Obesity is a pandemic that directly affects chronic health problems and mortality. Researchers have shown that more than 54% of nurses are obese. The increasing rate of obesity among nurses and the long hours they work make healthy lifestyles, including daily physical activity, difficult. Tracking daily activity using a pedometer or fitness application has shown improved awareness and sustainability of daily physical activity. This project was an investigation of the daily steps of bedside nurses working a 12-hour shift, and their subsequent awareness of their daily physical activity. Pender's Health Promotion Model was used to consider motivating factors for improving daily physical activity. Thirty-seven nurses were recruited to use a pedometer application for 24 hours on a (12-hour) workday to track their steps for 3 consecutive days, as well as complete a final survey. A repeated measures ANOVA, with a Greenhouse-Geisser correction, determined that there was no statistical difference in the number of steps over the 3 time periods. Seventy-eight percent of the participants indicated that the project increased their awareness of physical activity. Extended research is needed to add a stronger support for the affect of wearing a pedometer and the benefits of increased awareness on health promotion. Pender's health promotion model suggests adding motivating factors such as competition. Fitness trackers now have this function and could play a large role in improving physical activity awareness and the battle of obesity for nurses and the general population. The results of this study may promote positive social change by making nurses more aware of the importance of their health and physical activity, given their long work days.

Many entry-level nurses are not prepared to handle medical emergencies. Although responsible for managing the care of individuals with complex medical conditions, many of these nurses compromise the safety of patients due to a lack of experience and an inability to apply clinical judgment. The purpose of this study was to explore the perceptions of registered nurses about their transition from entry-level to advanced beginner. Bandura's social cognitive theory, along with Colaizzi's descriptive method of data analysis, provided a basis for this phenomenological study. Research questions focused on challenges that entry-level nurses have experienced with problem-solving and complex patient care that requires advanced critical thinking and the application of clinical judgment. Criterion sampling facilitated recruitment of advanced-beginner RNs, with data collected through semistructured, one-on-one interviews. Data analysis occurred in a series of steps, including extracting and developing meanings from interview transcripts, clustering meanings into description lists, and eliminating outliers. Data analysis revealed 12 major themes aligned with behavior, clinical environment, and personal/cognitive factors. Among the findings were that nurses often felt unsupported, unable to manage conflict, unprepared, unseasoned, inefficient, and unable to lead others effectively. This study was necessary because its findings may provide insights leaders in health services can use to develop strategies to better prepare entry-level nurses to care for individuals with complex medical conditions. Among the implications for positive social change are developing a better tool for the training and advancement of entry-level nurses, consequently improving patient safety and reducing health care costs.

Registered nurses perceive the healthcare work environment as stressful. Stress can have a negative effect on patient care and nurses' attrition and health. In the literature, mentors have been identified as having a positive influence on nurses. This qualitative study was an examination of nurses in mentoring relationships in the early, middle, and late career stage and working in a hospital setting. Two research questions addressed mentoring relationship preferences and mentors' influence on perceived stress. Fourteen nurses were interviewed in the study. The conceptual framework was based on the career and psychosocial mentoring theory, the mentoring the adult learner theory, and the attachment theory. Data were analyzed electronically and manually into intuitively and inductively derived themes. The results of the study related to preferences showed nurses prefer mentors to be in the work setting, mentors to help nurses develop nursing competencies, and mentors to help nurses develop a positive self-concept. The difference among the nurses in the career stages was the type of competencies developed. The nurses identified that mentors had a positive influence on the perception of stress through the development of emotional intelligence and problem-solving skills with similarities and differences in the type of challenges nurses' experience. The implications for future research are studies with nurses working in other healthcare settings and quantitative studies to measure levels of stress with and without a mentor. Implications for practice are the development of mentoring programs where career stages and perception of stress are addressed. Limitations of this study were the setting and sample size. Implications for social change include the development of humanistic approaches to mentoring to address nurses' challenges and stressors in the healthcare work environment.

Registered nurses (RNs) have a significant role in communicating health information to patients. The problem addressed in this study was RNs roles with health literacy and communicating health information using words that the patient understands. This study found that ambulatory RN perspectives on their roles in health literacy and patient communication may improve health outcomes and optimal wellness. The purpose of this qualitative study was to examine and describe ambulatory RN perspectives on their roles in health literacy and patient communication, as these are necessary components linked to better health outcomes. The conceptual framework for this study was the nurse role effectiveness model. Fifteen RNs participated in face-to-face, structured, interviews using open-ended questions to contribute perspectives on health literacy roles and nurse-patient communication. Data analysis consisted of Miles and Huberman's methodology to code, extract, sort, review, generalize, and examine for themes. Emergent themes and key findings of this study may improve the gap in knowledge regarding ambulatory RN perspectives on health literacy roles and patient communication, as well as more awareness of the term health literacy, increased formal training on the concepts of health literacy, and techniques to formally assess patients' understanding of health information. An opportunity exists to bridge the gap between RN knowledge of health literacy roles and patient communication. Positive social change implications for health services include promoting RN health literacy roles and strategies for effective communication to promote patient behavior changes for optimal wellness.

