Abstracts

Ordered by Abstract ID

2-QI. Improving HIV/STI Screening for Older Adults in A Primary Care Clinic

Cassandre Milien, DNP, RN; St. Thomas University; Miami, Florida

9/27/2024, 12:00pm - 1:50pm, Breakout: Poster Showcase

This quality improvement project aimed to address the gap in HIV/STI screening by implementing guidelines from the American Academy of Family Physicians (AAFP) in a primary care clinic through a quantitative, quasi-experimental design. The project employed the COM-B theory and Kotter's 8-step model to enhance provider engagement in screening. A chi-square test was conducted to determine whether implementing the educational program impacted HIV/STI screening and referral among older adults at the project site. Pre-and-post intervention data regarding STI screening rates obtained from patient electronic health records showed a statistically significant increase in screening rates, from 2% to 10%, p < .0001. While provider knowledge and attitudes improved by 13.7%, this increase was not statistically significant, p = .67. The positivity rate for patients also saw a statistically significant increase, from 7% to 8%, p = .0035. These results suggest that implementing the educational intervention not only boosted screening rates but also improved provider capabilities in identifying positive cases.

3-R. The Relationship Between Gratitude and Job Satisfaction in Nursing Leadership

Tammy Aiken, DNP, RN; Bassett Healthcare System; Cooperstown, New York

9/27/2024, 12:00pm - 1:50pm, Breakout: Poster Showcase

In the current healthcare climate, retaining our workforce has become increasingly important. Even more so the retention of nursing leadership has become even more crucial, as the need to have nurse leaders guide the profession during tenuous and difficult times is now even more apparent. Looking at ways hospital organizations can potentially increase their retention of leaders, which would assist in the retention of their staff, would be instrumental in easing labor shortage and therefore improve the quality of care. There has been a great deal of research that has shown that gratitude plays a significant role in a person’s attitude, such as job satisfaction. These studies have included all disciplines and industries, including healthcare, but few focused on nurse leaders. The purpose of this study is to see if there is a significant relationship between gratitude and job satisfaction in nursing leadership. This presentation will also address what organizations can do to support this practice and the effect on its work environment.

4-ASP. Revolutionizing Nursing Leadership: The Power of Caring Science and the Caritas Leadership Program

Sara Horton-Deutsch, PhD, RN, FAAN, ANEF, SGAHN; University of San Francisco; San Francisco, California

9/26/2024, 2:10pm - 3:00pm, Breakout: 3

The Caring Science Leadership Program champions authentic human connections at the forefront of modern leadership, celebrating diversity and whole-person care. It fosters a spiritual leadership journey that values transparency, vulnerability, and unity over traditional power dynamics, encouraging environments of mutual respect and love. Central to this program are the principles of the Ethic of Belonging, Ethics of Face, Ethics of Hand, and Transpersonal Unitary Consciousness. These guide leaders on a transformative path, actualized through the Caritas Leadership Program—a 6-month immersive experience facilitated by WCSI Faculty Associates from academic and practice settings. The program involves executive dialogues, Caritas Leadership circles, and the collaborative creation of transformation plans, promoting personal authenticity and distinctive leadership contributions. The program was built and flourishes through solid academic-practice partnerships. This spiritual journey allows leaders to discover themselves and implement Caritas principles into practical caring-healing practices, fostering cultures of care that go beyond mechanistic healthcare approaches. Participants will learn how those who complete the program become beacons of trust and compassion, enhancing humility and appreciation within their organizations. The Caritas Leadership Program's impact is lasting, instilling a heightened awareness of caring leadership, embracing Unitary Caring Science, and enacting the 10 Caritas Processes. It encourages open communication, gratitude, recognition of contributions, and dignity for all, steering healthcare leadership in both academic and practice settings toward a future rooted in care, compassion, and moral integrity.

5-R. An International Comparison of Staff Perceptions of Professional Governance

Roberta Kaplow, Ph.D., APRN-CCNS, AOCNS, CCRN, FAAN; Emory University Hospital; Atlanta, Georgia

9/26/2024, 2:10pm - 3:00pm, Breakout: 2

Objective The objectives of this study were to evaluate differences among RNs and nurse leaders’ perceptions regarding shared governance (SG), and discern differences in perceptions regarding demographic variables, and determine if there are differences in perceptions of SG between two hospitals. Background Data suggest a relationship between SG and improved patient outcomes, nurses’ job satisfaction, and workplace engagement. Methods A cross-sectional descriptive comparative design was used. Perception of SG at two academic medical centers were compared. The United States (US) center has Magnet designation; the German center is pursuing designation. Participants completed a demographics questionnaire and the IPNG 3.0 (50 questions). Results Data indicated mostly traditional governance with some staff input. The US facility had higher IPNG scores than Germany except for the resources and goals subscales. No significant differences were seen between IPNG scores and most demographic variables. Conclusion Results reveal differences in all IPNG subscales between the sites.

6-R. Voices of the DNP Nurses

Patricia Allen, Ed.D., RN, CNE, ANEF, FAAN; Texas Tech University Health Sciences Center; Lubbock, Texas

9/27/2024, 10:10am - 11:00am, Breakout: 9

Problem, Background/Significance, Rationale: As a continuation of a previous study done in Texas, a 2021 mixed methods study investigated DNP practice across the USA to identify the distinctive skill set that DNP leaders bring to an organization was conducted. This study analyzed qualitative data for a year due to the extensive responses of the 207 participants. This presentation offers a portrait of how DNP leader’s practice across the USA as well as the impressive achievements shared by the DNP respondents. The significance of these findings is validation DNP graduates’ leadership in improving health outcomes. Consistent identification of DNP outcomes could inform executives, students and educators. Purpose, Specific Aims, Project Goals or Objectives: The DNP was created to produce more leaders in nursing. A gap in the literature appears to be specific outcomes of the DNP. For this reason, the study purpose included assessment of DNP graduates’ impact on staff, professional, and patient outcomes in local, regional, state, and global settings. The DNP Leaders in Practice Assessment Tool, previously validated in a study with Texas DNPs, was utilized to explore the following questions: a) How are DNP leaders consistently meeting the DNP Essential outcomes? And b) What do DNP leaders in the USA see as their strengths and their challenges in their chosen practice? Methods, Collaboration, Implementation and/or Evaluation Plan: Open ended text responses from the instrument DNP Leaders in Practice Assessment Tool were analyzed as an adjunct to a quantitative survey created in 2021. This approach is considered reasonable for the use of open text responses (LaDonna et al., 2018). One author has expertise in qualitative design and analysis providing ongoing rigor in analysis of findings with team consensus. Content analysis, specifically conventional and summative approaches as described by Hsieh and Shannon (2005) were used to analyze open ended responses. Researchers read the responses multiple times to gain a sense of meaning. Line by line coding was done to identify broad categories and subcategories, including specific concept areas, descriptors, and outcomes. A coding structure was developed using open ended responses of participants. New codes were added if content appeared to be different from existing codes. Category and subcategory codes were identified and consensus reached by all team members. A codebook of categories, subcategories, codes and exemplars was constructed to enable discussion and reach consensus. Subcategories were discovered for all categories and used to further organize the data. Results/Outcomes and Implications: Qualitative thematic analysis from text responses yielded the following three main categories, Implementation, Dissemination, and Professional Expectations, each with subcategories. DNP graduates documented a range of innovative leadership projects including: involvement in policy and advocacy initiatives at the state level, creating and leading an emerging leader hospital program, mentoring students and new leaders, expanding shared governance structure from a facility to system-wide, disseminating projects and innovations through conferences and publications, and serving on a variety of local to national boards. Implications for leaders considering the DNP degree or hiring a DNP graduate include: improved quality of care, influence and innovation.

7-QI. Impact of Interdisciplinary Rounding on Complex Medical Units on Length of Stay in an Academic Medical Center

Palactine Fleming, MSN, RN; Emory University Hospital; Atlanta, Georgia

9/27/2024, 2:00pm - 2:50pm, Breakout: 14

Background. An increasing number of patients experience delayed hospital discharge after they are deemed medically appropriate for discharge. Discharge delays may be related to patient need for living assistance or a different venue (with financial challenges), patient/family dispute over discharge plans, or lack of social support. Delayed discharge is associated with a number of sequelae (e.g., functional decline, mortality, and increased ‘never events’ [e.g., falls, pressure injuries, nosocomial infections]). It also results in increased hospital costs. Purpose. The goal of this project was to implement a test of change to decrease discharge delays. Methods. Nursing and medical leaders collaborated to develop a process for daily interdisciplinary rounds (IDRs). All patients are discussed to determine readiness for hospital discharge. Those ready have discharge orders written the day before. In collaboration with the IT Department, a discharge tracker was implemented in the electronic medical record. As rounds are conducted and the patient’s plan of care is updated, an expected discharge date is entered. As the date of anticipated discharge approaches, nurses and physicians receive a visual reminder to continue preparing the patient for discharge. Results. As a result of our interdisciplinary collaboration and implementation of IDRs, our project has resulted in improvements in three metrics. The range of mean hours from discharge order written to time the patient left was from 2.58 to 5.92 hours. Our most recent data reflect a decrease from 5.64 hours to 4.84 hours. The average time length of stay decreased from 4.99 to 4.37 days. Our range of patients being discharged from the hospital by 11 AM was from 3.1% to 24.5%. Our most recent data reveal an increase from 5.1% to 15.6%. Conclusion. IDRs is a valuable strategy for reducing LOS by promoting collaboration, communication, and coordination. By taking a holistic approach to patient care and addressing factors that may impact discharge, IDRs can contribute to more efficient care delivery, ultimately leading to decreased LOS. By bringing the team together, IDRs streamlined communication and collaboration. They allow for ongoing monitoring of patient progress. If there are changes, the team can adjust the care plan and address issues, helping to prevent discharge delays.

8-QI. CLABSI Prevention: It Takes a Village

QI, Berhanu; Nursing; Emory University Hospital, Georgia

9/27/2024, 12:00pm - 1:50pm, Breakout: Poster Showcase

Background. CLABSIs lead to prolonged hospital stays and increase healthcare costs and mortality. Most cases are preventable with proper aseptic techniques, surveillance, and management strategies. Interdisciplinary collaboration to prevent non-reimbursable ‘never events’ is essential to a comprehensive CLABSI prevention program. Purpose. The goal of this project was to implement an interdisciplinary test of change to mitigate CLABSI development. Methods. A PDSA method was used for this improvement project. All nurses, physicians, advanced practice providers (APPs), social workers, physical/occupational therapists, the pharmacist and transplant coordinator assigned to your unit participated in an interdisciplinary collaboration and education session. A pre- and post-intervention knowledge assessment was conducted. The interdisciplinary team members were then asked if they would make central line evaluation a part of their routine and inform the nurse if the dressing was not intact and occlusive. Physicians and APPs were also asked if they would encourage patients to adhere with the daily CHG treatments. Results. As a result of our interdisciplinary collaboration, the abdominal transplant stepdown unit has not had a CLABSI in the past six months. Conclusion. Interdisciplinary collaboration is not only an essential leadership competency but also a key driver of innovation, problem-solving, and organizational success. Leaders who prioritize collaboration across disciplines are better positioned to tackle complex challenges, drive innovation, and achieve sustainable results.

