealised influence; inspirational motivation; intellectual stimulation; and individual consideration. Key words: Transformational leadership n Nursing n Motivation n Staff support n Personal qualities ffectivenursingleadershipisavehiclethroughwhich healthcare delivery and consumer demands can be fulfilled. Traditionally, nurses were over-managed andinadequatelyled;theynowfaceunprecedented challengesandopportunities(BowlesandBowles,2000). Thenotionofleadershipisconstantlychanging,withmany theoriesandframeworksavailable...
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...AN INDEPENDENT VOICE FOR NURSING Work Engagement, Moral Distress, Education Level, and Critical Reflective Practice in Intensive Care Nurses nuf_237 256..268 Lisa A. Lawrence, PhD, RN Lisa A. Lawrence, PhD, RN, Instructional Faculty, Nursing Department, Pima Community College, Tucson, AZ Keywords Critical reflective practice, education level, moral distress, registered nurse, work engagement Correspondence Lisa A. Lawrence, PhD, RN, Nursing Department, Pima Community College, Tucson, AZ E-mail: llawrence@pima.edu AIM. The purpose of this study was to examine how nurses’ moral distress, education level, and critical reflective practice (CRP) related to their work engagement. The study is relevant to nursing, given registered nurse (RN) documented experiences of job-related distress and work dissatisfaction, and the nursing shortage crisis. A better understanding of factors that may enhance RN work engagement is needed. METHODS. A non-experimental, descriptive, correlational design was used to examine the relationships among four variables: moral distress, education level, CRP, and work engagement. The sample included 28 intensive care unit RNs from three separate ICUs in a 355-bed Southwest magnet-designated hospital. RESULTS. There was a positive direct relationship between CRP and work engagement, a negative direct relationship between moral distress and work engagement, and CRP and moral distress, together, explained 47% of the variance in work engagement. Additionally...
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... Engagement at work: A review of the literature Michelle R. Simpson * Center on Age and Community, College of Nursing, Cunningham Hall, 1921 East Hartford Avenue, University of Wisconsin-Milwaukee, Milwaukee, WI 53201-0413, United States Received 26 March 2008; received in revised form 20 May 2008; accepted 22 May 2008 Abstract Objectives: Engagement at work has emerged as a potentially important employee performance and organizational management topic, however, the definition and measurement of engagement at work, and more specifically, nurse engagement, is poorly understood. The objective of this paper is to examine the current state of knowledge about engagement at work through a review of the literature. This review highlights the four lines of engagement research and focuses on the determinants and consequences of engagement at work. Methodological issues, as identified in the current research, and recommendations for future nurse-based engagement research are provided. Design: A systematic review of the business, organizational psychology, and health sciences and health administration literature about engagement at work (1990–2007) was performed. Data sources: The electronic databases for Health Sciences and Health Administration (CINAHL, MEDLINE), Business (ABI INFORM), and Psychology (PsycINFO) were systematically searched. Review methods: Due to the limited amount of research that has examined engagement among the nursing workforce, published research that included...
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...Professional Presence & Influence Janene Mills Loga Western Governor's University Professional Presence and Influence C351 Professional Presence & Influence Introduction In these days of HCAHPS scores, and patient satisfaction being tied to reimbursement, it can be vitally important for the success of a healthcare facility, to have nurses who strive for quality relationships with their patients because this can influence the perception of the care received. A very important part of this is the professional presence the nurse conveys. A nurse’s professional presence is uniquely personalized; it is influenced by their own views on health and medicine, individual personality traits, how mindful they are in their practice, and in the type of healing environment in which they may be practicing. Professional Presence Models of Health and Healing Dr. Larry Dossey, MD describes his theory of Western Medicine as having three Eras’. (Dossey) Era One, which he states to have started in the 1860’s and continued to the 1940’s. Era Two, which he proposes to have begun in the post World War II period to recent times. Era Three is the most recent which he states is an emerging shift to a new focus which he calls “Transpersonal Medicine”. In Era One, Dr. Dossey describes the practice of medicine as being only physical in nature. He equates this era as focusing on the body and mind, and their functioning only in a physical way, not related to one another. He describes...
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...Company description Tested to work MASCOT Denmark MASCOT Europe Mascot Vietnam Corporate social responsibility : : : 9 9 9 9 10 10 11 11 13 13 14 14 15 15 17 19 22 23 24 25 European Workwear Customer Value Enhancement Award 2010 Key Industry Challenges Addressed by Enhancing Customer Value Western European Workwear Market Supply chain Industry challenges Market drivers Market Restraint Industry analysis Appendix 1 Movers & Shakers interview with Michael Grosb¢I Appendix 2: Western European Workwear Market 2010 Appendix 3: Growth at manufacturer of workwear Appendix 4: MASCOT International key-figures (n¢gletal pa dansk i Appendix 5) Appendix 5: MASCOT International n¢gletal (key-figures in English in appendix 4) Appendix 6: Facts on Vietnam Written exam after 1sl semester/Skriftlig eksamen efter 1. semester Page/Side 8 Bachelor ofInternational Sales and Marketing Management Professionsbachelor International Handel og Markedsf0ring Company description! Mascot International A/S is an international, family-owned business, which develops, manufactures and markets high-quality workwear and safety footwear for craftsmen and industry. For many years, the company has experienced rapid growth in turnover as well as revenue. At present, Mascot has a staff of more than 1300 competent and committed employees in Europe and Vietnam as well as a great number of workers in subcontracting sewing factories in the Far East. MASCOT is market leader withinworkwear in Denmark...
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