Thesis (Ph.D.)--Virginia Commonwealth University, 2006. / Prepared for: Dept. of Nurse Anesthesia. Bibliography: leaves 90-101. Available online via the Internet.

Thesis (Ph.D.)--University of Nebraska-Lincoln, 2006. / Title from title screen (site viewed May 16, 2007). PDF text: v, 282 p. ; 3.67Mb UMI publication number: AAT 3237556. Includes bibliographical references. Also available in microfilm and microfiche formats.

Thesis (Ph.D.)--Duquesne University, 2006. / Title from document title page. Abstract included in electronic submission form. Includes bibliographical references (p.114-121) and index.

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Objective: To determine the readiness of registered nurses (RNs) who provide care for patients with diabetes in a primary care setting for RN prescribing. Setting: Canadian provinces and territories. Participants: Canadian RNs working in primary care settings who provide care to patients with diabetes. Methods: A cross-sectional survey design was used to examine the readiness of RNs by measuring the attributes of readiness (value, confidence and willingness). The survey included questions on the demographic profile of participants including their age, education level and whether or not they had obtained additional certifications. This data was used to describe the sample and to determine whether there were differences between RNs who were ready to prescribe and RNs who were not ready to prescribe. Results: Almost 75% of the respondents were "ready" for RN prescribing. There were high positive correlations between "value" and "confidence", "value" and "willingness", and "confidence" and "willingness". There were no statistically significant differences in age, level of education and certifications for respondents who were ready to prescribe compared to those who were not ready to prescribe. Conclusions: The results of the present study indicate that RNs who provide care for patients with diabetes in a primary care setting are ready for prescribing. This practice has the potential to make more effective use of health human resources, allowing RNs to work to their full potential and increase accessibility to care for patients with diabetes.

The purpose of this study was to investigate nurses’ roles within nurse-led chemotherapy clinics. There has been a rapid expansion and development of nursing roles and responsibilities in oncology, but little understanding of how roles are enacted and their impact on patient experiences and outcomes. This was a two stage approach comprising a survey of UK oncology specialist nurses followed by an ethnographic study of nurses’ roles in nurse led chemotherapy clinics. Ethics approval was obtained prior to each study; research and development approval was obtained from each hospital site prior to Study 2. Study 1 used a questionnaire survey to explore the scope of nurses’ roles. A purposive sample of oncology specialist nurses perceived to be undertaking nurse-led clinics was obtained using snowball methods. Data analysis included descriptive and inferential statistics. Study 2 used ethnographic methods to explore nurses’ roles in nurse-led chemotherapy clinics, which included clinical observations, interviews with nurse participants and studying documentation (protocols) for nurse-led chemotherapy clinics. Findings were coded and thematic analysis undertaken. In study 1, 103 completed questionnaires were received with a response rate of 64%, however analysis identified 79 (76.7%) nurses undertaking nurse-led clinics, therefore statistical analysis was limited to this sample of 79 nurses. An additional 12 (11.7%) nurses wanted to undertake nurse-led clinics, therefore findings from this group were analysed separately. There was little congruence between nurses’ titles and clinical roles, with significant differences in practice between different groups of nurses, in relation to history-taking (p=.036), assessing response to treatment (p=.033). Although there was no difference in the number of nurses undertaking clinical examinations (p=.065), there were differences in the nature of examinations undertaken, including respiratory (p= .002). There were also significant differences between groups of nurses in relation to nurse prescribing (p<.0001). Study 2 included observations (61 consultations by 13 nurses) and interviews (n=11). There was variability in patient numbers within nurse-led clinics, identifying implications for service delivery and sustainability. Disparities in nurses’ roles and responsibilities revealed four different levels of nurse-led chemotherapy clinics, from chemotherapy administration to totally nurse-led clinics. The identification of four levels of nurse-led chemotherapy is a new finding, and suggests a framework for nurse-led chemotherapy clinics that could link with nurse competencies and training. Five main themes were identified in study 2; a central theme of autonomy linked with themes of knowledge, skills, power and beliefs. A key finding was the reduced emphasis on compassionate care with greater medical (clinical) responsibilities within nurses’ roles, and poor communication skills by some nurses. Despite a great diversity in oncology specialist nurses’ roles, the lack of clarity in roles and responsibilities is creating confusion. Similarly the rapid increase in nurse-led chemotherapy clinics has been ad hoc with no formal evaluations. Although nurses in study 2 perceived they were providing holistic care there was no evidence of this in observations, and nurses appear to use a medical model care based on doctor-nurse substitution, which may have led to reduced emphasis on nursing skills and compassionate care.