9-R. Prevalence and Associations Among Burnout, Mental Health, Healthy Behaviors, and Workplace Attributes in Nurse Managers

Theresa Chenot, EdD, MS, MEd, MSN, RN, FNAP, FAAN; The Ohio State University; Columbus, Ohio

9/26/2024, 3:10pm - 4:00pm, Breakout: 4

Objective: To describe burnout, mental health, and healthy lifestyle behaviors of nurses in a managerial role and assess associations among workplace culture factors (perceived culture, mattering, support, and staff shortages) with burnout, mental health outcomes, and healthy lifestyle behaviors. Background: Nurse managers foster unit-based wellness cultures, yet burnout and mental health problems adversely impact the culture and well-being of staff. Methods: A cross-sectional, descriptive correlational design was used. The Florida Organization for Nursing Leadership enabled distribution of a wellness survey to nurse managers. Results: There were 125 participants. Healthy lifestyle behaviors were infrequently practiced. Analysis revealed significant correlations among workplace culture factors, burnout, and mental health outcomes. Those without staff shortages were 6.11x more likely not to screen positive for burnout than those with staff shortages. Conclusions: Health systems should address workplace culture factors and staff shortages to reduce burnout, improve mental health, and enhance healthy behaviors in nurse managers.

11-ASP. The Impact of Academic and Practice Organizational Collaboration on the Sustainability of Doctor of Nursing Practice Projects

Esther Chipps, PhD, RN, NEA-BC, FAONL; The Ohio State University Wexner Medical Center and The Ohio State University College of Nursing; Columbus, Ohio

9/28/2024, 11:10am - 12:00pm, Breakout: 24

There is a growing number of student Doctor of Nursing Practice (DNP) projects that healthcare organizations are being asked to support. The literature has identified consistent challenges healthcare organizations face in evaluating and supporting these projects. There is significant variation in the types of projects, implementation plans for projects, and project rigor. Many of these projects lack a plan for sustainability after the student completes the projects. This project aimed to review our organization's process for managing DNP projects, assess the sustainability of DNP final projects, and explore opportunities for increased collaboration between the practice and academia. Our healthcare organization's review committee undertook a quality review of 53 completed DNP projects to achieve this. Following an extensive literature review, we developed an interview guide for former students and the healthcare organizational leader from the practice area where the project was conducted. The student interviews addressed the origin of the project idea, alignment of the project with organizational priorities, staff engagement with the project, project outcomes, and sustainability. The healthcare organizational leaders were asked similar questions. A total of 53 projects were conducted over 8 years. Our committee contacted and interviewed 40 former students and 32 healthcare organization leaders. Fifty-seven percent of the former DNP students believe that their project was an organizational priority, and 77.5% reported that the staff in the unit/area were engaged in their project. Sixty-eight percent of the students believe that their project was sustained post-implementation. It was noted that sustainability was higher when the student remained employed at the organization where the project was conducted. In contrast to the students, only 31% of the projects were viewed as an organizational priority by the leader, and only 50% of the leaders were aware of the project's results. Several themes were identified: a greater need to align the organization's priorities with student projects; developing a formal process for the handoff of projects to the organization following project completion; improved collaboration for student project reviews between academic and practice organizations; collaboration between academia and practice organizations to identify high-priority projects; selection of practice mentors to facilitate project implementation and sustainability. In conclusion, academic and practice organizations must work closely to select and implement DNP projects that provide an educational learning opportunity for doctoral students and sustainable improvements for the organization.

12-EBP. Cultivating a Culture of Civility in the Nursing Workplace

Susan Rux, PhD, DNP, RN, ACNS-BC, CENP, CNE, CPCC, FACHE, LNCC, NEA-BC, NPD-BC, OCN; Fox Chase Cancer Center; Philadelphia, Pennsylvania

9/27/2024, 11:10am - 12:00pm, Breakout: 11

Incivility hinders the delivery of safe patient care, as well as negatively impacts nursing retention in the workplace. To foster positive patient outcomes and satisfaction, nurses must develop workplace civility skills. The purpose of this DNP doctoral project was to develop organizational civility staff education for the RNs within a specialty cancer center. The primary model used to inform this project was Clark’s conceptual model for fostering civility in nursing education adapted for practice to guide the development and implementation of the project. The practice-focused question for this DNP doctoral project explored if an evidence-based civility staff education project would increase the knowledge base for RNs about how to manage uncivil peer-to-peer encounters in the workplace. Nine RN participants from the ambulatory nurse navigation department within the specialty cancer center participated in the civility staff education project. Data from pretests, posttests, and module evaluations were analyzed. The results represented an increase in awareness and learning. The preexisting knowledge of the participants was 74%, with a net learning of 12.5% after an increase in the post education knowledge to 86.5%. All the participants noted concerns regarding incivility in their workplace, with the majority indicating an interest in receiving additional civility education in the future. Solutions to address the practice gap include ongoing civility education. The project findings have implications for positive social change. The improved peer relationships among nurses can transcend to patients and positively impact the overall patient experience due to the application of professional conduct and civility standards.

13-R. The CNOs’ Experience in Hospital Incident Command Systems (HICS) during the COVID-19 Pandemic: Insights Gained

Sarah McKinnon, MSN, RN; Barnes and Thornburg, LLP; Dallas, Texas

9/27/2024, 12:00pm - 1:50pm, Breakout: Poster Showcase

The CNOs’ Experience in Hospital Incident Command Systems (HICS) during the COVID-19 Pandemic: Insights Gained Background The COVID-19 pandemic undoubtedly has changed healthcare in many ways. During the pandemic, hospitals relied on their executive leaders to make quick and effective decisions. The Hospital Incident Command System (HICS) establishes a national standardized approach to managing complex incidents (Broughard, 2020). The goal of HICS is threefold: The continuation of delivering safe, high-quality care while managing resources and costs (Rash, 2020) during a human or naturally caused disaster or pandemic. Problem There is little doubt that COVID-19 resulted in hospitals placing extraordinary demands on nursing practice, safety, morale, and ethics (Kaye et al., 2021). Understanding the decision-making process of Chief Nursing Officers in HICS during the pandemic needs exploration to better evaluate how future responses to similar epidemics/pandemics/disasters can be improved. It is also critical to understand the role of the CNO in the proper allocation of resources and effective utilization of healthcare workers during crisis such as the COVID-19 pandemic (Kaye et al., 2021). Methods Research Objectives Narrative inquiry was be used to interview Texas CNOs, exploring their role and experiences in the utilization of HICS during the COVID-19 crisis. The participants interviewed were Texas Hospital CNOs during COVID-19 and utilized HICS. As a qualitative pilot study, there was focus on obtaining data through a defined set of questions, accompanied by open-ended and conversational communication, capturing “what” the CNO thinks and “why” they think so, in relation to improving their role in the HICS. Utilizing networking with project advisors, I identified 8 Texas Hospital CNOs. Once identified, each participant received an email with information about the study and a demographic survey to capture demographic quantitative data only. Each CNO received the questions prior to the interview to gain a more robust response. The interview focused on the CNOs leadership role, responses and decision making as a HICS team member during COVID, anticipating the identification of gaps and areas for improvement in the command chain or processes. Data Analysis Plan Interviews were audio-visual recorded using Zoom© software and transcription into English text was completed before natural language processing text analysis by NVIVO 12 Plus© software (QSR International, 2021). NVIVO© is a software program used to organize and manage qualitative and mixed-methods research data from several different imported sources including interview documentation in Microsoft Word©, Excel© documents, articles, videos, emails. Demographics, including age, years in nursing, education attainment, years in the chief nursing officer role were analyzed with descriptive statistics of frequency and percentages, using SPSS v25. The transcribed text from recordings of the interviews were converted to text via Otter A.I. © software, and subsequently entered an Excel© spreadsheet to facilitate transfer into IBM Professional SPSS v25© software for further and additional analysis and exploration. The data analysis plan was analyzed by Bioinformatic Scientist, Richard Gilder, MS, RN-C.

16-R. An Examination of Innovation Competencies and Organizational Culture in a Sample of Texas Registered Nurses: A Pilot Study

Linda Cole, DNP, APRN, CCNS, CNE, FCNS; Cizik School of Nursing, UT Health, Houston; Houston, Texas

9/27/2024, 12:00pm - 1:50pm, Breakout: Poster Showcase

Problem, Background/Significance, Rationale: The American Association of Colleges of Nursing [AACN] identified innovation as “a great idea, executed brilliantly, and communicated in a way that is both intuitive and fully celebrates the magic of the initial concept” as a competency needed by all nurses (2021, p. 60). The existing research shows individual innovation competencies of nurse leaders and organizational culture as precursors to innovation. The research problem concerns the lack of studies with direct care RNs. This study aimed to fill a knowledge gap by examining innovation competencies and associated organizational culture in a sample of direct care RNs. Focus on nursing innovation in direct care RNs is essential, as the COVID-19 pandemic forced all nurses to innovate to improve quality and costs. Purpose, Specific Aims, Project Goals, or Objectives: Research aims were focused on RNs’ ratings of 1) the importance of innovation competencies, 2) preparedness in innovation competencies, 3) innovativeness of their organizational culture, 4) associations among individual innovation competencies, importance of innovation competencies, and innovativeness of organizational culture, and 5) the differences in perceived importance of innovation competencies, perceived level of innovation competency, as well as perceived innovativeness of organizational culture based on demographic and organizational characteristics. Methods, Collaboration, Implementation, and/or Evaluation Plan: This observational, cross-sectional survey study used a convenience sample of direct care RNs in Texas. RNs were recruited through the Texas Nurses Organization and social media campaigns. Links to an anonymous electronic survey were provided, allowing interested RNs who meet inclusion criteria (hold a license as an RN in Texas, have access to the internet, actively practicing as a direct care RN in Texas) to access the survey. The survey included two tools with reported face validity and acceptable internal consistency reliability measuring innovativeness - the Innovation Competencies Questionnaire (Cronbach’s alpha = 0.96) and the Perceived Organizational Innovativeness Scale (PORGI) (Cronbach’s alpha = .073). Demographics and employment data were collected. Surveys took approximately 30 minutes. Results/Outcomes and Implications: Results from the pilot study indicated a difference between importance and competence scores (p < .032), with importance of innovation scores consistently higher than competence to innovate scores. Those employed at a Magnet organization had higher PORGI scores (p = .047), indicating that the organizational culture of Magnet facilities supported innovation. A small correlation (r = .216) between the innovation competency of resiliency and PORGI scores was noted. Innovation is a newly required competency for all nurses by the AACN. Although limited to Texas RNs, our pilot study was the first to provide knowledge on the innovation skills of direct care RNs. The pilot study noted that while direct care nurses felt innovation was important, they were not as competent in being innovative. The organizational culture of Magnet facilities supports the innovation of direct care RNs. This knowledge is essential for nurse leaders and academicians to prepare direct care RNs better to innovate and align organizational culture to support innovation.

