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Leung T, Horn SD, Sharkey PD, Brooks KR, Kennerly S. The Nursing Home Severity Index and Application to Pressure Injury Risk: Measure Development and Validation Study. JMIR Aging 2023; 6:e43130. [PMID: 36757779 PMCID: PMC9951072 DOI: 10.2196/43130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 12/10/2022] [Accepted: 12/23/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND An assessment tool is needed to measure the clinical severity of nursing home residents to improve the prediction of outcomes and provide guidance in treatment planning. OBJECTIVE This study aims to describe the development of the Nursing Home Severity Index, a clinical severity measure targeted for nursing home residents with the potential to be individually tailored to different outcomes, such as pressure injury. METHODS A retrospective nonexperimental design was used to develop and validate the Nursing Home Severity Index using secondary data from 9 nursing homes participating in the 12-month preintervention period of the Turn Everyone and Move for Ulcer Prevention (TEAM-UP) pragmatic clinical trial. Expert opinion and clinical literature were used to identify indicators, which were grouped into severity dimensions. Index performance and validation to predict risk of pressure injury were accomplished using secondary data from nursing home electronic health records, Minimum Data Sets, and Risk Management Systems. Logistic regression models including a resident's Worst-Braden score with/without severity dimensions generated propensity scores. Goodness of fit for overall models was assessed using C statistic; the significance of improvement of fit after adding severity components to the model was determined using the likelihood ratio chi-square test. The significance of each component was assessed with odds ratios. Validation based on randomly selected 65% training and 35% validation data sets was used to confirm the reliability of the severity measure. Finally, the discriminating ability of models was evaluated using propensity stratification to evaluate which model best discriminated between residents with/without pressure injury. RESULTS Data from 1015 residents without pressure injuries on admission were used for the Nursing Home Severity Index-Pressure Injury and included laboratory, weights/vitals/pain, underweight, and locomotion severity dimensions. Logistic regression C statistic measuring predictive accuracy increased by 19.3% (from 0.627 to 0.748; P<.001) when adding four severity dimensions to Worst-Braden scores. Significantly higher odds of developing pressure injuries were associated with increasing dimension scores. The use of the three highest propensity deciles predicting the greatest risk of pressure injury improved predictive accuracy by detecting 21 more residents who developed pressure injury (n=58, 65.2% vs n=37, 42.0%) when both severity dimensions and Worst-Braden score were included in prediction modeling. CONCLUSIONS The clinical Nursing Home Severity Index-Pressure Injury was successfully developed and tested using the outcome of pressure injury. Overall predictive capacity was enhanced when using severity dimensions in combination with Worst-Braden scores. This index has the potential to significantly impact the quality of care decisions aimed at improving individual pressure injury prevention plans. TRIAL REGISTRATION ClinicalTrials.gov NCT02996331; http://clinicaltrials.gov/ct2/show/NCT02996331.
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Affiliation(s)
| | - Susan D Horn
- School of Medicine, University of Utah, Salt Lake City, UT, United States
| | - Phoebe D Sharkey
- Sellinger School of Business, Loyola University Maryland, Baltimore, MD, United States
| | - Katie R Brooks
- School of Nursing, Duke University, Durham, NC, United States
| | - Susan Kennerly
- College of Nursing, East Carolina University, Greenville, NC, United States
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Campbell AR, Kennerly S, Swanson M, Forbes T, Anderson T, Scott ES. Relational Quality Between the RN and Nursing Assistant: Essential for Teamwork and Communication. J Nurs Adm 2021; 51:461-467. [PMID: 34411062 DOI: 10.1097/nna.0000000000001046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Nurse (RN) and nursing assistant (NA) relational quality was examined along with associations between relational quality and evaluations of teamwork and communication. BACKGROUND RN and NA teams constitute the primary nursing care delivery method, and the quality of their relationship affects system capacity for improving patient outcomes; adverse events are linked to communication and teamwork breakdowns. METHODS RN (N = 889) and NA (263) relational quality was examined using a cross-sectional secondary analysis from system assessment with the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture. RESULTS RN and NA perceived relational quality indicated significant differences in teamwork and safety grade ratings, with both groups reporting perceived teamwork as high when patient safety grade was low. CONCLUSIONS This study supports the benefits of improving the RN-NA teamwork-communication relationship. An enhanced RN-NA relational quality can be used by nurse leaders to optimize patient care delivery outcomes.
