IU Indianapolis ScholarWorks :: Browsing by Author "Ebright, Patricia"

Browsing by Author "Ebright, Patricia"

Now showing 1 - 10 of 12

Bedside Interprofessional Rounding: The View From the Patient's Side of the Bed
(Sage, 2017-03) Burdick, Kailee; Kara, Areeba; Ebright, Patricia; Meek, Julie; School of Nursing
BACKGROUND: Bedside interprofessional rounding is gaining ground as a means to improve collaboration and patient outcomes, yet little is known regarding patients' perceptions of the practice. METHODS: This descriptive study used individual patient interviews to elicit views on interprofessional rounding from 35 patients at a large, urban hospital. RESULTS: The findings identified three major categories: 1) about the rounding process; 2) clinical information; and 3) the impact/value of bedside inter-professional rounding. DISCUSSION: Intentionally eliciting and responding to our patients' views of interprofessional rounding may help us design methods that are patient centered and effective.
Content counts, but context makes the difference in developing expertise: a qualitative study of how residents learn end of shift handoffs
(BMC, 2018-11-03) Rattray, Nicholas A.; Ebright, Patricia; Flanagan, Mindy E.; Militello, Laura G.; Barach, Paul; Franks, Zamal; Rehman, Shakaib U.; Gordon, Howard S.; Frankel, Richard M.; Anthropology, School of Liberal Arts
BACKGROUND: Handoff education is both formal and informal and varies widely across medical school and residency training programs. Despite many efforts to improve clinical handoffs, little evidence has shown meaningful improvement. The objective of this study was to identify residents' perspectives and develop a deeper understanding on the necessary training to conduct safe and effective patient handoffs. METHODS: A qualitative study focused on the analysis of cognitive task interviews targeting end-of-shift handoff experiences with 35 residents from three geographically dispersed VA facilities. The interview data were analyzed using an iterative, consensus-based team approach. Researchers discussed and agreed on code definitions and corresponding case examples. Grounded theory was used to analyze the transcripts. RESULTS: Although some residents report receiving formal training in conducting handoffs (e.g., medical school coursework, resident boot camp/workshops, and handoff debriefing), many residents reported that they were only partially prepared for enacting them as interns. Experiential, practice-based learning (i.e., giving handoffs, covering night shift to match common issues to handoff content) was identified as the most suited and beneficial for delivering effective handoff training. Six skills were described as critical to learning effective handoffs: identifying pertinent information, providing anticipatory guidance, applying acquired clinical knowledge, being concise, incorporating delivery strategies, and appreciating the styles/preferences of handoff recipients. CONCLUSIONS: Residents identified the immersive performance and the experience of covering night shifts as the most important aspects of learning to execute effective handoffs. Formal education alone can miss the critical role of real-time sense-making throughout the process of handing off from one trainee to another. Interventions targeting senior resident mentoring and night shift could positively influence the cognitive and performance capacity for safe, effective handoffs.
THE EFFECT OF CURRICULAR SEQUENCING OF HUMAN PATIENT SIMULATION LEARNING EXPERIENCES ON STUDENTS’ SELF-PERCEPTIONS OF CLINICAL REASONING ABILITIES
(2011-11-18) Jensen, Rebecca Sue; Ebright, Patricia; Pesut, Daniel J.; Fisher, Mary L., Ph.D.; Welch, Janet L.
It is unknown whether timing of human patient simulation (HPS) in a semester, demographic (age, gender, and ethnicity), and situational (type of program and previous baccalaureate degree and experience in healthcare) variables affects students’ perceptions of their clinical reasoning abilities. Nursing students were divided into two groups, mid and end of semester HPS experiences. Students’ perceptions of clinical reasoning abilities were measured at Baseline (beginning of semester) and Time 2 (end of semester), along with demographic and situational variables. Dependent variable was Difference scores where Baseline scores were subtracted from Time 2 scores to reveal changes in students’ perceptions of clinical reasoning. Students who were older and had previous healthcare experience had higher scores, as well as students in the AS program, indicating larger changes in students’ perceptions of clinical reasoning abilities from Baseline to Time 2. Timing of HPS, mid or end of semester, had no effect on Difference scores, and thus students’ perceptions of clinical reasoning abilities.