17-QI. Health Policy for Health Professionals: Leadership in a 5-Year Collaboration

Francine Snow, DrPH, MSN, RN, CNE, NPD-BC; Cizik School of Nursing at UTHealth Science Center at Houston; Houston, Texas

9/26/2024, 3:10pm - 4:00pm, Breakout: 5

Problem Health-related agencies and organizations have called for the integration of health policy competencies into degree programs. Health policy and population-level advocacy are often underrepresented in curricula. To address this gap, one university designed a 5-year quality improvement plan to address this call to action to enhance health policy instruction. Evidence Evidence for needed change did not come from rigorous clinical trials but rather from accreditation and expert sources with years of observation of trends in the healthcare industry. This current trend is that health policy is being made and changed by legislators without a healthcare background. And policy should be driven by desired equitable outcomes of care. There is an identified need for nurses and other health professionals to engage in health policy and advocacy. These trends have been called out by the AACN 2021 Essentials where 9 of the 10 Domains include competency-based outcome behaviors that students should demonstrate, and from the Future of Nursing 2020-2030 Report stating nurses should engage in health policy and advocacy efforts. Nurses constitute the largest group of health professionals. If nursing spoke with a united voice, the profession, and all health professions together would be a powerful force for change. Implementation Learning modules and activities were designed collaboratively by faculty representing all six health profession schools which brought together students of nursing with those from medicine, dentistry, biomedical sciences, biomedical informatics, and public health. Faculty and students were engaged in the development and revision of material. Evaluation After completing year 2 of a 5-year plan, findings demonstrate significant improvement in knowledge gained around advocacy and health policy. Lesson Learned A team of faculty representing various health professions, with a collaborative spirit and strong relationships, can design interprofessional learning activities to assess and meet health policy and advocacy learning needs among students representing a variety of schools and degree plans.

18-R. Developing the Next Generation of Nurse Executives: A Nurse Executive Fellowship Program

Michelle Nelson, MSN, RN, NE-BC; University of Alabama & Norton Healthcare; Louisville, Kentucky

9/27/2024, 11:10am - 12:00pm, Breakout: 10

Abstract Introduction: Over the past several decades, the role of the Chief Nurse Executive has expanded and requires enhanced skills such as resilience and emotional intelligence to better address increased interprofessional teamwork and collaboration. With this enhanced scope and added responsibilities, many organizations are seeing a significant exodus of qualified candidates in the CNE role. Therefore, the purpose of this DNP project is to evaluate the impact a structured nurse executive fellowship program has on a nurse leader’s level of resilience and emotional intelligence. Methods: This is a mixed-methods, retrospective program evaluation of the Nurse Executive Fellowship program at a large community-based healthcare system in the Midwest. Twelve nursing directors were selected to participate in the program via an application and interview process. The two-year program consisted of didactic sessions, coaching sessions, immersion experiences, and completion of a process improvement project. The Wilcoxon signed-rank test was used to analyze the program’s impact on resilience and emotional intelligence. Dedoose software was used to identify themes from fellows’ comments during focus group sessions. Results: Both resilience and emotional intelligence levels were greater after the program (Mdn = 91; Mdn = 6 respectively) than before the program (Mdn = 88, p >0.025; Mdn = 5.88, p = 0.760). The greatest growth was seen in the areas of self-emotional appraisal (Mdn-pre = 6; Mdn-post = 6.7; p = 0.010) and total use of emotion (Mdn-pre = 5.75; Mdn-post = 6.5, p = 0.082). Discussion: Providing nurse leaders with a structured executive development program can increase levels of resilience and emotional intelligence, both of which are needed to successfully serve in the nurse executive role. Keywords: nurse executive development, resilience, emotional intelligence

25-R. Exploring Caregiver Support: Healthcare Leaders' Perspectives on Medical Errors

Denise Cummins, DNP, RN, WHNP-BC, CPHQ; Brigham Young University College of Nursing - Provo, UT; Provo, Utah

9/27/2024, 3:00pm - 3:50pm, Breakout: 18

Medical errors are usually multifactorial failures beyond individual caregivers’ control; nevertheless, caregivers may experience debilitating psychological trauma and other consequences, including legal action, after errors leading to patient harm. Organizational support can mitigate the detrimental effects of serious errors for caregivers but may be suboptimal. Healthcare leaders, including nursing executives, offer important perspectives and insights on caregiver support that should be used in developing robust CSPs. The purpose of this study is to examine healthcare leaders’ perspectives about medical errors and caregiver support. The aim is to derive insights that promote the development of optimal caregiver support after medical errors. Mixed methods were used in this research, including an electronic survey and semi-structured interviews. A convenience sample of healthcare leaders was recruited for participation through a purchased healthcare executive listserve, social media channels, and snowball sampling. Findings from the survey are included in this report. The semi-structured interviews are discussed in a separate abstract. The survey comprised three sections: •Güleç and Intepeler’s (2013) Medical Error Attitude Scale (MEAS) evaluated attitudes toward medical errors, including attitudes of blame, attitudes toward investigation and reporting, and perceptions about factors contributing to errors. •Twenty-nine multiple-choice questions evaluated perspectives about and experiences with caregiver support and CSPs; the questions were derived from best practice recommendations and themes noted in current literature. •Demographic data was collected. Seventy-nine healthcare leaders participated in the study. A majority (58%) were “C-suite” executives, including chief nursing officers, and most participants (82%) were employed in acute care settings. MEAS data revealed statistically significant differences in attitudes of blame and perceptions about factors contributing to errors based on demographic differences. Significant findings among participant responses to caregiver support questions include: •Less than 2/3 of participants’ organizations have a CSP •Significant barriers to establishing CSPs include a lack of resources (money, time, staff, expertise, or knowledge) and organizational leaders' lack of awareness or interest. •CSPs do not consistently include key elements advocated in best practice recommendations: significant gaps include confidentiality protections, executive champions, and tiers of support for caregivers who do not recover with peer support or face litigation. •CSPs are used inconsistently, possibly due to caregiver hesitation regarding confidentiality, legal protections, other ramifications, and caregiver stigma about errors and the need for support. •CSPs do not consistently support caregivers’ mental health or meet their needs after a serious error. •Most respondents believed their organization’s CSP contributes to a strong patient safety culture and is worth the expenditure of time, money, and effort. Nursing leaders should use best practice recommendations and collaborate with patient safety and quality improvement organizations to seek guidance and support in establishing robust CSPs. Efforts should initially focus on raising awareness among executive colleagues, re-evaluating strategic priorities, and deploying necessary resources. The effectiveness of existing CSPs should be thoroughly evaluated, and CSPs should be modified, as needed, to ensure they align with best practice recommendations and fully address caregiver needs.

26-ASP. Leadership during crisis: Developing Future Nurse Leaders Through a Large-Scale Mass Casualty Simulation

Matthew Anderson, DNP, APRN, FNP-C; Brigham Young University; Provo, Utah

9/27/2024, 10:10am - 11:00am, Breakout: 8

The escalating frequency of natural disasters, violent acts, and resultant mass casualties underscore the imperative nature of disaster preparedness and response within the realms of nursing practice and leadership. Nurses must cultivate the requisite skills to adeptly manage unforeseen crises, ensuring optimal patient outcomes. Consequently, integrating simulation of disaster scenarios into undergraduate education emerges as a crucial method to equip nursing students with the necessary competencies for effective participation and leadership in disaster response. This student-led Mass Casualty Incident (MCI) Simulation, conducted biannually by the College of Nursing and campus emergency medical services, provides a comprehensive leadership development experience for a substantial number of students. The drill planning, orchestrated in large part by students, involves organizing 100-150 individual patient roles and injuries, coordinating vital sign progressions based on care provided, securing on-campus locations, and collaborating with external partners from the community. The academic-service partnership formed between nursing students and Emergency Medical Technicians (EMTs), fire and rescue teams, and police exemplifies an extensive collaboration involving multiple organizations. This collaboration not only expands awareness of various aspects of disaster response but also improves collaborative skills in high-pressure situations. Nursing students engaged in this simulation event gain essential leadership and collaboration skills pivotal for their future roles in the healthcare sector. The extensive academic-service partnership and the scale of the simulation, involving ~300 participants, highlight the profound impact of this initiative. The MCI simulation serves as a transformative tool, fostering competency in both scientific proficiency, evidenced-based practice, and collaborative teamwork among nursing professionals. This initiative builds bridges of understanding between students, organizations, educators, and community members, ultimately contributing to the healthcare community by instilling a culture of leadership and teamwork.

27-ASP. Clinical Nurse Specialist Internship: Promoting an Academic and Health System Collaboration to Transition Registered Nurses to Advanced Practice Registered Nurses

Karrie Boss, DNP, RN, APRN, ACCNS-AG, EBP-C, CCRN; Summa Health; Akron, Ohio

9/27/2024, 12:00pm - 1:50pm, Breakout: Poster Showcase

Abstract Clinical nurse specialists (CNSs) are pivotal members of the health care team who drive quality outcomes and best practices. Unfortunately, many organizations have vacant CNS positions due to a nationwide CNS shortage. The CNS Academy is a collaborative partnership between a local university and a large healthcare system to recruit nurses to pursue CNS education while providing hands-on experience as a CNS intern. This “grow your own” approach provides on-the-job opportunities to gain CNS competencies and ease role transition upon graduation. The program recruited 5 nurses within the organization to pursue education as a CNS at the local university and provided tuition support, employment as a CNS intern, and mentorship by seasoned CNSs within the organization. As a result of growing our own CNSs who collaborated and supported front line staff, the organization saw a statistically significant positive change in the nurse engagement scores, particularly in autonomy, professional development, adequacy of resources and staffing, and teamwork and collaboration. Additionally, the 2023 RN turnover rate is at 14%, a 3% decrease from the previous year while the first-year turnover rate is 4% which was a decrease by 9% from the previous year. Furthermore, the CNS interns partnering with their CNS mentors, searched and synthesized the evidence on more than 15 initiatives in the past 18 months.