There is an enduring and prevailing disparity between the clinical prevalence of alcohol, tobacco and other drug-related problems and the frequency that nurses recognise and intervene in these common problems. The extant nursing literature has long determined an urgent need for further investigation into why nurses do not respond to patients with ATOD-related problems in the consistent and effective manner that the prevalence of these costly health problems require, or in a manner that reflects the opportunities that nurses have to offer brief and timely intervention. This thesis reports and discusses the investigation of factors that determine identification, assessment and interventions of patients with alcohol, tobacco and other drug-related problems by a randomly selected sample of Registered Nurses [n=1281] in practice in New South Wales, Australia. Of particular interest was the relationship between nurses' ATOD knowledge, therapeutic attitudes and clinical activity. Multiple quantitative and qualitative methods were used, firstly to systematically investigate factors within the nurse and their clinical setting that might predict desired clinical behaviour towards addressing ATOD-related problems, and secondly, to analyse and describe nurses' self-reported perceptions, views and experiences of the issue and what aids or impedes it. The research instrument - a 72 item self-completed questionnaire was developed and refined within a process of three (3) pilot studies and test-retest method. A multiple regression model was developed to establish the predictors of key clinical behaviours. Thematic coding was used to analyse the perceptions of these nurses as to the factors that affect their ability to intervene with patients who have ATODrelated problems. Convergent and divergent concerns between quantitative and qualitative findings became apparent. Thematic analysis of open-ended responses demonstrated that nurses report a complex of factors that affect their ability and capacity to intervene with patients who have ATOD-related problems. Among these are factors located within nurses themselves, within their patient(s), within their workplace, within other health professionals and within the broader social/cultural context. The latter part of the thesis systematically considers the relationships between the quantitative and qualitative findings within this large sample of registered nurses. From this comprehensive level of analysis, workforce implications for ATOD education, training and organisational support for nurses, the most numerous group of health care workers, have been readily identified. The major empirical finding of this investigation is that there is a significant difference between positive attitudinal sets and motivation of practicing registered nurses to perform desired ATOD-related clinical activities, and the lower reported frequency at which this occurs. The qualitative findings are highly convergent with the empirical ones. It is the nurse's self-identified lack of knowledge, skills, experience and confidence that is now reported as having the greatest effect on their ability to assess, identify and offer brief and timely intervention for patients with ATOD-related problems, rather than any prevailing beliefs and attitudes that these patients were not worthy of their care, or outside the legitimate framework of their nursing role.

The purpose of this study was to examine the relationship between characteristics of refreshed registered nurses and reemployment in the nursing workforce post Refresher programme. The application forms completed by the participants of the six programmes conducted by the ACT Health Authority (ACTHA, now Department of Community Services and Health ACT) provided data for a profile analysis. Employment data was derived mostly from statistics compiled by the Research Officer, Nursing, ACTHA. The findings of this study demonstrated that inactive registered nurses do return to nursing from periods of non-participation as nurses, following completion of Refresher programmes. Moreover, significant numbers of these returning nurses remain in nursing employment. In relation to that aspect of workforce planning which considers sources of supply for the registered nurse labour market an area for further study would be to explore the area of patient care in which the greater concentration of refreshed nurses were to be found post programme: acute care settings or extended care facilities. The study found that predictions of the successful reentry to nursing of the individual refreshed nurse and of retention in the nursing workforce could not be based on the characteristics of that person, alone. These findings supported the study's hypothesis that there would be no statistically significant difference between the characteristics of refreshed registered nurses who returned to, and remain in, the nursing workforce and those refreshers who either did not reenter nursing post programme or who left during the following twelve months. The characteristics examined were age, family status, post registration nursing experience, post registration nursing courses, worked as a nurse in the ACT prior to the programme, previous employment status, and time inactive from nursing pre-Refresher programme. Trends were identified which indicated that with some characteristics there was a greater likelihood of post programme reemployability in nursing. Refreshed nurses who reentered and remained in the nursing workforce tended to be younger.than those not working as nurses. There was a trend for post programme participators in the nursing workforce to have had fewer years of post registration nursing experience and to be more likely not to have obtained post registration nursing qualifications than their counterparts not working in nursing positions. Perhaps not surprisingly the study found that a higher proportion of the refreshers employed as nurses had previously worked at some stage in ACT health care facilities as registered nurses. A somewhat unexpected finding was that amongst the group of refreshed nurses working in nursing the largest contingent had been inactive from nursing for more years than was the case for those not working as nurses. The majority of refreshed registered nurses, whether they were working as nurses post programme or not had a family status of partner/husband and child(ren) and were unemployed before undertaking the Refresher programme. Refreshed registered nurses have provided a source of supply to the nursing workforce during a period of shortage of qualified nurses in the health care system. In the latter part of the 1980's there have been indications that shortage is largely confined to nurses with specialised skills. The findings from this study should assist the nursing profession in deciding the future role of programmes of reentry for inactive registered nurses who require reskilling for current clinical competence for general patient care areas.