Factors that Facilitate and Inhibit Engagement of Registered Nurses: An Analysis and Evaluation of Magnet versus Non-Magnet Designated Hospitals
(2012-03-16) Wonder, Amy C.; Fisher, Mary L., Ph.D.; Pesut, Daniel J.; Ebright, Patricia; Halstead, Judith A.
Work engagement of registered nurses (RNs) has gained attention in health care, as an organizational process that is requisite to promoting optimal patient outcomes. Improving patient outcomes has caused a movement to examine what can be done to bridge the disparity between good and excellent care. Standards that enhance RN engagement to promote professional care are seen as vital to excellence. Magnet designation, awarded by the American Nurses Credentialing Center, signifies an organization meets such standards. Therefore, the purpose of this study was to evaluate whether a correlation exists between RN engagement and the organizational structures common to Magnet designation. This study also evaluated the influence of social and institutional demographics on the relationship between engagement and Magnet designation. The variables in this study included: age (generation), gender, nursing degree, years of RN experience, years of unit longevity, shift, hours scheduled and worked per week, percentage of time in direct patient care, nursing unit, and shared governance council participation. Finally, this study evaluated the influence of RN perception related to organizational support for work on the relationship between engagement and Magnet designation. A total of 370 RNs in Magnet (n = 220) and non-Magnet (n = 150) designated hospitals completed a 17-item engagement survey and a 15-item demographic survey. Major findings of the study indicated no significant difference in RN engagement between nurses who work at Magnet versus non-Magnet designated hospitals. Within the Magnet sample, significant relationships were found between engagement and shift, years of RN experience in any clinical setting, and RN perceptions related to organizational support for work. Scatter plots for nursing experience showed positive slopes for total engagement, vigor, dedication, and absorption. Post-hoc results for RN perception related to organizational support for work identified the significant areas of engagement were total engagement, vigor, and absorption. No significant post-hoc results were noted for the variable of shift. Through significant and non-significant findings, several insights were gained about engagement. As a result of this study, leadership can better assess the needs of the RN workforce to provide what RNs perceive to be important to professional practice and RN engagement.
New graduate nurse transition into practice : psychometric testing of Sims Factor H Assessment Scale
(2014-01-29) Sims, Caroline E.; Ebright, Patricia; Bakas, Tamilyn; Ironside, Pamela M.; Pacini, Christine M., 1949-
Factor H is a newly identified phenomenon which describes a constellation of attributes of the new graduate nurse reflecting personality traits, intellectual abilities, and clinical judgment. In a previous pilot study conducted by this researcher nurse managers and experienced Registered Nurse (RN) preceptors described characteristics demonstrated by new graduate nurses demonstrating Factor H and the new graduate nurse’s ability to transition quickly and successfully into the RN role in the acute care environment. There is currently no instrument available to measure this phenomenon. The specific aim of this research was to develop and psychometrically test a scale designed to identify the presence of attributes of Factor H in the new graduate nurse. The Sims Factor H Assessment Scale (SFHAS) was developed and piloted with a sample of one hundred one new graduate nurses within three months of completing the their nursing program at one of three nursing schools in central and south central Indiana. Evidence of content validity was demonstrated through the use of the Content Validity Index conducted with a panel of four experts. Evidence of face validity was demonstrated through interviews with a group of new graduate nurses, nurse managers, and experienced RN preceptors. Principle Axis Factoring with Varimax rotation was used to demonstrate evidence of construct validity and the scale was found to have a single component which was identified as nursing personality. Evidence of criterion-related validity was demonstrated utilizing analysis of the SFHAS and the criterion scale for personality traits (NEO-FFI). Evidence of internal consistency reliability was demonstrated through analysis of inter-item correlations, Cronbach’s coefficient correlations, and item-total correlations. Test re-test reliability using interclass correlation was also conducted to demonstrate stability of the scale. The SFHAS was found to be reflective of nursing personality and not general mental ability or clinical judgment. Use of the SFHAS will allow organizations to evaluate the nursing personality of the new graduate nurse for fit into the work environment. Further study is recommended to gain clarity around the attributes which support successful transition of the new graduate nurse into practice in the acute care environment, also known as Factor H.