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Affiliation(s)
- Amy Richmond Campbell
- Author Affiliations: Associate Clinical Professor (Dr Campbell), Professor (Dr Kennerly), Associate Clinical Professor (Dr Swanson), and Associate Professor (Dr Forbes), East Carolina University; Vice President of Quality (Dr Anderson), Vidant Medical Center; and Professor (Dr Scott), East Carolina University, Greenville, North Carolina
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Campbell AR, Kennerly S, Swanson M, Forbes T, Scott ES. Manager's influence on the registered nurse and nursing assistant relational quality and patient safety culture. J Nurs Manag 2021; 29:2423-2432. [PMID: 34272913 DOI: 10.1111/jonm.13426] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/20/2021] [Accepted: 07/15/2021] [Indexed: 11/28/2022]
Abstract
AIMS The purpose of this study is to describe the perceptions of relational quality of the registered nurse and nursing assistant and examine how their view of the manager's influence impacts overall patient safety culture of a unit. BACKGROUND The primary delivery of nursing care within acute care systems uses teams of registered nurses and nursing assistants. METHODS A cross-sectional secondary analysis of data collected in the spring of 2018 using the Agency for Healthcare and Quality Hospital Survey of Patient Safety Culture and a seven-item questionnaire measuring relational quality was conducted. The sample included 1,152 responses. RESULTS The manager influenced overall perceptions of safety regardless of the relational quality between the registered nurse and nursing assistant. CONCLUSIONS This study found manager behaviours that promote patient safety and also influence overall perceptions of patient safety culture regardless of the relational quality between the registered nurse and nursing assistant. IMPLICATIONS FOR NURSING MANAGEMENT Positive registered nurse and nursing assistant relational quality amplifies perceptions of patient safety culture, yet it is the manager's behaviours regarding safety that make the stronger contribution in building a culture of safety.
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Affiliation(s)
| | - Susan Kennerly
- Department of Nursing, East Carolina University, Greenville, North Carolina, USA
| | - Melvin Swanson
- Department of Nursing, East Carolina University, Greenville, North Carolina, USA
| | - Thompson Forbes
- Department of Nursing, East Carolina University, Greenville, North Carolina, USA
| | - Elaine S Scott
- Department of Nursing, East Carolina University, Greenville, North Carolina, USA
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Yap T, Alderden J, Sabol V, Horn S, Kennerly S. Real-time Positioning Among Nursing Home Residents Living With Dementia: A Case Study. Wound Manag Prev 2020. [DOI: 10.25270/wmp.2020.7.1622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Kitzmiller RR, Vaughan A, Skeeles-Worley A, Keim-Malpass J, Yap TL, Lindberg C, Kennerly S, Mitchell C, Tai R, Sullivan BA, Anderson R, Moorman JR. Diffusing an Innovation: Clinician Perceptions of Continuous Predictive Analytics Monitoring in Intensive Care. Appl Clin Inform 2019; 10:295-306. [PMID: 31042807 PMCID: PMC6494616 DOI: 10.1055/s-0039-1688478] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 03/18/2019] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The purpose of this article is to describe neonatal intensive care unit clinician perceptions of a continuous predictive analytics technology and how those perceptions influenced clinician adoption. Adopting and integrating new technology into care is notoriously slow and difficult; realizing expected gains remain a challenge. METHODS Semistructured interviews from a cross-section of neonatal physicians (n = 14) and nurses (n = 8) from a single U.S. medical center were collected 18 months following the conclusion of the predictive monitoring technology randomized control trial. Following qualitative descriptive analysis, innovation attributes from Diffusion of Innovation Theory-guided thematic development. RESULTS Results suggest that the combination of physical location as well as lack of integration into work flow or methods of using data in care decisionmaking may have delayed clinicians from routinely paying attention to the data. Once data were routinely collected, documented, and reported during patient rounds and patient handoffs, clinicians came to view data as another vital sign. Through clinicians' observation of senior physicians and nurses, and ongoing dialogue about data trends and patient status, clinicians learned how to integrate these data in care decision making (e.g., differential diagnosis) and came to value the technology as beneficial to care delivery. DISCUSSION The use of newly created predictive technologies that provide early warning of illness may require implementation strategies that acknowledge the risk-benefit of treatment clinicians must balance and take advantage of existing clinician training methods.
