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- Member of: ASU Electronic Theses and Dissertations
Description
This cross-sectional descriptive study was designed to examine critical care registered nurses’ perceptions of nurse-to-nurse incivility and professional comportment, and the extent to which education, nurses’ age, nursing degree, and years of nursing experience is related to their perceptions on these topics. Professional comportment is comprised of nurses’ mutual respect, harmony in beliefs and actions, commitment, and collaboration. Yet, it was unknown whether a relationship existed between a civil or uncivil environment in the nursing profession and nurses’ professional comportment. Correlational analyses were conducted to explore the relationship between perceptions of nurse-nurse incivility and professional comportment, and the relationships between incivility and professional comportment education and perceptions of nurse-nurse incivility and professional comportment. Multiple linear regression analyses were conducted to identify predictors of perceptions of nurse-nurse incivility and professional comportment. Results indicated statistically significant relationships between perceptions of nurse-nurse incivility and professional comportment, and between professional comportment education and perceptions of professional comportment. Professional comportment education was identified as a statistically significant predictor of increased perceptions of professional comportment. Findings of the current study may assist in establishing more targeted and innovative educational interventions to prevent, or better address, nurse-nurse incivility. Future research should more clearly define professional comportment education, test educational interventions that promote professional comportment in nurses, and further validate the Nurse-Nurse Collaboration Scale as a measure of nurses' professional comportment.
ContributorsOja, Kenneth John (Author) / Komnenich, Pauline (Thesis advisor) / Hagler, Debra (Thesis advisor) / Kelly, Lesly (Committee member) / Arizona State University (Publisher)
Created2015
Description
The healthcare system is plagued with increasing cost and poor quality outcomes. A major contributing factor for these issues is that outdated leadership practices, such as leader-centricity, linear thinking, and poor readiness for innovation, are being used in healthcare organizations. Through a qualitative case study analysis of innovation implementation, a new framework of leadership was uncovered. This framework presented new characteristics of leaders that led to the successful implementation of an innovation. Characteristics uncovered included boundary spanning, risk taking, visioning, leveraging opportunity, adaptation, coordination of information flow, and facilitation. These characteristics describe how leaders throughout the system were able to influence information flow, relationships, connections, and organizational context to implement innovation.
ContributorsWeberg, Daniel Robert (Author) / Fluery, Julie (Thesis advisor) / Malloch, Kathy (Thesis advisor) / Porter-O'Grady, Timothy (Committee member) / Hagler, Debra (Committee member) / Arizona State University (Publisher)
Created2013
Description
The measurement of competency in nursing is critical to ensure safe and effective care of patients. This study had two purposes. First, the psychometric characteristics of the Nursing Performance Profile (NPP), an instrument used to measure nursing competency, were evaluated using generalizability theory and a sample of 18 nurses in the Measuring Competency with Simulation (MCWS) Phase I dataset. The relative magnitudes of various error sources and their interactions were estimated in a generalizability study involving a fully crossed, three-facet random design with nurse participants as the object of measurement and scenarios, raters, and items as the three facets. A design corresponding to that of the MCWS Phase I data--involving three scenarios, three raters, and 41 items--showed nurse participants contributed the greatest proportion to total variance (50.00%), followed, in decreasing magnitude, by: rater (19.40%), the two-way participant x scenario interaction (12.93%), and the two-way participant x rater interaction (8.62%). The generalizability (G) coefficient was .65 and the dependability coefficient was .50. In decision study designs minimizing number of scenarios, the desired generalizability coefficients of .70 and .80 were reached at three scenarios with five raters, and five scenarios with nine raters, respectively. In designs minimizing number of raters, G coefficients of .72 and .80 were reached at three raters and five scenarios and four raters and nine scenarios, respectively. A dependability coefficient of .71 was attained with six scenarios and nine raters or seven raters and nine scenarios. Achieving high reliability with designs involving fewer raters may be possible with enhanced rater training to decrease variance components for rater main and interaction effects. The second part of this study involved the design and implementation of a validation process for evidence-based human patient simulation scenarios in assessment of nursing competency. A team of experts validated the new scenario using a modified Delphi technique, involving three rounds of iterative feedback and revisions. In tandem, the psychometric study of the NPP and the development of a validation process for human patient simulation scenarios both advance and encourage best practices for studying the validity of simulation-based assessments.
ContributorsO'Brien, Janet Elaine (Author) / Thompson, Marilyn (Thesis advisor) / Hagler, Debra (Thesis advisor) / Green, Samuel (Committee member) / Arizona State University (Publisher)
Created2014
Description
The purpose of this study was to investigate the use of the design characteristics component of the Jeffries/National League for Nursing Framework for Designing, Implementing, and Evaluating Simulations when developing a simulation-based approach to teaching structured communication to new graduate nurses. The setting for the study was a medium sized tertiary care hospital located in the southwestern United States. Participants in the study were an instructional designer (who also served as the researcher), two graduate nursing education specialists, one unit based educator, and 27 new graduate nurses and registered nurses who had been in practice for less than six months. Design and development research was employed to examine the processes used to design the simulation, implementation of the simulation by faculty, and course evaluation data from both students and faculty. Data collected from the designer, faculty and student participants were analyzed for evidence on how the design characteristics informed the design and implementation of the course, student achievement of course goals, as well as student and faculty evaluation of the course. These data were used to identify the strengths and weaknesses of the model in this context as well as suggestions for strengthening the model. Findings revealed that the model generally functioned well in this context. Particular strengths of the model were its emphasis on problem-solving and recommendations for attending to fidelity of clinical scenarios. Weaknesses of the model were inadequate guidance for designing student preparation, student support, and debriefing. Additionally, the model does not address the role of observers or others who are not assigned the role of primary nurse during simulations. Recommendations for strengthening the model include addressing these weaknesses by incorporating existing evidence in the instructional design of experiential learning and by scaffolding students during problem-solving. The results of the study also suggested interrelationships among the design characteristics that were not previously described; further exploration of this finding may strengthen the model. Faculty and instructional designers creating clinical simulations in this context would benefit from using the Jeffries/National League for Nursing Model, adding external resources to supplement in areas where the model does not currently provide adequate guidance.