Outcomes of Adding Patient and Family Engagement Education to Fall Prevention Bundled Interventions.
(Lippincott, Williams, and Wilkins, 2017-07) Opsahl, Angela G.; Ebright, Patricia; Cangany, Marty; Lowder, Melissa; Scott, Dawn; Shaner, Tamara; IU School of Nursing
Nurses strive to reduce risk and ensure patient safety from falls in health care systems. Patients and their families are able to take a more active role in reducing falls. The focus of this article is on the use of bundled fall prevention interventions highlighted by a patient/family engagement educational video. The implementation of this quality improvement intervention across 2 different patient populations was successful in achieving unit benchmarks.
Severe Sepsis and Septic Shock Readmissions in Older Adults
(2020-08) Hodge, Kimberly Sue; Fulton, Janet; Ebright, Patricia; Davis-Ajami, Mary Lynn; Huber, Lesa
Hospital readmission is of growing importance in the healthcare industry because of associated patient and system costs, impact to the quality of patient care, and hospital Medicare payment penalties. The increasing interest in sepsis readmission prevention has highlighted the uniqueness of severe sepsis or septic shock survivors. The results of this study provide insight into the relationship between index hospital length of stay (LOS) and 30-day readmissions for older adults (> 65 years) who discharged home from an index hospital with a principle or secondary discharge diagnosis of severe sepsis or septic shock. The purpose of this study was to investigate the relationship between index hospital LOS and 30-day readmissions in older adults (> 65 years) whose expected primary payer was Medicare and who discharged home with a principle or secondary diagnosis of severe sepsis or septic shock. Data used to answer the proposed research questions consisted of older adult discharge records from the 2014 Nationwide Readmissions Database (NRD), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality. Differences in 30-day readmissions between older adult age groups, gender, and older adult location were examined. The number of days to readmission since discharge was evaluated for the subset of older adults with a readmission. Approximately 15.6% of older adults were readmitted within 30 days of their discharge. Readmissions were statistically different based on the older adult’s age, gender, and LOS. Location did not have a significant effect on readmissions. Mean LOS among readmitted older adults was 10.1 days. Analysis indicates that an older adult’s LOS had a significant effect on readmissions, although models performed poorly. Findings suggest that there are certain factors that can predict older adults who are at risk for being readmitted after being discharged with a principle or secondary discharge diagnosis of severe sepsis or septic shock.
Situation awareness and the selection of interruption handling strategies during the medication administration process : a qualitative study
(2014) Sitterding, Mary Cathryn; Ebright, Patricia; Patterson, Emily S., 1972-; Broome, Marion; Ironside, Pamela M.
Medication administration error remains a leading cause of preventable death. A gap exists in understanding attentional dynamics, such as nurse situation awareness (SA) while managing interruptions during medication administration. The aim was to describe SA during medication administration and interruption handling strategies. A crosssectional, descriptive design was used. Cognitive task analysis (CTA) methods informed analysis of 230 interruptions. Themes were analyzed by SA level. The nature of the stimuli noticed emerged as a Level 1 theme, in contrast to themes of uncertainty, relevance, and expectations (Level 2 themes). Projected or anticipated interventions (Level 3 themes) reflected workload balance between team and patient foregrounds. The prevalence of cognitive time-sharing during the medication administration process was significant or may be remarkable. Findings substantiated the importance of the concept of SA within nursing as well as the contribution of CTA in understanding the cognitive work of nursing during medication administration.