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Affiliation(s)
- Rebecca R. Kitzmiller
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Ashley Vaughan
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Angela Skeeles-Worley
- Curry School of Education and Human Development, University of Virginia, Charlottesville, Virginia, United States
| | - Jessica Keim-Malpass
- School of Nursing, University of Virginia, Charlottesville, Virginia, United States
| | - Tracey L. Yap
- School of Nursing, Duke University, Durham, North Carolina, United States
| | | | - Susan Kennerly
- College of Nursing, East Carolina University, Greenville, North Carolina¸ United States
| | - Claire Mitchell
- Curry School of Education and Human Development, University of Virginia, Charlottesville, Virginia, United States
| | - Robert Tai
- Curry School of Education and Human Development, University of Virginia, Charlottesville, Virginia, United States
| | - Brynne A. Sullivan
- Division of Neonatology, University of Virginia, Charlottesville, Virginia, United States
| | - Ruth Anderson
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Joseph R. Moorman
- Departments of Cardiology and Biomedical Engineering, University of Virginia, Charlottesville, Virginia, United States
- Center for Advanced Medical Analytics, University of Virginia, Charlottesville, Virginia, United States
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Yap T, Kennerly S, Horn S, Bergstrom N, Colon-Emeric C. TEAM-UP CLINICAL TRIAL: INVESTIGATING REPOSITIONING INTERVALS FOR NURSING HOME PRESSURE ULCER/INJURY PREVENTION. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - S Kennerly
- East Carolina University College of Nursing
| | - S Horn
- University of Utah School of Medicine
| | - N Bergstrom
- University of Texas at Houston, School of Nursing
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Woznyj HM, Heggestad ED, Kennerly S, Yap TL. Climate and organizational performance in long-term care facilities: The role of affective commitment. J Occup Organ Psychol 2018. [DOI: 10.1111/joop.12235] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Batchelor-Murphy M, McConnell E, Anderson R, Barnes A, Yap T, Kennerly S, Colon-Emeric C. HOW NURSING HOME STAFF MANAGE CHALLENGING FEEDING BEHAVIORS IN RESIDENTS WITH DEMENTIA. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - E.S. McConnell
- Duke University, School of Nursing, Durham, North Carolina,
- Geriatric Research, Education and Clinical Center (GRECC) of the Department of Veterans Affairs Medical Center, Durham, North Carolina,
| | - R.A. Anderson
- University of North Carolina Chapel Hill, School of Nursing, Chapel Hill, North Carolina
| | - A. Barnes
- Duke University, School of Nursing, Durham, North Carolina,
| | - T. Yap
- Duke University, School of Nursing, Durham, North Carolina,
| | - S. Kennerly
- East Carolina University, College of Nursing,
Greenville, North Carolina,
| | - C. Colon-Emeric
- Geriatric Research, Education and Clinical Center (GRECC) of the Department of Veterans Affairs Medical Center, Durham, North Carolina,
- Duke Medicine, Durham, North Carolina,
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Kennerly S, Yap T. EXPLORING THE ADAPTIVE AND TECHNICAL CHALLENGES NURSING STAFF EXPERIENCE IN USING NEW TECHNOLOGY. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S. Kennerly
- College of Nursing, East Carolina University, Chapel Hill, North Carolina,
| | - T. Yap
- Duke University, Durham, North Carolina
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Yap T, Kennerly S. EXAMINING THE IMPACT OF NURSING CULTURE ON TECHNOLOGY USE TO FACILITATE CARE PRACTICES. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T. Yap