This study examines the perceived causes of occupational stress amongst female Registered Nurses working in the clinical setting at both Calvary Public and Calvary Private Hospitals ACT Incorporated. A modified Gray-Toft, Anderson Nursing Stress Scale (1981) was used as the instrument for the research. The questionnaire was modified by the addition of six questions. The questionnaire was distributed to seventy female Registered Nurses. Twenty questionnaires were distributed to staff working within the Private Hospital and fifty to staff in the Public Hospital. Relevant data dating back to 1956 was examined regarding stress and burnout amongst nurses and allied health professionals. The results of this study, not surprisingly, supported the finding of Gray-Toft, Anderson. That is that nursing remains an inherently stressful occupation. Respondents working in both public and private hospitals indicated that Lack of Funding and Death and Dying were considered to be major sources of perceived stress. Registered Nurses working in the Public Hospital perceive higher levels of stress than do those Registered Nurses working within the Private Hospital with respect to relative staffing levels, workload and funding. Comparisons by age group indicated a generally higher reported level for the youngest age group. Comparison of full time versus part time staff indicated a significantly higher level of perceived stress from full time staff. Analysis of reported stress by ward type indicated that staff working in the "medical" groupings experienced higher perceived levels of stress than those working in the "surgical" groupings.

Adverse drug events, resulting in preventable patient harm or death, are of great concern. To keep patients safe, hospitals have implemented barcode medication administration (BCMA) technology for RNs who have accepted this technology with varying levels of satisfaction. When nurses are dissatisfied with a BCMA system, they may find alternative methods to complete their work. Framed by the Technology Acceptance Model (Davis, 1989), this analytic, cross-sectional study aimed to understand the relationship between BCMA satisfaction and workarounds, perceived ease of use (PEOU) and perceived usefulness (PU) of a BCMA system by 80 hospital-based RNs in northeastern US. Data were collected using the Workaround Usage and Satisfaction with Barcoding Instrument for Nurses (WUSBIN), which was adapted from Hurley's (2006) Medication Administration System-Nurses Assessment of Satisfaction Scale (MAS-NAS) Halbesleben and Rathert's (2010) Workaround Assessment. Results suggested that RNs who were more satisfied with the BCMA system were less likely to use workarounds than nurses who were less satisfied (r2(78)= -.681, p < .05). Significant relationships were noted among BCMA Satisfaction and PEOU (r2(78) = -.725, p < .05), Workaround Usage and PEOU (r2(78) =.943, p < .05) and Workaround Usage and PU (r2(78)=.501, p < .05). RNs perceived the BCMA system to be easy to use (PEOU), but not very useful (PU). BCMA Satisfaction was significantly related to the use of six workarounds, while Workaround Usage was significantly related to five. Significant relationships were also noted among both BCMA Satisfaction (r2(78) = -.393, p < .01), and Workaround Usage (r2(78) = .423, p < .01) with the total number of workarounds used. Significant relationships were found among demographic variables, BCMA Satisfaction, and Workaround Usage. Since admitting to the use of workarounds may be a sensitive matter for RNs, measuring BCMA satisfaction may help understand the state of patient safety related to medication administration. Based on high satisfaction scores and low workaround usage, a profile may be developed to identify nurse champions to improve quality of care. Further research is indicated to fully understand these possibilities. / School of Nursing / Nursing / PhD / Dissertation

Thesis (Ph. D.)--University of North Carolina at Greensboro, 2006. / Title from PDF title page screen. Advisor: Richard Luecht; submitted to the School of Education. Includes bibliographical references (p. 89-94).

The profession of nursing is experiencing a shortage of qualified nursing professionals. Hospitals understaffed with nurses are likely to experience several negative consequences including low quality care, which places the health and safety of patients at risk. In order to ensure an effective selection process for hospital nurses, a structured situational interview, developed using a content validation approach, was validated using a criterion-related approach. Interviews that have a high degree of structure consistently demonstrate higher predictive validities with job performance than do interviews with less structure. The structured situational interview in this study had a high degree of structure and was developed after a job analysis was completed. Interviewee responses were evaluated using a behavioral summation scale. The results of the current study confirmed the hypothesis that there would be a positive relationship between nursing student interview scores and Grade Point Average, thus indicating that the structured interview should be useful in the selection of professionals in the field of nursing. However, the observed validity coefficient (r = .29) was lower than expected based on a review of previous research on the criterion-related validity of structured situational interviews. It is recommended that future research with this instrument use a larger sample of nurse incumbents as participants and nurse managers as interviewers. Additional interview items, developed following a content validity approach, would likely increase the reliability and the validity of the interview