28-QI. The Center for Clinical Inquiry™: An Innovative Collaborative Model to Promote and Support Change

Penelope Gorsuch, DNP, rN, NEA-BC, EBP-C, FACHE; Summa Health; Akron, Ohio

9/26/2024, 3:10pm - 4:00pm, Breakout: 5

Problem/Background The purpose of this evidence-based practice quality improvement (EBPQI) leadership initiative was to address the lack of a nursing vision and strategy for creating a culture of inquiry to apply an evidence-based approach to solving problems. Using an evidence-informed theory practice is transformed through teamwork and collaboration. The significance of this lack of strategy as a driver of quality outcomes was evident in multiple quality measures being below the national benchmark. Additionally, engagement scores were below the national average, and nurse turnover over had increased to 17.4% while first-year turnover over had increased to 23%. Purpose Based on the synthesis of the literature, the purpose of this EBPQI initiative was to create a vision and strategy to elevate the professional practice of nursing following an evidence-based approach and to create an infrastructure to promote and support change management. Methods, collaboration, implementation, evaluation The strategic plan was created utilizing the Convergent Care Theory (Wei, 2022). An organizational assessment was completed utilizing the Advancing Research through Close Collaboration (ARCC) model (Melnyk and Fineout-Overholt, 1999). Additionally, a novel approach to creating the infrastructure necessary to promote and support change was used. Kotter (2014) explains that traditional, hierarchical, static organizational structures that operate singularly were not built for constantly changing environments. Kotter advocated for a new model, defined as a ‘dual operating system’ to manage complex, challenging issues. The Center for Clinical Inquiry™ represents Kotter’s model and provides the infrastructures to support staff in using an EBP methodology to solve problems (Gorsuch, et al., 2020). The human resources needed to build the infrastructure for The Center for Clinical Inquiry™ included a System Director of Evidence-based Practice (SD EBP) and System Director Nursing Professional Practice (SD NPP). Additionally, the manager for Nursing Data Quality now the System Director Nursing Data Analytics (SD NDA), and clinical leaders (Clinical Nurse Specialists (CNSs), EBP Specialists, RN Educators, and Magnet Director) were realigned to The Center for Clinical Inquiry™. Additionally, an important organizational consideration was the horizontal alignment and collaboration between nursing administrative (CNO, ACNOs, Directors, Nurse Managers) and clinical leaders. To further manage change, a “triad” leadership team consisting of Divisional Directors, CNSs, and RN Educators was created. Results, outcomes, implications The Center for Clinical Inquiry™ led two skill-building workshops educating over 200 interprofessionals in EBP and implementation strategies. Resources have been developed to organize, prioritize, implement, and sustain change. These resources include a centralized repository, an internal website, and an Evidence-based Practice and Research Council (EBPRC). A centralized repository was created to provide intake for clinical inquiry, a step-by-step guide with tools embedded to apply EBP methodology, and calculators to determine the return on investment. The 2023 RN turnover rate is at 14% and the first-year turnover rate is at 4%. Nurse engagement scores had a statistically significant increase and were higher than national average. There were more than 15 evidence-based practice or process changes implemented with a cost-avoidance calculated for five of those which demonstrated a savings of more than $2.1M.

29-R. An Academic Nurse Leader’s Action Guide to Improve Nurse Faculty Job Satisfaction

Cori Heier, PhD, RN, CNE, CHSE, NE-BC; University of Alabama at Birmingham; Birmingham, Alabama

9/27/2024, 11:10am - 12:00pm, Breakout: 10

Problem, Background/Significance, Rationale: Like in the clinical setting, nurse leaders in academe often come into their leadership role without specific knowledge or training in leadership. Thus, many struggle with knowing how to connect with their faculty, create a positive culture, and improve nurse faculty job satisfaction. In academic nursing, relational leadership approaches such as transformational leadership, have been associated with faculty job satisfaction. Despite this evidence, a gap remains in connecting theoretical concepts to specific, actionable behaviors academic nurse leaders can do to improve nurse faculty job satisfaction. Purpose, Specific Aims, Project Goals or Objectives: The purpose of this study was to 1) determine how academic nurse leader behaviors align with relational leadership theories, and 2) translate research and theory into practice by creating an action guide academic nurse leaders can use to improve nurse faculty job satisfaction. Methods, Collaboration, Implementation and/or Evaluation Plan: Literature was reviewed to identify core concepts of five relational leadership theories: adaptive, authentic, servant, transformational, and human-centered leadership in healthcare. Then, using inductive thematic analysis, academic nurse leader behavioral themes from a qualitative descriptive study were mapped to core concepts of the leadership theories. The theory most aligned with academic nurse leader behaviors that improve nurse faculty job satisfaction was identified and used to inform the creation of an action guide for academic nurse leaders. Results/Outcomes and Implications: Human-Centered Leadership in Healthcare (HCL-HC) emerged as the best-fit leadership theory for academic nurse leader behaviors that improve nurse faculty job satisfaction. Using the guiding principles of HCL-HC, an action guide for academic nurse leaders in any level of leadership, from directors to deans, was created to improve nurse faculty job satisfaction. The overarching action guide includes (a) getting to know your faculty, (b) contributing to a positive work environment, and (c) investing in yourself, with suggestions for specific behaviors described within each. Results from this analysis reveal that HCL-HC is an important emerging theory for academic nurse leaders to guide their actions to improve nurse faculty job satisfaction. These findings are in contrast with the widely accepted transformational leadership approach encouraged in the nursing profession. Academic nurse leaders should consider these findings and reflect on their leadership style and behaviors. With the implementation of an action guide for academic nurse leaders grounded in HCL-HC, improved nurse faculty job satisfaction can be realized, and nurse faculty retention may increase.

30-R. Breaking the Cycle of Nurse Manager Presenteeism

Claire Bethel, PhD, RN-BC; UPMC; Harrisburg, Pennsylvania

9/28/2024, 10:10am - 11:00am, Breakout: 21

The aim of this study was to describe the factors leading to nurse manager presenteeism and to explore coping strategies and consequences. Presenteeism, or presence at work while not fully functioning, is prevalent among direct-care nurses, yet no studies have explored nurse manager presenteeism. This study used a convergent mixed methods design with conventional content analysis of 1:1 interview transcripts, and descriptive/inferential statistics to analyze results from a demographic questionnaire, mental/physical health and work situation questions, and the Job-Stress-Related Presenteeism Scale (JSPS). The sample included 14 nurse managers from three hospitals in Central Pennsylvania. Mixed methods results revealed convergence among the quantitative and qualitative results. Quantitative results reveal participants’ physical and mental health, results of the JSPS, and inferences between presenteeism and health/demographic items. The overarching finding was the cyclic nature of presenteeism. Work demands and other contributing factors, like illness and personal factors, contribute to presenteeism, which leads to adverse consequences. The consequences lead to more work demands and can ultimately lead to considering quitting. The cycle can be broken by protective factors, coping mechanisms, and support. Executive leaders must help nurse managers break the cycle of nurse manager presenteeism or they risk losing their nurse managers. Nurse managers need fewer work demands and more support.

31-ASP. Activating Rural Health Equity through a Pioneering APRN Residency Program

Johanna Stiesmeyer, DNP, MS, RN, NPD-BC; JKStiesmeyer, LLC; PLACITAS, New Mexico

9/27/2024, 10:10am - 11:00am, Breakout: 8

Health inequity calls for focused national efforts to design innovative solutions addressing the rural population’s healthcare disparities. A triad of factors contributing to these inequities includes inadequate healthcare access, rural workforce shortages, and healthcare organizational financial constraints. Formidable poverty, poor health literacy, an aging population, challenging geographic healthcare access, and considerable chronic disease complexity generate daunting obstacles for the rural population served, the workforce providing care, and healthcare organizations. Recognizing this need, a Presbyterian Healthcare Services (PHS) interprofessional, Nursing Leadership-led team partnered with the University of New Mexico College of Nursing (UNM CON) to design the first Rural Advanced Practice Registered Nurse Residency in New Mexico. The focus of this effort was to create a workforce pipeline to attract and retain newly graduated APRNs in rural communities. Using UNM CON to collaborate and build a state-wide program gives PHS Nursing Leadership the advantage of combining extensive expertise, core competencies in operational design and services with academic resources and state-of-the-art knowledge in rural population care. This collaboration incorporated a curriculum development framework developed by Flinter & Bamrick’s groundbreaking work and a business strategy map to address the development, deployment, evaluation, and sustainment of the rural workforce pipeline. The Program goals included: obtaining executive sponsorship and investment, receiving national funding through a 4-year Health Resources and Services Administration (HRSA) Grant for new-graduate APRNs, gaining rural primary care clinic leadership and clinic team endorsement, and creating a rural care focused curriculum and clinical experience infrastructure that embraced the organization’s family practice primary care clinic workflows. The resulting Program produced a sustainable endeavor with significant return on investment. Twenty-one APRN residents expanded their rural population focused care needs expertise supported by expert preceptors and Program instructors. Focus areas included: wellness and disease prevention, women’s and children’s health, obesity, cultural competency for underrepresented patients of all diversity, equity and inclusion approaches, mental and behavioral health care with emphasis on suicide prevention, substance abuse, pain/opioid management, diabetes, aging patients, acute and chronic care management, procedures, coding, and effectively managing 15-20 patients a day. The APRN Residents saw over 8400 patients and addressed essential hypertension, diabetes, high-risk pregnancy, anxiety, pain management, severe stress and adjustment disorders, and lipoprotein metabolism disorders. Significant increases in the residents’ confidence in cultural care, pain and opioid management, clinic operational efficiency, procedural care, and mental/behavioral health resulted. All twenty-one residents found jobs and 79% remain in rural or underserved clinics in New Mexico, Florida, Colorado, Texas, California, and Georgia. Robust retention of the APRN residents as employees reduced turnover costs, increased procedural revenue, and successfully enculturated the APRNs into their team and community. This Program is replicable and can be groundbreaking for any organization considering building a program to address healthcare disparities. Lessons were discovered and included how to integrate educational platforms effectively, gaining program champions, securing funding even through executive leadership changes and intense organizational financial challenges, and incorporating an on-going data collection methodology to demonstrate significant program relevance in reducing health inequity.