- School of Nursing, Duke University, Durham, North Carolina,
| | - S. Kennerly
- East Carolina University, Greenville, North Carolina
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Yap T, Kennerly S. THE USE OF MUSICAL CUEING TO FACILITATE AND IMPROVE CARE PRACTICES IN NURSING HOMES. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- T. Yap
- Duke University, School of Nursing, Durham, North Carolina,
| | - S. Kennerly
- East Carolina University, College of Nursing, Greenville, North Carolina
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Corazzini KN, Vogelsmeier A, McConnell ES, Day L, Kennerly S, Mueller C, Flanagan JT, Hawkins K, Anderson RA. Perceptions of Nursing Practice: Capacity for High-Quality Nursing Home Care. Journal of Nursing Regulation 2015. [DOI: 10.1016/s2155-8256(15)30780-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Kennerly S, Boss L, Yap TL, Batchelor-Murphy M, Horn SD, Barrett R, Bergstrom N. Utility of Braden Scale Nutrition Subscale Ratings as an Indicator of Dietary Intake and Weight Outcomes among Nursing Home Residents at Risk for Pressure Ulcers. Healthcare (Basel) 2015; 3:879-97. [PMID: 27417802 PMCID: PMC4934619 DOI: 10.3390/healthcare3040879] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 08/23/2015] [Accepted: 09/21/2015] [Indexed: 11/16/2022] Open
Abstract
The Braden Scale for Pressure Sore Risk(©) is a screening tool to determine overall risk of pressure ulcer development and estimate severity of specific risk factors for individual residents. Nurses often use the Braden nutrition subscale to screen nursing home (NH) residents for nutritional risk, and then recommend a more comprehensive nutritional assessment as indicated. Secondary data analysis from the Turn for Ulcer ReductioN (TURN) study's investigation of U.S. and Canadian NH residents (n = 690) considered at moderate or high pressure ulcer (PrU) risk was used to evaluate the subscale's utility for identifying nutritional intake risk factors. Associations were examined between Braden Nutritional Risk subscale screening, dietary intake (mean % meal intake and by meal timing, mean number of protein servings, protein sources, % intake of supplements and snacks), weight outcomes, and new PrU incidence. Of moderate and high PrU risk residents, 61.9% and 59.2% ate a mean meal % of <75. Fewer than 18% overall ate <50% of meals or refused meals. No significant differences were observed in weight differences by nutrition subscale risk or in mean number protein servings per meal (1.4 (SD = 0.58) versus 1.3 (SD = 0.53)) for moderate versus high PrU risk residents. The nutrition subscale approximates subsequent estimated dietary intake and can provide insight into meal intake patterns for those at either moderate or high PrU risk. Findings support the Braden Scale's use as a preliminary screening method to identify focused areas for potential intervention.
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Affiliation(s)
- Susan Kennerly
- School of Nursing, University of North Carolina at Charlotte, Charlotte, NC 28223, USA.
| | - Lisa Boss
- School of Nursing, UT Health Houston, Houston, TX 77030, USA.
| | - Tracey L Yap
- School of Nursing, Duke University, Durham, NC 27710, USA.
| | | | - Susan D Horn
- School of Medicine, University of Utah, Salt Lake City, UT 84108, USA.
| | - Ryan Barrett
- International Severity Information Systems and the Institute for Clinical Outcomes Research, Salt Lake City, UT 84102, USA.
| | - Nancy Bergstrom
- School of Nursing, UT Health Houston, Houston, TX 77030, USA.
