The highly complex role of the Chief Nursing Officer (CNO) requires the refinement of a multitude of competencies and leadership skills in this unprecedented time of healthcare reform. As the senior most patient advocate in our medical centers the CNO is responsible for translating research into practice, policy development and implementation creating value based patient-centric strategies to transform health care. The ability to sustain and thrive in this role is essential in repositioning nursing as a knowledgeable discipline actively contributing to the redesign of healthcare. This exploratory descriptive phenomenological study was designed to explore and describe the elements that contribute to the sustainment of CNOs in their practice of nurse executive leadership. Ray’s (1989) Theory of Bureaucratic Caring, Authentic Leadership Theory (Wong & Cummings, 2009), and Resiliency Theory (Earvolino- Ramirez (2007) provided the theoretical lens through which this study was grounded. Semi-structured telephonic interviews were conducted with twenty CNOs all with two consecutive years experience in their current role. Six themes emerged after thorough content analysis which describes the lived experience of sustainment. Each theme was supported by several subthemes. Themes emerged as: Loving the Profession, Having a Broader Impact Reflecting on One’s Own Work, Learning to Manage Conflict, Maintaining Work/Life Balance Working with Supportive Leaders. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2014. / FAU Electronic Theses and Dissertations Collection

Now more than ever, speech clinicians are being required to justify the effectiveness of their work by showing results. There are different ways to measure outcomes. For example, outcomes may be measured by testing to determine if change has occurred regarding clinical goals, or by comparing the cost of the treatment to the benefit of the treatment to determine if the treatment was economically sound. Another type of measure is subjective outcomes, such as client satisfaction. Subjective outcomes are difficult to define and measure and few studies of this type have been reported in the literature. Because clinical outcome is dependent, at least to some extent, on client satisfaction (Williams, 1994), and because few studies have been reported in the literature regarding client satisfaction with speech and language services, this area became the focus of the current study. This study sought to answer the following questions: (a) Did the parents think their child benefrtted from the articulation intervention services received at the clinic? and (b) What were parents' attitudes regarding the clinical atmosphere and staff? The Consumer Satisfaction Measure of the American SpeechLanguage- Hearing Association (ASHA) was used in this study because it is broad in scope and contains statements relating to the research questions of the current study. Answers to the research questions were derived from the responses to the survey that was mailed to the parents of 86 children who had received articulation services from the PSU Speech and Hearing Clinic. Ninety-five percent of the parental responses regarding whether parents felt that their children benefited from services obtained at the PSU Speech and Hearing Clinic were positive, indicating that parents were satisfied with the services received. Ninety-one percent of the parental responses regarding parent's attitudes toward the clinical atmosphere and staff were positive. It appears that parents hold favorable views regarding the clinical atmosphere and staff and that they were satisfied with the services their children received at the PSU Speech and Hearing Clinic.

The purpose of this study was to investigate the survey as a method of assessing client satisfaction with clinical services and to then assess parental satisfaction of clinical services at Portland State University's language clinic using the survey method. The survey asked questions regarding the parents' perceived benefits from the clinic, their perception of the skills of the clinicians who served their children, and the parents' perception of the clinical atmosphere. Eighty-five Consumer Satisfaction Surveys were mailed to 81 parents of children receiving services at Portland State University Speech-Language Clinic between the years 1987 and 1994. Eleven surveys were returned, all containing a signed consent letter, representing a 13% rate. Determining the cause behind the poor response rate for this particular survey was not difficult. No surveys were returned from the years 1987 through 1989. The highest percentage of return was from the year 1994 (38% ), indicating that higher response rates were achieved if the client was polled within 1 year of using clinical services. To further substantiate this conclusion, two of the parents contacted by telephone refused to participate in the survey, and gave length of time as the reason behind their refusal. The overall response to the survey was positive, indicating a high rate of satisfaction among the survey respondents with the services provided at the Portland State University Speech-Language clinic.

Royal Perth Hospital is the largest hospital in Western Australia and also has the largest intensive care unit (ICU) in the State. It was the first public hospital to provide intensive care services in Western Australia. This thesis examines the intermediateand long-term outcomes of patients admitted to the Royal Perth Hospital ICU between 1987 and 2002. Intermediate-term survival, defined as survival after discharge from hospital to one year and long-term survival, that exceeding one year after discharge, are important outcomes. Information on outcomes can be used by ICU staff in discussions with patients and their families and to inform policy decision-making and future research. The aim of this research was to examine one-year and long-term outcomes of patients admitted to the ICU between 1987 and 2002 and explore the factors that might be associated with the outcomes for 22,298 patients admitted to the ICU. A clinical ICU database was linked to morbidity and mortality databases by Data Linkage WA. A wide range of demographic and clinical factors were examined for their effect on outcome. These included age, sex, comorbidity, severity of illness, organ failure, ICU diagnostic groups, type of admission (medical, elective surgical and non-elective surgical), length of stay in ICU and era of admission (1987-1990, 1991-1994, 1995-1998, 1999-2002). Patients were followed-up to study end, 31st December 2003 or death if it occurred before study end, that is, up to 17 years after the index ICU admission. Kaplan Meier survival curves and Cox regression models were used to examine intermediate and long-term survival for patients who survived to hospital discharge. A comparison of admissions to hospital before and after the index ICU admission was made using descriptive statistics and logistic regression. Throughout the study period survival for the ICU cohort was shorter when compared to the Australian population. This was consistent throughout the follow-up period. The most important determinants of long-term survival were age, comorbidity, severity of illness and diagnostic group but the strength of association varied with the duration of follow-up. Although age, comorbidity and severity of illness increased among the critically ill survival improved over time. Hospital admissions were more frequent after a discharge from hospital that required an admission to ICU than before the index admission, even after adjusting for the ageing of the cohort. This study provides unique information about the survival and other outcomes of patients discharged from a hospital admission that included an ICU stay. The strength of this study lies in the follow-up to 17 years and the more comprehensive range of explanatory factors than in previous studies. This thesis demonstrates that follow-up studies after intensive care should be of sufficient duration to account for the changes that occur in survival over time and indicates the range of factors that should be taken into account when making comparisons of long-term survival.

Thesis (Ph. D.)--University of California, San Diego and San Diego State University, 2008. / Title from first page of PDF file (viewed July 11, 2008). Available via ProQuest Digital Dissertations. Vita. Includes bibliographical references (p. 67-76).

Thesis (Ph. D.)--University of Washington, 2007. / Vita. Includes bibliographical references (leaves 77-82).

Thesis (M.S.)--West Virginia University, 2005. / Title from document title page. Document formatted into pages; contains xiii, 177 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 147-154).

Thesis (M.S.)--University of Michigan, 1999. / Includes bibliographical references.

Thesis (Ph.D.)--University of Alberta, 2009. / A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Doctor of Philosophy, Department of Public Health Sciences. Title from pdf file main screen (viewed on September 20, 2009). Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 1999. / Includes bibliographical references.