33-QI. Quality Improvement: Collaborating to Improve Student Retention and Graduation Rates

Deborah Sikes, DNP, RN, CNE; Texas Tech University Health Sciences Center; El Paso, Texas

9/27/2024, 3:00pm - 3:50pm, Breakout: 17

Nurse educators are charged with preparing students to take the NCLEX upon graduation. Students who withdraw or are academically dismissed from nursing programs incur a significant financial burden and may negatively impact their future pathway toward becoming a professional nurse. Course exams provide evidence of student progression toward achievement of programmatic student learning outcomes required to graduate. To increase faculty presence and involvement throughout an accelerated online program, a quality improvement project to implement a new exam remediation process was developed for students who scored below 75% on any exam. The project aimed to provide early identification and resources for at-risk students who scored below 75% on course exams. The primary goal was to increase subsequent course exam scores to 75% or higher. Secondary project goals included improving performance on standardized national benchmark exams, decreasing academic dismissals, and increasing NCLEX pass rates. Early identification of and intervention with at-risk students using prescribed remediation protocols is an effective means of improving student retention and graduation rates in addition to first-time pass rates on NCLEX. Through increased collaboration between faculty, faculty and students, faculty and technology support services, improved retention rates and better prepared nurse leaders for clinical patient care are the expected outcomes for the quality improvement project.

34-EBP. NorthBay Health's Leadership Development Program - A Program Evaluation

Heather Resseger, MSN, RN, CNL, CPHQ; NorthBay Health; Fairfield, California

9/27/2024, 12:00pm - 1:50pm, Breakout: Poster Showcase

Leadership plays a pivotal role in organizational quality and employee engagement, with leaders selected based on potential, education, and career experiences. However, continual improvement in leadership acumen is essential. This program evaluation aims to assess the effectiveness of NorthBay's Leadership Development Program, identify areas for enhancement, and provide recommendations for future development. Guided by the CDC's (1999) program evaluation framework and an organizational logic model, stakeholders were identified, and evaluation questions formulated. The evaluation, scheduled for April 2023, will employ qualitative and quantitative methods, including semi-structured interviews and employee engagement surveys. The evaluation will focus on three key areas: leader engagement, leadership development, and the employee-leader relationship. Data collection will also incorporate employee engagement survey responses pertaining to the leader-employee dynamic. The findings will offer valuable insights to NorthBay Health stakeholders, highlighting successful processes and areas for improvement. Additionally, the synthesis of literature related to leadership development programs will inform future program initiatives. Ultimately, this evaluation will serve as a resource for NorthBay's Leadership Development Program steering committee, aiding in the refinement and enhancement of the program to foster effective leadership and sustained employee engagement.

35-ASP. Innovative Academic Leadership Prioritizing Wellness for Health Sciences Students

Alice Teall, DNP, APRN-CNP, FAANP, FNAP; The Ohio State University; Colubmus, Ohio

9/27/2024, 12:00pm - 1:50pm, Breakout: Poster Showcase

Clinician burnout is a crisis that persists at the expense of the healthcare workforce, and the quality of care provided. Clinician wellness is a professional imperative, yet health sciences students continue to report high levels of burnout, stress, anxiety, and depression. Cultivating an academic learning environment that supports the development of resiliency, well-being, and improved student wellness requires a coordinated and sustained effort from educators and academic leaders. Innovative wellness director positions within a college of nursing were created under the leadership of the university chief wellness officer to integrate wellness academic strategies into curricula, promote engagement in health behaviors, and create a community that values all dimensions of wellness. The purpose of this presentation is to outline effective leadership initiatives that positively impact academic culture, and to highlight novel strategies for incorporating wellness into health sciences curricula. This presentation aims to inspire educators to take the first or next steps toward integrating wellness into curricula. Academic leaders have a responsibility to implement strategies that promote wellness and build resilience for students, as health and well-being are priorities for the provision of safe, quality care. For health sciences students to honestly answer “yes” to the question “RUOK 2DAY?” necessitates access to resources, and awareness of the need to prioritize wellness self-care.

36-R. The Leadership Experience of ACNAs During the COVID-19 Pandemic Upon Return to Campus: A Qualitative Study

Susie Jonassen, PhD, MSN-Ed, RN, CPN; University of West Georgia; Carrollton, Georgia

9/28/2024, 11:10am - 12:00pm, Breakout: 23

The impact of the COVID-19 global pandemic has been rated as the highest factor of intent to leave the profession in nurses serving in a leadership role. During the pandemic, crisis leadership swept across academia partly because nursing academia was not prepared for the rapid transition to virtual instruction. The reopening of nursing programs, while pandemic restrictions were still required, caused unprecedented disruptions and stress for academic leaders. One-third of nursing faculty anticipate retirement within the next two years. With the present burnout and shortage of nursing academia leaders, there was a need to explore the lived experience of academic chief nurse administrators (ACNAs) to illuminate the phenomena of crisis leadership during the pandemic and the effects of the pandemic on nursing academic leadership. The purpose of this study was to explore the lived experience of ACNAs in pre-licensure nursing programs (PLNPs) who returned to campus after full virtual instruction due to the pandemic. This qualitative study utilized descriptive phenomenology through Husserlian phenomenology with Colaizzi’s method of data analysis as the philosophical and methodological framework. The sample included ACNAs in the state of Georgia who had been serving in their role since the onset of the pandemic, held a Master of Science in Nursing (MSN) or above, were a registered nurse (RN), and served in a PLNP that went to full virtual instruction during the pandemic. One-on-one semi-structured interviews were conducted with seven participants. Interviews were completed via Zoom®. Four themes emerged: ACNA Leadership and Challenges During a Pandemic on Campus; Navigating Leadership Challenges and Obstacles During an Ongoing Pandemic on Campus; Managing Support and Work-Life Balance; and Reflection and Moving Forward as an ACNA Leader. This study illuminated ACNAs' leadership experiences during a global pandemic, when they were confronted with experiences no one had seen before. The results highlighted ACNAs' strengths and weaknesses. ACNAs can use these results to determine the professional development needed to improve their weaknesses and utilize their strengths to mentor other, and future, ACNAs. Furthermore, this study’s results can help current and future ACNAs understand the importance of having mentorship and leadership tools for future crises.

37-QI. A Pilot Project Using the Creighton Competency Evaluation Instrument 2.0 (C-CEI 2.0) to Evaluate Nursing Leadership Simulations

Shelly Luger Shelly Luger, RN, DNP, NE-A BC; Creighton University; Omaha, Nebraska

9/27/2024, 12:00pm - 1:50pm, Breakout: Poster Showcase

Simulation is a well-known and a successful tool for helping learners develop clinical skills (Cole et al., 2021). Most simulation experiences do not provide leadership development opportunities (Waxman and Delucas, 2014). Limited evidence exists related to leadership simulation for nurse managers, even though leadership simulation offers learners the ability to practice leadership skills needed to emulate successful leadership styles. Furthermore, there are variations of simulation evaluation methods. The Creighton Competency Evaluation Instrument (CCEI©) measures nursing student performance in simulated clinical environments and has the potential to objectively quantify student performance in clinical settings (Manz et al., 2022). The CCEI© has well established validity and reliability (Manz, 2022; Adamson & Kardong-Edgren, 2012; Hayden et al., 2014; Rizzolo et al., 2015; Roldán-Marino et al., 2019; Todd et al., 2008). The Creighton Competency Evaluation Instrument (CCEI) 2.0© is an instrument designed to evaluate competency of nurses, nurse practitioners, prelicensure nursing students, and nurse practitioner students in simulated and/or traditional clinical/practicum learning environments. The authors of the (CCEI) 2.0© believe that the instrument can be used in evaluation of a variety of simulated and clinical experiences, therefore, the instrument could be applied to graduate level leadership simulated experiences. The purpose of this innovative project is to pilot the use of the Creighton Competency Evaluation Instrument (CCEI) 2.0© as an evaluation instrument for graduate level nursing leadership simulated experiences. The expected minimum behaviors (EMB) were developed to guide the evaluation of graduate nursing leadership simulation experiences using the CCEI 2.0© . The developed expected minimum behaviors were reviewed by the CCEI 2.0© development team. The EMB content areas focused on communication and professionalism. Graduate nursing leadership students participated in two leadership simulation experiences. The simulated experiences were recorded by the student in Sim Capture©. Two investigators/ authors will independently review recorded graduate level nursing leadership students’ simulated leadership experiences and evaluate the simulated experience using the CCEI 2.0©. Investigators will then compare each content areas scores and overall instrument score for consistency and interrater reliability. The simulation is occurring April 2024. Results will be available after that and by September for conference .

39-R. Tipping the Moral Resiliency Scale : Internationally trained nurses vs. United States trained nurses- who are more morally resilient?

Shiny Edward, MSN, RN NPD-BC, CCRN-CMC-CSC, PCCN, CVRN -BC, MEDSURG-BC,ECG- BC; Baylor Scott & White The Heart Hospital Plano; Plano, Texas

9/27/2024, 12:00pm - 1:50pm, Breakout: Poster Showcase

This study investigated the differences in moral resilience between internationally and US-trained nurses at Baylor Scott & White East Region, with 214 participants completing the Rushton Moral Resiliency Scale (RMRS). Analysis using the Mann-Whitney U test revealed significant differences in RMRS scores between the two groups, with US-trained nurses exhibiting higher average scores (mean=3.26, SD=0.46) compared to their internationally trained counterparts (mean=3.12, SD=0.46). Significant disparities were also observed in the subscales of Buoyancy, Personal Integrity, and Moral Efficacy, but not in Relational Integrity. These findings underscore the impact of training background on moral resilience among nurses, suggesting a need for tailored interventions to bolster moral resilience, potentially enhancing nurse retention, and promoting healthier work environments and patient outcomes.