Social capital and human capital of nurse managers and registered nurses
(2017-07-13) Gilbert, Jason Howard; Von Ah, Diane; Boone, Marion E.; Ford, Jeffrey D.; Ebright, Patricia; Chase, Linda K.
Nurse managers and the teams of registered nurses they lead play a major role in the provision of healthcare outcomes nationally. Nursing leadership models have evolved with contemporary society and have shifted from hierarchical models to those based on interactive relationships. Traditional study of nurse managers and registered nurses has focused on human capital (acquired knowledge, skills, and experience). However, nurse managers and registered nurses must utilize human capital through a network of social relationships or social capital in order to produce positive healthcare outcomes. Little is known about human capital and social capital in nurse managers and registered nurses in the provision of healthcare outcomes. The purpose of this dissertation was to improve our understanding of the importance of human capital and social capital in nurse managers and the nurses. Specific aims included: 1) to explore and describe the concepts of human capital and social capital and to explore if human capital and social capital vary by individual characteristics/human capital attributes (such as education level or years of experience) or by organizational characteristics (such as hospital size or unit type); 2) to examine if human capital and social capital were related; and 3) to explore whether human capital and social capital were related to turnover intent and job satisfaction in a sample of nurse managers and registered nurses. A quantitative descriptive cross-sectional survey of 64 nurse managers and 1139 registered nurses in a 15 hospital healthcare system was conducted. Measures included human capital, social capital, individual characteristics, organizational characteristics, turnover intent, and job satisfaction. The four major findings of this study were: 1) nurse manager human capital is acquired primarily through experience in the role, 2) nurse manager human capital is positively related to social capital, 3) nurse manager and registered nurse social capital varies by individual and organizational characteristics, and 4) social capital is positively related to job satisfaction and negatively related to turnover intent. This dissertation provides the foundation for further research and targeted interventions for development of human and social capital of nurse managers and registered nurses.
Staff Nurse Perceptions of Nurse Manager Behaviors that Influence Job Satisfaction
(2012-03-19) Feather, Rebecca A.; Ebright, Patricia; Bakas, Tamilyn; Duffy, Joanne R.; Sims, Sharon L.
The Bureau of Labor Statistics projected a shortage of registered nurses (RNs) growing to an estimated 581,500 by the year 2025 (an increase of 22 percent since 2008). Recent economical downturns have found many healthcare organizations experiencing a positive effect with the stabilization of nursing turnover. Once the economy begins to recover, however, experts predict the profession of nursing will still face the largest shortage in history according to projections by the American Nurses Association. Because lack of job satisfaction is a precursor to resignation, additional research regarding the identification of interventions that increase RN job satisfaction may result in retaining professionally qualified and prepared staff. This study proposed to identify through focus groups, staff nurse perceptions of nurse manager behaviors that influence RN staff nurse job satisfaction. A sample of 28 RNs, each participating in one of five focus groups, answered questions related to satisfaction with nurse manager behaviors. The investigator used qualitative content analysis to identify patterns within and across focus group data. Major findings of the study resulted in the identification of two conceptual categories (manager behaviors supportive of RNs and RN’s perceived disconnect of work issues from the manager’s role) and three major themes related to supportive behaviors (communication, respect, and feeling cared for). The results suggest the following as staff nurse preferences for nurse manager behaviors: open and honest communication that involves listening, consistency, and confidentiality; an increased level of respect including fairness and recognition of a job well done; and the sense of feeling cared for as when a manager meets individual needs and supports staff as professionals. The investigator compared the categories and themes to previous tools used in healthcare, which indicate the need for further item and/or tool development as well as further research regarding RNs’ perceived disconnect of work issues from the manager’s role.

Browsing by Author "Ebright, Patricia"

Results Per Page

Sort Options