Development of a Transformational, Relationship-Based Charge Nurse Program

95 Pages·2017·1.85 MB·English

Walden University
ScholarWorks
Walden Dissertations and Doctoral Studies
Walden Dissertations and Doctoral Studies
Collection
2017
Development of a Transformational, Relationship-
Based Charge Nurse Program
Kimetha D. Broussard
Walden University
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Walden University

College of Health Sciences

This is to certify that the doctoral study by

Kimetha Broussard

has been found to be complete and satisfactory in all respects,
and that any and all revisions required by
the review committee have been made.

Review Committee
Dr. Marisa Wilson, Committee Chairperson, Nursing Faculty
Dr. Murielle Beene, Committee Member, Nursing Faculty
Dr. Jonas Nguh, University Reviewer, Nursing Faculty

Chief Academic Officer
Eric Riedel, Ph.D.

Walden University
2017
Abstract

Development of a Transformational,
Relationship-Based Charge Nurse Program
by
Kimetha D. Broussard

MS, University of Oklahoma, 2004
BS, Southwestern Oklahoma State University, 1996

Project Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Nursing Practice

Walden University
August 2017
Abstract
Leaders of a rural Southwest Oklahoma hospital requested the development of an
evidence-based program that could transform unit charge nurses into effective leaders in
order to improve the leadership of direct care nurses. Nursing executive leadership
discovered staff members were demonstrating high levels of stress, dissatisfaction, and
burnout. Press-Ganey survey results revealed that staff felt they were not supported and
did not believe nurses cared for patients’ or other co-workers’ well-being or safety. The
Hospital Consumer Assessment of Healthcare Providers and Systems outcome scores
which were below hospital and national desired benchmarks revealed that patients were
not satisfied with the care they received. Thus, the goal of this project was to use
evidence to craft a program and evaluation plan that could be used by the hospital to
develop stronger charge nurse leaders. A detailed examination of evidence supported the
development of a program based on the relationship-based care (RBC) model. The RBC
model is a transformational leadership development program that increases leadership
skills and positive interaction between people. A full program was adapted from the RBC
model and designed for the rural hospital. An evaluation plan to measure the short-and
long-term objectives was developed. Implementation is expected to create social change
by imparting charge nurses with leadership and relationship skills, thus empowering them
with greater abilities to provide care. Benner’s novice to expert and Watson’s theory of
caring models served as the foundation of the RBC model. The goal is to present the
results at the hospital level and to disseminate the findings locally at professional nursing
leadership conferences.
Development of a Transformational,
Relationship-Based Charge Nurse Program
by
Kimetha D. Broussard

MS, The University of Oklahoma, 2004
BS, Southwestern Oklahoma State University, 1996

Project Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Nursing Practice

Walden University
August 2017
Dedication
This project is dedicated to charge nurses employed in healthcare hospitals who
feel they were selected as the next one up for the charge nurse position but were not
granted the benefit of attending a formal leadership program. This project is also in
dedication to those up-and-coming charge nurses who will be granted the privilege of
attending a relationship based care program. The relationship-based care charge nurse
program was developed to bring about a sense of leadership, competency and self-
empowerment in performing the charge nurse role.
Acknowledgments
The project completion was with the support and encouragement of my family
and friends. First, I would like to send a huge thank you to my precious and beloved
mother who was my best friend and greatest life supporter. Thank you for always
encouraging me to do more, to reach higher and to lend a hand-up to bring others along
the way. Next, to my husband, who believed in me, constantly prayed for me and who
funded my educational endeavors as a life-long learner. To my children, grandchildren
and sister who supported me and told me I could do it when I felt overwhelmed and ready
to throw in the towel. I thank everyone who contributed in any form, great or small, and
believed I could obtain a doctoral of nursing practice degree.
I would like to thank all my Walden professors and especially my project
committee chair, committee member and URR for their support and encouragement
during my development as a doctor of nursing practice. This project would have been
difficult beyond measure without the support and guidance of my preceptor. I would like
to thank you for supporting the advancement of the nursing profession by being an
exceptional preceptor and mentor. Lastly, but above all, I thank God and Jesus Christ, my
father, in whom I can do all things.
Table of Content
List of Tables .......................................................................................................................v
Section 1: Nature of the Charge Nurse Project ....................................................................1
Introduction ....................................................................................................................1
Problem Statement .........................................................................................................4
Significance and Relevance to Practice .........................................................................5
Purpose Statement and Project Objectives ....................................................................7
Project Question .............................................................................................................8
Reductions in Gaps ........................................................................................................8
Implications for Social Change in Practice ..................................................................10
Definition of Terms......................................................................................................11
Scope of the Study .......................................................................................................12
Assumptions .................................................................................................................13
Limitations ...................................................................................................................14
Delimitation .................................................................................................................14
Summary ......................................................................................................................15
Section 2: Review of the Literature ...................................................................................16
Introduction ..................................................................................................................16
Specific Literature of a RBC Charge Nurse Program ..................................................17
General Literature of Charge Nurse Leadership ..........................................................21
Conceptual Models and Theoretical Framework .........................................................25
Summary ......................................................................................................................28
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Section 3: Methodology .....................................................................................................29
Approach ......................................................................................................................29
Course Objectives ........................................................................................................30
Course Modules ...........................................................................................................31
Module 1: Charge Nurse’s Role and Job Description ...........................................31
Module 2: Leadership Styles and Completion of the Self-Assessment
Pretest .........................................................................................................31
Module 3: Foundations of Empowerment .............................................................32
Module 4: Responsibility, Authority, and Accountability (R+A+A) ....................33
Module 5: Disciplines of Execution using principles of I2E2 ...............................33
Module 6: Building Trusting Relationships ...........................................................34
Module 7: Crucial Confrontations .........................................................................35
Module 8: Effective and Ineffective Communication ...........................................35
Module 9: Appreciative Methods ..........................................................................36
Module 10: Lean Methodology .............................................................................36
Module 11: Hospital Nuts and Bolts ......................................................................37
Module 12: Summary, Self-Assessment Posttest and Program Evaluation ..........37
Population and Sample ................................................................................................38
Program Design ...........................................................................................................39
Data Collection ............................................................................................................39
Data Analysis ...............................................................................................................42
Project Evaluation Plan ................................................................................................43
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Summary ......................................................................................................................44
Section 4: Findings and Recommendations .......................................................................45
Introduction ..................................................................................................................45
Findings and Implications ............................................................................................46
Discussion ....................................................................................................................48
Positive Social Change ................................................................................................49
Recommendations ........................................................................................................51
Contribution of the Doctoral Project Team .................................................................54
Strength and Limitations of the Project .......................................................................57
Program Strengths ..................................................................................................57
Limitations of the project .......................................................................................58
Summary ......................................................................................................................58
Section 5: Dissemination Plan of the Scholarly Product.... ...............................................59
Introduction ..................................................................................................................59
Dissemination ..............................................................................................................60
Analysis of Self ............................................................................................................63
Scholar ...................................................................................................................64
Practitioner .............................................................................................................64
Project Manager .....................................................................................................65
Project Completion ......................................................................................................66
Summary ......................................................................................................................67
References ..........................................................................................................................69
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