40-R. Addressing the Nurse Faculty Shortage: A Delphi Method Approach

Suja Davis, PhD, RN, CGRN; University of North Carolina at Chapel Hill; Chapel Hill, North Carolina

9/28/2024, 11:10am - 12:00pm, Breakout: 22

Problem/Purpose: The lack of sufficient numbers of academic nurse educators (ANE) is severely impacting the current nursing shortage in the US.For example, nursing schools denied close to 92,000 qualified applicants in 2021 due to a lack of nursing faculty. Recruitment and retention of ANEs is essential to maintaining and growing the nursing workforce. While multiple factors contribute to the ANE shortage, more work is needed to determine how to effectively recruit and retain ANEs. Objective: Following work done to develop a series of action statements, a modified Delphi approach was identified as an effective method to prioritize steps to improve recruitment and retention of ANEs. The objective of this study is to describe the modified Delphi approach utilized and discuss how this methodology can be applied to other research questions. Design and Methods: In June 2023, a group of 25 ANEs in the US came together to consider how to resolve the ANE shortage. Following IRB approval, a review of the literature was conducted and, using nominal group technique, five stakeholder groups were identified and action item statements were developed. It was determined that a modified Delphi approach including two rounds of data collection could identify and prioritize items most likely to be effective in recruiting and retaining ANEs. A team of 13 researchers came together to implement the study. After review of the initial 44 action statements, 42 action statements were agreed upon. These statements were then reviewed by three experts in the academic workforce arena to determine validity. After refinement, the final panel o finalized 42 items, to which 11 demographic items were added. Snowball sampling was used to recruit participants from across the US for a month. For each item, subjects were asked to select keep, keep after modifying (KAM), or delete. If participants chose KAM or delete, they were asked to indicate what needed to be changed. After the survey closed, the research team began both quantitative and qualitative analyses. All subjects who did not include an email address were removed from the sample since they could not be included in the second round. An a priori decision of establishing Kappa at 0.7 was made to determine which items should be kept for the second round. New statements were developed for inclusion in the second round of data collection. Results: There were 1011 respondents. After eliminating responses without email addresses or with no data entry, the final sample size was 502 respondents. Seventeen items achieved a Kappa of 0.7 or higher. Content analysis will be conducted on these items to determine if there are any additional statements for consideration in the second round of data collection. Conclusions:This modified Delphi study will provide holistic recommendations for leaders of various stakeholder groups to include educational institutions, healthcare organizations, policy makers, professional organizations, and the public/business sectors. Through collaboration with leaders in these stakeholder groups the shortage of academic nurse educators can be addressed and ultimately impact the shortage of nurses practicing at the bedside.

41-R. Effectiveness of Interventions to Address Nurses’ Mental Health: What Nurse Leaders Need to Know and Do

Lynn Varagona, PhD, MSN, MBA, RN; Kennesaw State University; Kennesaw, Georgia

9/28/2024, 10:10am - 11:00am, Breakout: 21

Background Multiple factors contribute to elevated stress among nurses working in busy healthcare settings. These include the demanding nature of their job, long work hours, exposure to traumatic events, heavy workload, emotional demands inherent in patient care, overtime, a fast pace, lack of physical or psychological safety, chronicity of care, moral distress, lack of social support, and incivility. Job stressors can contribute to anxiety, burnout, depression, post-traumatic stress disorder, and other mental health challenges which can negatively impact patient care and increase turnover. Nurse leaders need evidence-based knowledge of ways to help alleviate mental health issues of their nursing staff. A realist review published in 2019 examined workplace interventions to promote mental health among healthcare workers in general. Of the articles which focused on nurses, the most recent publication was 2017. The literature lacks a comprehensive understanding of the efficacy of recent interventions designed to enhance nurses’ mental health. Purpose The purpose of this review was to integrate what is known in the recent literature about interventions designed to improve the mental health of nurses who work in healthcare facilities. Methods Toronto and Remington’s guide to conducting an integrative review was used. CINAHL, PubMed, and MEDLINE databases were searched from January 2018 to May 2023. Key terms were “nurses’ mental health” AND interventions. When few intervention studies were found, articles which identified factors influencing nurses’ mental health were included. Twelve articles were analyzed using Braun & Clarke’s thematic analysis process. Results and Implications Mental health issues are common among nurses throughout the world. In addition to a main theme of interventions designed to improve nurses’ mental health, three main themes emerged pertaining to factors which may influence nurses’ mental health: work conditions, work culture, and nurses’ personal factors. Regarding work conditions, long work hours, working night shifts, staffing concerns, heavy workload, lack of work-life balance, and precarious job contracts negatively influenced nurses’ mental health. Work culture elements which negatively influenced nurses’ mental health included lack of managerial/leadership support, lack of a team culture, and workplace incivility. Personal factors which negatively influenced nurses’ mental health included demographics (lower education level, lower income, age < 30 or > 51, and 6-10 years of nursing experience), poorer physical health, lower personal resilience, and higher perceived job stress. All the intervention studies addressed nurses’ personal resilience and significantly improved nurses’ psychological well-being. However, research has shown environmental protective factors have the greatest influence on personal resilience. While nurse leaders can implement programs designed to improve nurses’ resilience, emphasis should be placed on interventions to improve work conditions and work cultures. Although nurse leaders may have less control over staffing concerns which influence nurses’ long work hours, need to work night shifts, and heavy workloads, they can influence work cultures by modeling and fostering a supportive environment, team culture, and civil relationships.

42-R. Examining the Prevalence of Well-Being and its Impact on Healthcare Outcomes: A Cross-sectional Survey Study of New Nurses

Cory Church, PhD, RN, NPD-BC; Texas Tech University Health Sciences Center; Lubbock, Texas

9/27/2024, 10:10am - 11:00am, Breakout: 7

This study aims to investigate the prevalence of well-being among new nurses within their first year of practice and its relationship with job satisfaction, turnover intent, and patient safety issues. Nurses' well-being is a critical concern, particularly for new nurses facing the transition from education to practice, which often leads to burnout and turnover. However, studies specifically focusing on well-being among new nurses are lacking. The study will employ a cross-sectional survey design to collect data from 1,000 new nurses practicing in the United States. Utilizing the Systems Model of Clinician Burnout and Professional Well-Being, the conceptual framework will guide the exploration of well-being. Data collection will include measures such as the Nurse Well-Being Index, single-item job satisfaction and turnover intent measures, and the National Council of State Boards of Nursing Patient Safety Indices. The findings will contribute to the understanding of how well-being influences new nurses' outcomes and inform nursing leadership practices aimed at promoting a healthier workforce and improving patient care. By addressing the gap in research on well-being among new nurses, this study aligns with the conference theme of Nursing Leadership: Relationships, Collaboration & Science, emphasizing the importance of scientific inquiry and collaborative efforts in advancing nursing leadership and practice.

43-EBP. Enhancing Nurse Manager Resilience with a Resilience-Enhancing Toolkit

Rosarina Javier Pelikan, DNP, RN, CNS, CENP, RN-BC; Providence Saint John's Health Center; Santa Monica, California

9/27/2024, 12:00pm - 1:50pm, Breakout: Poster Showcase

Nurse managers have one of the most stressful jobs in nursing leadership. They experience more burnout and are more likely to leave the job or leave the nursing profession altogether, leading to vacancies or burned-out leaders. The organization experienced high nurse manager turnover. Of 12 positions, four have more than two years of experience, three have less than two years, and five are filled with interims. Strategies to address burnout are decreasing stressors or arming leaders with skills to withstand stressors. The organization offers programs that address burnout but are designed to be used outside of work and may be difficult to use in while on the job. An evidence-based, resilience-enhancing toolkit for nurse leaders was designed to be easy to use at work. The toolkit contained techniques on mindfulness, cognitive reframing, and gratitude, which are strategies demonstrated to enhance resilience. The project took place between August and December 2022. Pre- and post-surveys were created to evaluate the effectiveness of the toolkit. There was no difference in the Connor-Davidson Resilience Scale (CDRS) mean pre- and post-intervention score. Mindfulness (50.0% to 87.5%), cognitive reframing (40.0% to 75.0%), and gratitude practices (90.0% to 100.0%) increased. However, the number of nurse managers placing in the most resilient CDRS quartile increased. Currently, 11 of 13 nurse managers remain in the organization as a nurse manager or higher role. Although mean resilience scores did not change, resilience-enhancing practices increased.

45-ASP. Rising Nurse Leader Academy: Building Future Nurse Leaders through Academic-Practice Partnerships

Christine Young, DNP, MBA, RN, NEA-BC; Akron Children's; Akron, Ohio

9/28/2024, 10:10am - 11:00am, Breakout: 20

The Rising Nurse Leader Academy is an academic-service partnership between a free-standing pediatric healthcare organization and college of nursing. RNLA provides aspiring nurse leaders with opportunities to acquire essential knowledge, skills and abilities for leadership development and career progression. This program creates a solid succession plan to ensure smooth and seamless nursing leadership transitions. RNLA demonstrates transformational leadership’s long-term impact by developing aspiring leaders to sustain and enhance an organizational culture of excellence that provides the highest quality patient care and healthy work environment while earning nursing leadership micro-credentials that can culminate into the MSN degree. This succession planning strategy identifies and develops high performers for internal promotions, supporting successful transition to practice in nursing leadership. Recognizing the importance of leadership this program is generously funded through philanthropy. The two-year RNLA offers a highly interactive curriculum incorporating expert faculty, mentoring, thoughtful peer dialogue and reflection, and experiential learning to engage and prepare future nursing leaders. The organization’s leadership competencies and American Organization for Nursing Leadership (AONL) competencies drive learning needs assessments to determine the monthly RNLA learning sessions. The academic institution provides a track with three micro-credentials and practicum courses to earn a master’s degree in nursing leadership. Participants complete two of the four micro- credentials, a project and meet monthly with mentors using an individualized development plan to demonstrate progression toward career goals. RNLA supports aspiring nurses to develop an authentic leadership style leveraging individual strengths and goals and increased awareness of current professional practice issues relevant to nurse leaders in alignment with AONL competencies. Participants develop skills to facilitate change, including integration of best practices, quality improvement methodologies and project management. First cohort evaluation data showed positive results: eight participants completed the first year including academic credit hours, mentoring and interactive sessions with self-evaluation indicating increase in leadership competencies. Two participants received leadership position promotions and participants report numerous other professional accomplishments including council/committee involvement, volunteerism, professional organization membership, and certification. On the AONL self-assessment survey, participants demonstrated an improvement in overall average scores in all 12 domains with 58% of domains exceeding the national benchmark average compared to 0% at the beginning of the academy. Participants completed the AONL self-assessment prior to the beginning of the program and then again after one year in the program. The competencies reflect the skills, knowledge and abilities that guide nurse leader practice in the science of business management, the art of leading people and the leader within. The increase is self-perception of competency indicates improvement in self-awareness, self-efficacy, and skill acquisition. Academically, participants report being able to differentiate leadership styles at the organization and their own leadership strengths and areas for development as well as the importance of accreditation, Magnet status and nursing informatics. RNLA supports high performers with leadership potential to advance to the next level. Evaluation data show the program’s positive impact and contribution to organizational culture driven by future transformational leaders. Based on cohort one’s success, cohort two began in 2024 with eight participants.