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Kennerly S, Heggestad ED, Myers H, Yap TL. Using the Nursing Culture Assessment Tool (NCAT) in Long-Term Care: An Update on Psychometrics and Scoring Standardization. Healthcare (Basel) 2015; 3:637-47. [PMID: 27417786 PMCID: PMC4939571 DOI: 10.3390/healthcare3030637] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 07/08/2015] [Accepted: 07/21/2015] [Indexed: 11/16/2022] Open
Abstract
An effective workforce performing within the context of a positive cultural environment is central to a healthcare organization's ability to achieve quality outcomes. The Nursing Culture Assessment Tool (NCAT) provides nurses with a valid and reliable tool that captures the general aspects of nursing culture. This study extends earlier work confirming the tool's construct validity and dimensionality by standardizing the scoring approach and establishing norm-referenced scoring. Scoring standardization provides a reliable point of comparison for NCAT users. NCAT assessments support nursing's ability to evaluate nursing culture, use results to shape the culture into one that supports change, and advance nursing's best practices and care outcomes. Registered nurses, licensed practical nurses, and certified nursing assistants from 54 long-term care facilities in Kentucky, Nevada, North Carolina, and Oregon were surveyed. Confirmatory factor analysis yielded six first order factors forming the NCAT's subscales (Expectations, Behaviors, Teamwork, Communication, Satisfaction, Commitment) (Comparative Fit Index 0.93) and a second order factor-The Total Culture Score. Aggregated facility level comparisons of observed group variance with expected random variance using rwg(J) statistics is presented. Normative scores and cumulative rank percentages and how the NCAT can be used in implementing planned change are provided.
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Affiliation(s)
- Susan Kennerly
- School of Nursing, University of North Carolina at Charlotte, Charlotte, NC 28223, USA.
| | - Eric D Heggestad
- Department of Psychology and Organizational Science, University of North Carolina at Charlotte, Charlotte, NC 28223, USA.
| | - Haley Myers
- Department of Organizational Science, University of North Carolina at Charlotte, Charlotte, NC 28223, USA.
| | - Tracey L Yap
- School of Nursing, Duke University, Durham, NC 27710, USA.
- Center for the Study of Aging and Human Development, Duke University, Durham, NC 27710, USA.
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Corazzini KN, McConnell ES, Day L, Anderson RA, Mueller C, Vogelsmeier A, Kennerly S, Walker B, Flanagan JT, Haske-Palomino M. Differentiating Scopes of Practice in Nursing Homes: Collaborating for Care. Journal of Nursing Regulation 2015. [DOI: 10.1016/s2155-8256(15)30009-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Yap TL, Kennerly S, Corazzini K, Porter K, Toles M, Anderson RA. Evaluation of Cueing Innovation for Pressure Ulcer Prevention Using Staff Focus Groups. Healthcare (Basel) 2014; 2:299-314. [PMID: 27429278 PMCID: PMC4934592 DOI: 10.3390/healthcare2030299] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 07/03/2014] [Accepted: 07/10/2014] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED The purpose of the manuscript is to describe long-term care (LTC) staff perceptions of a music cueing intervention designed to improve staff integration of pressure ulcer (PrU) prevention guidelines regarding consistent and regular movement of LTC residents a minimum of every two hours. The Diffusion of Innovation (DOI) model guided staff interviews about their perceptions of the intervention's characteristics, outcomes, and sustainability. METHODS This was a qualitative, observational study of staff perceptions of the PrU prevention intervention conducted in Midwestern U.S. LTC facilities (N = 45 staff members). One focus group was held in each of eight intervention facilities using a semi-structured interview protocol. Transcripts were analyzed using thematic content analysis, and summaries for each category were compared across groups. RESULTS The a priori codes (observability, trialability, compatibility, relative advantage and complexity) described the innovation characteristics, and the sixth code, sustainability, was identified in the data. Within each code, two themes emerged as a positive or negative response regarding characteristics of the innovation. Moreover, within the sustainability code, a third theme emerged that was labeled "brainstormed ideas", focusing on strategies for improving the innovation. IMPLICATIONS Cueing LTC staff using music offers a sustainable potential to improve PrU prevention practices, to increase resident movement, which can subsequently lead to a reduction in PrUs.