M.Cur. (Nursing Education) / Performance appraisal is a continuous process for identifying, evaluating and developing the work performance of nurse educators so that the goals and objectives of the college are more effectively achieved, while at the same time benefiting individual nurse educators in terms of reward and recognition of performance, professional development and career guidance. Performance appraisal entails structured formal interaction between an appraiser and appraisee, which usually takes the form of a periodic interview (annual or semiannual), in which the work performance of the appraisee is examined and discussed with a view to identifying weaknesses and strengths as well as opportunities for improvement and skills development. The challenge faced by the nurse educators is the lack of knowledge in execution of the performance appraisal. The purpose of the study is to describe guidelines to improve the performance appraisal system of nurse educators at all eight nursing colleges in Botswana. The research design is qualitative, exploratory and descriptive. Purposive sampling was used in this study to recruit nurse educators to participate in individual semistructured interviews. A qualitative open coding data analysis method was used. The researcher ensured the trustworthiness of the study by using Lincoln and Guba’s model of trustworthiness, which is based on four strategies: credibility, dependability, transferability and conformability. Inadequate knowledge among the nurse educators regarding performance appraisal emerged as the only main theme from the semi-structured interviews. Two subthemes that emerged from this theme were: inadequate knowledge of the appraisers and appraisees regarding the performance appraisal process and inadequate knowledge of the appraisers regarding mentoring and coaching of appraisees during the performance appraisal period. The theme and the sub-themes are conceptualised within the existing relevant literature, and guidelines to improve the performance appraisal system at the eight iv nursing colleges in Botswana are then described. Recommendations are made with regard to nursing education, nursing practice and nursing research. It is recommended that the nurse educators be trained in performance appraisal with emphasis on the performance appraisal process and the application of coaching and mentoring strategies throughout the performance appraisal period.

Thesis advisor: Jane Flanagan / AbstractPurpose/Specific Aims: A qualitative descriptive research design was employed to gain insights in how nurse educators describe nursing ethics from a disciplinary perspective and how they teach nursing ethics in a pre-licensure nursing program. The study aimed to identify how nurse educators describe ethical knowledge needed for nursing practice and how nursing ethics is viewed in relation to bio, medical and healthcare ethics. Rationale/Significance of Study: Recent works in nursing ethics has provided some clarity about what is needed to develop nurses who are confident in using ethical decision-making in every-day practice. Nurse educators are responsible for the development of novice nurses who can effectively practice from a disciplinary perspective rooted in nursing ethics. To date, there is scant research exploring nurse educators’ understanding of what constitutes disciplinary specific ethics and impact on daily nursing practice. This study is a necessary first step to identify how nurse educators understand the ethical warrants of their profession and the ways in which this is, or is not, transmitted to nursing students. Sample and Recruitment: Nurse educators teaching in baccalaureate nurse programs in the US were purposely recruited through the Nurse Educators Group in Facebook, with subsequent snowball sampling. The final sample consisted of 16 nurse educators who met inclusion criteria and agreed to participate in the study. Data Analysis: Data was collected using open-ended interview questions and analyzed using conventional content analysis. Data was clustered into “meaning units” from which codes and categories were derived. Codes and categories were further reexamined several times to determine if the analysis accurately portrayed the data. The codes were then developed into themes that expressed the manifestation of the content. Findings: Four major themes were identified during data analysis. They include: Inherent personal qualities guide nurses’ sense of professional ethics, The ethical nurse is a ‘good’ nurse as reflected in their practice, Disciplinary nursing ethics is not discernable from other ethics, and Nursing ethics education is inconsistent across schools of nursing. Conclusions: Findings reveal there is no common viewpoint and a lack of conceptual disciplinary language of what constitutes nursing ethics among nurse educators. The research presented here suggests there is a gap in theory and practice with respect to nursing ethics in daily practice, with implications in policy, further research and nursing education. / Thesis (PhD) — Boston College, 2022. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

In a report on the nursing shortage, the American Association of Colleges of Nursing cited insufficient preceptors as one of the factors influencing the decreased intake of nursing students to registered nurse (RN) programs, thus compounding the shortage issue. The site selected for this project was a teaching hospital that annually facilitates hundreds of nursing students for clinical practice. Graduate nurses rotating through the hospital are assigned to work with RNs within their assigned units. The purpose of this doctoral project was to develop a preceptor training program for RNs in a teaching hospital. The practice-focused question examined whether RNs would identify perceived competence and understanding in the preceptor role as a result of preceptor training. Knowles'€™s adult learning theory and Benner'€™s theory of skills acquisition framed the project. Participants (N = 7) completed a 2-week didactic and clinical training in preceptorship. As a result of the educational intervention, the preceptor trainees reported an increase in knowledge, skills, and confidence in the preceptor role. Seven participants (100%) expressed that the training was interesting, relevant, beneficial to their work, and stimulated sharing. The implications of this project for positive change include the potential benefits to new and experienced graduate nurse preceptors by reducing feelings of inadequacy, stress, and burnout and enhancing job satisfaction. Additionally, graduate nurses who work with competent, confident preceptors experience less anxiety, improved job satisfaction and a smoother transition to the role of professional nurses prepared to deliver quality health care to patients. Improving preceptor-graduate nurse experiences may result in reduced turnover among nurses and improved customer experiences.

Nurse managers are stakeholders in creating a culture of nurse retention. The purpose of this staff education project was to identify evidence-based best practices that promote nurse retention and to educate nurse managers about these strategies. Knowles's theory of adult learning was the theoretical framework for the project. The practice-focused question addressed whether an education program for nurse managers would increase their understanding of evidence-based strategies to create a culture of nurse retention. The education program centered on 4 themes: professional development, communication and relationships, culture and work environment, and organizational structures and support. The concepts of 5 domains-- status, certainty, autonomy, relatedness and fairness (the SCARF model)--were used to educate nurse managers about the conceptual foundations of individuals' engagement within their environment. Education was delivered using a presentation software program with a follow-up question-and-answer session. A reference toolkit was included in the program. Twenty-seven nurse managers completed a 7-question post presentation survey to assess their level of understanding related to creating a culture of nurse retention; all reported excellent and good levels of understanding based on the program. The nurse manager toolkit and education program can assist nurse mangers in developing leadership strategies supporting nurse retention and positive social change in the culture of the organization.