ContributorsWilson, Rebecca D (Author) / Klein, James D. (Thesis advisor) / Hagler, Debra (Committee member) / Savenye, Wilhelmina (Committee member) / Arizona State University (Publisher)
Created2011
Description
Nurses are ideally positioned to lead the transformation of healthcare delivery in the United States, however they must be prepared to do so. The Institute of Medicine has called for nurses to become change agents and assume leadership positions across all levels in order to become full partners with physicians and other health care providers. While clinical leadership is a responsibility for all nurses, expectations for new nurse clinical leadership have not been well studied.
This study sought to determine the nursing leadership competencies clinical managers expect of new nurses in an acute care setting and to identify gaps between end-of-program nursing leadership competencies, as outlined in The Essentials of Baccalaureate Education for Professional Nursing Practice, with leadership competencies identified by clinical managers in an acute-care setting.
A single, bounded case study approach was used to collect data from nurse managers and assistant nurse managers at one acute care hospital. Data from intensive interviews, focus groups, and archival records were analyzed. Seven major themes related to clinical leadership emerged, including intentional learning, communication, professional practice, advocacy, teamwork, influencing practice, and systems thinking. Traits, mentoring, and generational differences emerged as secondary themes.
Data from this study revealed a developmental sequence for clinical leadership. Certain expectations identified as antecedent to clinical leadership emerged initially, whereas other aspects of clinical leadership, developed later in the career trajectory. It was clear that accomplishing nursing care tasks was a fundamental expectation for professional nursing practice. Communication, teamwork and advocacy are crucial leadership competencies which help the new nurse to effectively manage time and provide safe, high-quality nursing care. As the new nurse continues to develop, systems thinking and influencing nursing practice emerge as significant expectations. Nurse managers have clear expectations for how new nurses should be prepared for clinical leadership. The degree to which clinical practice partners employing new nurses and academic nursing programs educating future nurses collaborate to establish expected outcomes is variable; however, academic-practice collaborations are crucial in developing educational standards for entry to practice in complex healthcare delivery systems.
This study sought to determine the nursing leadership competencies clinical managers expect of new nurses in an acute care setting and to identify gaps between end-of-program nursing leadership competencies, as outlined in The Essentials of Baccalaureate Education for Professional Nursing Practice, with leadership competencies identified by clinical managers in an acute-care setting.
A single, bounded case study approach was used to collect data from nurse managers and assistant nurse managers at one acute care hospital. Data from intensive interviews, focus groups, and archival records were analyzed. Seven major themes related to clinical leadership emerged, including intentional learning, communication, professional practice, advocacy, teamwork, influencing practice, and systems thinking. Traits, mentoring, and generational differences emerged as secondary themes.
Data from this study revealed a developmental sequence for clinical leadership. Certain expectations identified as antecedent to clinical leadership emerged initially, whereas other aspects of clinical leadership, developed later in the career trajectory. It was clear that accomplishing nursing care tasks was a fundamental expectation for professional nursing practice. Communication, teamwork and advocacy are crucial leadership competencies which help the new nurse to effectively manage time and provide safe, high-quality nursing care. As the new nurse continues to develop, systems thinking and influencing nursing practice emerge as significant expectations. Nurse managers have clear expectations for how new nurses should be prepared for clinical leadership. The degree to which clinical practice partners employing new nurses and academic nursing programs educating future nurses collaborate to establish expected outcomes is variable; however, academic-practice collaborations are crucial in developing educational standards for entry to practice in complex healthcare delivery systems.
ContributorsMiehl, Nickolaus (Author) / Komnenich, Pauline (Thesis advisor) / Hagler, Debra (Thesis advisor) / Lamb, Gerri (Committee member) / Arizona State University (Publisher)
Created2018
Description
This mixed-methods study explored the metacognitive development of prelicensure nursing students by examining the relationship between motivation to learn and using self-regulated learning (SRL) strategies and describing the effect of guided self-regulation learning strategies on metacognitive development. Scores derived from the Learning and Study Strategies Inventory (LASSI) were analyzed quantitatively. Narrative data collected from student diary entries were analyzed qualitatively to identify major themes. The quantitative results revealed significant positive correlations between motivation and concentration, as well as motivation and time management at pre-intervention. Post-intervention, a significant positive correlation was found between motivation and the use of academic resources. Analysis of the qualitative data indicated a trend toward students incorporating active learning tools, such as flashcards and concept maps, in addition to traditional resources like textbooks. The findings suggest that guided self-regulation learning strategies are associated with metacognitive development in prelicensure nursing students.
ContributorsNaiman, Jesica (Author) / Hagler, Debra (Thesis advisor) / Castro, Felipe G. (Thesis advisor) / Morris, Brenda (Committee member) / Arizona State University (Publisher)
Created2025