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Affiliation(s)
- Tracey L Yap
- School of Nursing, Duke University, Durham, NC 27710, USA.
- Center for the Study of Aging and Human Development, Duke University, Durham, NC 27710, USA.
| | - Susan Kennerly
- School of Nursing, University of North Carolina at Charlotte, Charlotte, NC 28223, USA.
| | - Kirsten Corazzini
- School of Nursing, Duke University, Durham, NC 27710, USA.
- Center for the Study of Aging and Human Development, Duke University, Durham, NC 27710, USA.
| | - Kristie Porter
- RTI International, Research Triangle Park, NC 27709, USA.
| | - Mark Toles
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Ruth A Anderson
- School of Nursing, Duke University, Durham, NC 27710, USA.
- Center for the Study of Aging and Human Development, Duke University, Durham, NC 27710, USA.
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Abstract
Turnover of nurse faculty is an increasingly important issue in nursing as the available number of qualified faculty continues to decrease. Understanding the factors that contribute to turnover is important to academic administrators to retain and recruit qualified nursing faculty. The purpose of this study was to examine predictors of turnover intention in nurse faculty working in departments and schools of nursing in Carnegie Doctoral/Research Universities-Extensive, public and private, not-for-profit institutions. The multidimensional model of organizational commitment was used to frame this study. The predictor variables explored were organizational climate, organizational commitment, work role balance, role ambiguity, and role conflict. The work roles examined were research, teaching, and service. Logistical regression was performed to examine the predictors of turnover intention. Organizational climate intimacy and disengagement, affective and continuance organizational commitment, and role ambiguity were shown to predict turnover intention in nurse faculty.
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Kennerly S. The impending reimbursement revolution: how to prepare for future APN reimbursement. Nurs Econ 2007; 25:81-4, 55. [PMID: 17500492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Health care reimbursement reform is underway as part of a national effort to enhance quality outcomes and bring spiraling health care costs under control. Implications of pay-for-performance reimbursement are discussed along with ways to prepare for changes in APN reimbursement.
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Affiliation(s)
- Susan Kennerly
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
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Abstract
Advanced practice nurses (APNs) are well prepared for patient care, but not for the financial aspects of clinical practice. A lack of reimbursement knowledge and skills limits the prospects for APNs to be key players in business and practice ventures. Faculty are challenged to strengthen the advanced practice reimbursement component of the financial management core to promote the reimbursement competency of APNs. The author discusses 4 primary content categories that are critical to financial success in clinical practice.
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Affiliation(s)
- Susan Kennerly
- College of Nursing, University of Cincinnati, Cincinnati, Ohio 45221-0038, USA.
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Abstract
Multimedia is a vehicle for fostering interaction and reinforcing the connection between curriculum and learning. The author discusses ways to energize, reshape, and enrich educational experiences by integrating multimedia into instruction. Examples of teaching-learning strategies and processes that promote learner-content, learner-learner, and learner-instructor interactions are offered to demonstrate how multimedia use can enhance student self-reflection, problem solving, critical analysis, cultural sensitivity, and acquisition and development of new knowledge.
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Affiliation(s)
- S Kennerly
- College of Nursing, University of Cincinnati, Ohio, USA.
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Abstract
The popular notion that worker autonomy is an outcome of shared governance is challenged in this critical analysis of the author's research and selected literature. Growing evidence is presented that environment, expectations, and clarity of meaning play important roles in fostering and supporting personal autonomy. Staff and administrators can use this valuable information about autonomy to refocus partnership models and team-based strategies for enhanced team effectiveness.
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Affiliation(s)
- S Kennerly
- College of Nursing, University of Cincinnati, Ohio, USA.
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Kennerly S. A Case of Quadruple Birth. Med Exam (Phila) 1854; 10:693-694. [PMID: 38121887 PMCID: PMC10317415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
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