46-ASP. Developing a Structure of Engagement and Recognition in Clinical Scholarship

Roberta Pawlak, PhD, RN, NEA-BC; University of Wisconsin - Madison; Madison, Wisconsin

9/27/2024, 12:00pm - 1:50pm, Breakout: Poster Showcase

Clinical Faculty Scholarship is not often clearly defined within the research university setting supporting tenure-track individuals in their development of programs of research. However, universities employ both tenure-track and clinical faculty to fulfill their mission of research, scholarship, teaching and service. This work describes a structure for ‘nursing scholarship’ needed to recognize the work of Clinical Faculty and promote their development in this area. Clinical Faculty Scholarship Definition and Scope: The definition and scope of this work was based on the Boyer model Scholarship is inclusive of discovery, integration, application, and teaching (Boyer, 1999), recognizing Clinical Faculty scholarship can be expressed in areas of Evidence-Based Practice, quality & safety of care, nursing education, clinical and professional leadership, quality improvement (Carter et al., 2017; Clark et al. 2020), policy and innovation. Methods: The structure and process to develop a space for Clinical Faculty scholarship development and recognition evolved over three years, and involved input from nursing faculty, School of Nursing leadership, University and School of Nursing governance, Marketing and Communications. Clinical Faculty scholarship was defined, and examples interwoven into mentoring, supervision, annual review materials, and promotional communications. Clinical Faculty Scholarship categories identified include: 1. Community Outreach and Engagement 2. Health Systems and Policy 3. Professional Practice and Education 4. Teaching and Learning Areas are described in detail on the School of Nursing website and are tied to specific faculty work. Review of professional development, mentoring, performance expectations and marketing promotion of Clinical Faculty scholarship work is reviewed in this presentation.

47-R. Trust and Organizational Commitment in a Post-Pandemic Environment

Marlene Porter, PhD, RN, NPD-BC, CCRN, CEN; Baylor Scott & White Health -Central Texas; Temple, Texas

9/28/2024, 10:10am - 11:00am, Breakout: 19

Problem, Background/Significance of Study: Nurses are the largest sector in healthcare and are critical to the quality of care delivered to patients. However, nationwide hospital organizations face a significant nursing shortage exacerbated by COVID-19. The vast number of nurses leaving the bedside and the prolonged length of time it takes to fill the vacancy has drawn attention from nurse leaders and researchers to investigate the nurse leaders’ role in front-line nurses’ organizational commitment. Many studies in various occupations have explored the relationship of employee trust with organizational commitment. However, the nursing literature examining employee trust and organizational commitment is sparse. Purpose statement: The purpose of the study was to evaluate the level of nurses’ trust in their leader (supervisor, nurse manager, nursing director) and organizational commitment post-pandemic and to examine the relationship between nurses’ trust in their leader and organizational commitment post-pandemic. Methods: The social exchange theory is the theoretical framework guiding the development of the study. The study employed a cross-sectional, descriptive, correlational design. An electronic survey including demographics, employee trust scale, and organizational commitment scale was sent to over 1,000 inpatient full-time and part-time nurses working at a three-hospital region in central Texas. A statistical a priori power analysis was calculated indicating a sample size of 105 was required to test the primary research question. Data was collected over six weeks with a final sample size of 135. Descriptive statistics summarized participant demographics and Spearman’s Correlation to determine the relationship between study variables. Results/ Implications for Practice: Study results demonstrated high levels of employee trust and organizational commitment. The correlation coefficients of all study variables were significant (p<0.001). Study results yielded a strong relationship between employee trust and affective organizational commitment. Additionally, the study found a moderate relationship between employee trust and normative organizational commitment. Study findings inform leaders that developing leadership skills in building trust with the nursing team contributes to increased organizational commitment. Interventions such as leader development in establishing trust and building relationships with their team members may improve nurse retention and organizational commitment.

50-QI. Enhancing Nurses' Emotional Intellegence and Resilience

Karen Fowler, Ph.D., RN, CENP, CNE; University of Texas at El Paso; El Paso, Texas

9/27/2024, 11:10am - 12:00pm, Breakout: 12

Abstract Background- A new nurse considered work-ready has skills that include clinical competence and characteristics such as emotional intelligence (EI), resilience, and clinical reasoning. Current trends in neuroscience suggest that emotions play an integral part in cognitive functioning, particularly in the areas of memory, attention, and decision-making. EI may safeguard against job dissatisfaction, poor decision-making, and burnout. Through EI coaching/training, resilience and job satisfaction should increase. Moreover, research has linked staff intent to leave with the EI of the nurse leader, so coaching/training with the manager should improve the work environment, leading to improved outcomes for new nurses. Objective- The project reviewed the impact of EI training on new nurses and nurse managers within their first year of hire. Methods- The project used a time-series survey format. The survey collected biographical data, resilience scores, EI scores, and intent to leave data. Semi-structured questions were also used to garner perceptions of EI in the clinical setting. Participants were new nurses and nurse managers in their first year of hire. The new nurses were given 12 months of EI coaching/training sessions. Nurse managers were given EI training specifically designed for nurse leaders in 5- two-hour sessions over ten months. Data collection occurred during the first session for new nurses and nurse managers and was repeated during the last session. Results- The project's impact has yet to be realized since the coaching sessions are in progress and will be completed in April 2024. Preliminary analysis was conducted using descriptive statistics and multivariate correlational analysis. EI scores for the nurse leader were higher than those of the new RNs. Nurse leaders scored higher in 3 of the four EI categories (self-appraisal, emotion regulation, using emotion to reason). The nurse leader and new nurse scored the same in understanding others’ emotions. This indicates a need for training in the nurse leader since understanding others’ emotions is a vital component of communication, team building, empathy, and building trust. The resilience scores of new RNs were lower than those of nurse leaders. The majority of those surveyed scored in the high category of resilience. Overall intent to leave scores indicate that the new RNs have more of an intent to leave than nurse leaders, with the highest score found with intent to leave in 5 years. Preliminary data shows significant correlations between EI, resilience scores, and intent to leave. Nurses with higher EI scored lower on the intent to leave scale. There was a significant correlation between EI and resilience. Nurses with higher EI also had higher resilience, meaning that improvement in EI can produce a more resilient staff. Linking Evidence to Action- Specific tactics and strategies to increase new nurse EI and resilience must be adopted to support nurses and nursing managers. Increased EI, and thus resilience, will lead to decreased intent to leave, which supports better patient and staff outcomes. Nurse managers can influence the work environment using EI strategies and tactics.

51-EBP. The Effects of Human Centered Leadership in Healthcare Framework on Leader Engagement and Mindfulness

Karen Steiner, MSN, RN, NE-BC, NPD-BC; Summa Health; Akron, Ohio

9/27/2024, 12:00pm - 1:50pm, Breakout: Poster Showcase

The 2023 AONLF Nursing Leadership Insight Longitudinal Study revealed that 12% of nurse leaders plan to leave their positions within 6 months and 25% of those leaving plan to leave nursing all together. Additionally, 23% of those surveyed are contemplating leaving their positions. Adopting a defined nursing leadership framework in an organization may provide an opportunity to develop and support nursing leaders as they navigate the complexities within health systems. The Human Centered Leadership (HCL) in Healthcare framework is a new leadership framework that has not been widely adopted or evaluated regarding its effectiveness on leader engagement or mindfulness. The purpose of this scholarly project is to evaluate the impact of adopting the HCL in Healthcare framework on nurse leader mindfulness and engagement. The methodological approach is a retrospective study focusing on the engagement and mindfulness of nurse leaders. Leader engagement and mindfulness will be evaluated pre/post implementation of the HCL Essentials Course. This project has several potential contributions to the field of nursing. Adopting a defined nursing leadership framework may also increase staff engagement, patient satisfaction and may also impact patient outcomes, specifically NDNQI (National Database of Nursing Quality Indicators) data. Providing a leadership framework that is rooted in self-awareness, self-care and mindfulness may provide an organization with an opportunity to support a nursing leadership culture that can positivity impact leaders, staff and patient experience and patient outcomes.

52-QI. Resiliency and Spirituality of Rural Clinic Healthcare Workers: An Interdisciplinary Quality Improvement Project

Kelly Moseley, DHSc, MSN, RN, CNE; TTUHSC School of Nursing; Odessa, Texas

9/27/2024, 11:10am - 12:00pm, Breakout: 12

COVID-19 was recognized and began spreading in December of 2019 and resulted in a pandemic affecting 210 countries and territories with the current tally exceeding 767 million infected people and more than 6,900,000 deaths. The COVID-19 pandemic placed a great amount of strain on the healthcare system. Healthcare workers experienced an influx of patients, shift overload, and an increased risk of infection. The stress burdening these individuals led to burnout. Burnout is defined as physical and mental stress including “emotional exhaustion, depersonalization, and a decrease in self-worth”. An increase in stress and anxiety compounded the problem of being understaffed, underappreciated, and overworked in a career that often includes incivility in very unhealthy work environments. A need for increased resiliency for healthcare workers prompted the development of an interdisciplinary Quality Improvement Project (QIP) by three nurses, a Nurse Practitioner (NP), and two Physician Assistants (PAs). The goal of this project was to find methods of decreasing stress, anxiety, and depression by increasing resiliency and workplace satisfaction. After obtaining permission from clinic directors or Chief Nursing Officers (CNOs) at rural clinics in West Texas, the team members visited the clinics. The purpose of the project was explained in detail to all potential participants, and they were reminded they could cancel at any time and that all responses would remain confidential. The measurement tool for anxiety, stress, spirituality, and resilience was given to the healthcare workers to complete. The results from the tool were examined and conclusions provided to the clinic director or CNO. An anxiety, stress, and compassion fatigue tool kit were provided as a means of help for employees to promote well-being and increase resiliency. The employees were instructed to use the toolkit for a period of three months. At the end of that time frame, the team members returned to the clinic to re-administer the surveys. Employees kept the tool kit for future use to promote resilience

54-R. Ready or Not: New Graduates' Perceptions of the Readiness to Start Their Professional Career

R, Diatta; Nursing; Emory University Hospital, Georgia

9/27/2024, 12:00pm - 1:50pm, Breakout: Poster Showcase

The nursing profession is under intense pressure to hire clinicians who exhibit critical thinking (CT) skills. The nursing practice gap has resulted in the separation of academic educators from current clinical practices. New graduate nurses are entering the clinical setting inadequately prepared to safely care for patients. A generic qualitative approach sought to describe and understand the topic at hand. Study participants reported a lack of skills training as the main reason for being ill-prepared in the clinical setting. A call for collaboration between academia and hospital settings with shared responsibilities for meeting the learning needs of new graduates is a must. The profession of nursing has become fast-paced. It is assumed that nurse competency assures patient safety. Nurses must have critical thinking skills and the ability to implement quick interventions to ensure patient safety. Unfortunately, over 50% of new graduates do not perform to the clinical level expected by hospital leaders. Nursing education is made up of content learning and skills acquisition, it has been “piecemealed together.” How to assess, teach, and determine if a nurse possesses these skills is unclear. Critical thinking assessments are based upon an individual’s ability to memorize, recall, and apply content learned into clinical situations. Memorization only shows the ability for recall, it does not result in critical thinking or the ability to shift content into practice. The purpose of this study was to explore the experience of new graduate nurses from a Baccalaureate program and their transition into clinical practice. A generic qualitative approach sought to describe and understand the topic of interest, with respect to nurses’ preparedness to meet the demands of their profession. The results of the study found that the new graduate nurses did not feel confident entering the workforce of the nursing profession. Study participants reported the lack of skills training as the major reason for their feelings of being ill-prepared in the clinical setting. Collaboration between academia and hospital settings must focus on shared responsibilities for meeting the learning needs of new graduate nurses. In so doing, this will enhance the quality of care provided and ensure patient safety.

55-EBP. Level UP: Lifting healthcare system RN certification rates

Annabelle Zakarian, MSN, RN, CPHRM, NE-BC; BSWH; Plano, Texas

9/27/2024, 12:00pm - 1:50pm, Breakout: Poster Showcase

Explore Level UP. This systemwide initiative can be implemented to increase RN certification rates. A highly desired Magnet empirical outcome – RN certification rate increase by 62.3% across 7 hospitals. A worthwhile initiative to explore for nurse educators, nurse executives and nursing administration by fostering relationships and collaboration among hospitals with a common goal.

56-ASP. Building Modern Nursing Education in the Country of Georgia

Kimberley Crawford, PhD. MPH, APRN, FNP-C; University of West Georgia; Carrollton, Georgia

9/26/2024, 2:10pm - 3:00pm, Breakout: 3

Background Since 1998, the nursing workforce in the country of Georgia has consistently declined with very few nurse leaders with any education higher than a diploma. Nurses are 595.3 per 100,000 compared to 740.4 per 100,000 in the WHO European Region (Health Care Statistical Yearbook 2021, 2022; Squires et al., 2019). In 2011, the Georgian government approved a baccalaureate nursing degree and the current higher professional nursing certificate (available after secondary school graduation) to improve the nursing workforce (Wold et al., 2013). However, despite a few attempts to start a successful baccalaureate program, no Georgian nursing students made it past the second year before transferring to another major (viz., medicine). One private university decided to develop an international baccalaureate nursing program in English with the help of a master's prepared nurse from the USA. This was to help bring international nurses to work in Georgia, establish a solid modern nursing program in English that could be reproduced in Georgian, and promote nursing leadership in the country. Goals The project goals were to develop the country’s first baccalaureate nursing program based on a modern nursing model that promotes nursing leadership and to graduate baccalaureate-prepared nurses in four years. Process and Collaboration The Georgian nursing school had Georgian physicians collaborate with a master’s prepared American nurse to design and write the curriculum. Local Georgian professors would teach didactic core classes and some nurse specialty classes. The American nurse designed and taught the nursing-specific didactic courses (e.g., Fundamentals in Nursing, Health Assessment, Nursing Research). Additionally, the American nurse designed eight different clinical rotations that required the construction of every element needed for modern nursing (i.e., training nursing clinical instructors, nursing documentation, generic medication lists with Western translations, etc.). The current nursing workforce did not chart, assess, or think autonomously. Therefore, after their first year of school, nursing students were more educated than the nurses working on the floor and served as informal leaders in some clinical settings. Results The program’s first graduation was in July 2016, when 21 Nigerian students graduated, which showed time and again the importance of nurses and nurse leadership in the hospital setting. As of Spring 2024, the school has 180 international nursing students enrolled in the program, with no Georgian students. The country has three international university nursing school programs taught in English and two Georgian programs. No Georgian programs have graduated a baccalaureate-prepared nurse. Due to the negative stigma surrounding nurses, only three baccalaureate nursing schools in Georgia (two are for international students) and less than five higher professional nursing schools graduate approximately 100 nurses annually. Implications for Nursing Leadership The nursing profession needs graduate-level nursing education to train nurse educators and leaders. Additionally, despite having a few nursing associations, little activity exists from these organizations. Finally, Georgian nurse leaders in education and through associations must develop a licensure exam and regular continuing education requirements for practicing nurses.

57-R. Enhanced Communication and Health Literacy Awareness to Decrease Heart Failure Readmission Rates

Bria Hollingsworth, MSN, RN, CCRN-K; Baylor Scott & White Medical Center Plano; Plano, Texas

9/27/2024, 12:00pm - 1:50pm, Breakout: Poster Showcase

Abstract Title: Enhanced Communication and Health Literacy Awareness to Decrease Heart Failure Readmission Rates Submission Category: Research Purpose: To determine the effect on heart failure readmission rates of an educational intervention to enhance nursing communication and health literacy awareness Background significance: Approximately 6.5 million adults in the US have heart failure costing an estimated $30.7 billion a year. Value based purchasing reduces payments for excess readmissions from heart failure. Self-care is vital in preventing readmission but is dependent on a patient’s understanding of their disease. Historically, nurses have taught self-care using prewritten education along with verbal instruction regardless of health literacy status. A literature review shows low health literacy increases risk of readmission and effective communication is crucial to patient care and understanding. However, there is no training for nurses in conjunction with health literacy awareness. There is a lack of literature on effects of enhanced communication, health literacy awareness and heart failure readmissions. Methodology: We used a quasi-experimental retrospective and prospective study at two acute care hospitals in Texas. Our educational intervention involved training all RNs caring for heart failure patients regarding enhanced communication and health literacy awareness by defining and identifying prevalence of low health literacy, utilizing communication strategies using the Communicate Clearly Tool from the Agency for Healthcare Research and Quality (AHRQ), and demonstrating the use of teach-back. The outcome we measured was heart failure readmission rate. Our sample included adult patients with an admission diagnosis of heart failure who were alive at discharge and discharged to home. Using a convenience sampling, we had a pre-intervention and a post-intervention group with 250 in each group. Results: There was a decrease in readmission rates from 11.2% pre-intervention to 7.6% post-intervention, and although not statistically significant, it was clinically significant (P value = 0.2202). Age is positively associated with readmission with older patients more likely to be readmitted. (mean age 78 and 74 respectively, P=0.0254). Conclusion and Implications: The patient population may have affected the results given our hospitals have a higher socioeconomic demographic, thus we would like to replicate this study in a more socially and economically diverse patient population. Even though we did not have statistically significant results, we did receive positive feedback from nurses about the intervention and did lower heart failure readmission rates. Decreasing heart failure readmissions is a complex problem and hospitals may consider educating nurses about health literacy and enhance communication as part of their strategy to affect readmission rates.

58-EBP. Workforce Sustainability: Redefining Resource Strategies

Adam Fronczek, DNP, MBA, RN, NEA-BC, ANP-BC; UCLA Health; Venice, California

9/26/2024, 3:10pm - 4:00pm, Breakout: 6

This transformative project introduces a comprehensive staffing model within a healthcare organization, incorporating cross-training initiatives and short-term assignments (STAs) to enhance workforce adaptability and address operational challenges. Guided by the Systems Theory, the practice change aims to create a responsive and proficient workforce capable of seamlessly transitioning between various specialty areas, including pediatrics, psychiatric care, procedural units, and critical care settings. The study employs evidence-based practice (EBP) principles to implement and assess the impact of these innovative strategies. The project's specific aims focus on successfully implementing cross-training programs and integrating STAs to optimize staffing levels. Cross-training is designed to equip staff with specialized skills, fostering adaptability to diverse patient needs. STAs offer flexibility and voluntary participation opportunities, promoting staff engagement and enhancing patient care continuity. Preliminary outcomes reveal a notable improvement in workforce adaptability, demonstrated by staff successfully transitioning between diverse specialty areas. Patient outcomes and experiences have also shown enhancement, reflecting the organization's improved capacity to meet evolving healthcare needs. Financially, the organization achieved a significant 60% reduction in contract labor reliance, highlighting the cost-effectiveness of internal staff expertise. Key lessons learned include the importance of transparent communication, the value of a phased approach with pilot testing, and the need for continuous staff support and training. To sustain the practice change, the organization plans to prioritize ongoing education and training programs, ensuring staff competence and adaptability. Leadership commitment will be reinforced to embed the new staffing model into the organizational culture. Periodic reviews and updates to cross-training and STA programs will align practices with emerging best standards. The organization also aims to share its experiences with the broader healthcare community, contributing to knowledge exchange and advancing evidence-based practices in workforce optimization. In conclusion, this transformative staffing model, grounded in EBP principles and Systems Theory, has demonstrated positive outcomes in workforce adaptability, financial sustainability, and strengthening relationships among different specialty units. Lessons learned and plans for sustainability underscore the commitment to ongoing learning, adaptability, and a culture of continuous improvement within the organization. The project's success offers valuable insights for healthcare institutions seeking innovative solutions to address staffing challenges in the dynamic healthcare landscape.

59-R. Comparing high fidelity simulator versus wearable simulator on team communication, clinical judgment, and patient safety in an interprofessional team

Rebecca Lyon, MS, PA-C; Baylor College of Nurses; Temple, Texas

9/27/2024, 3:00pm - 3:50pm, Breakout: 18

Introduction: The prevalence of maternal morbidity and mortality is increasing in the United States. High-fidelity simulations have been shown to improve clinical judgment in healthcare providers. The purpose of the study is to explore the differences in communication, clinical judgment, and patient safety of an interprofessional team utilizing a high-fidelity simulator compared to a wearable simulator by a standard patient. Methods: The study employed an observational, two group comparative, quasi-experimental design at a large academic medical center. Interdisciplinary members to include registered nurses, unlicensed professionals, medical residents, physicians, and advanced practice providers were recruited and cluster randomized to two groups. The intervention group participated in simulation with a standard patient with a wearable simulator and the control group participated in scenarios with a high- fidelity mannequin. A sample size of 48 was required to achieve powered results. Results: The final sample consisted of 85 individuals, 49 for the intervention group and 33 for the control group. There were no significant differences between the groups related to the effectiveness of the simulation with prebriefing, learning, confidence, and debriefing outcomes. Conclusion: The equivalence in performance outcomes suggests that institutions and educators can choose either simulation modality based on factors such as cost, availability, and logistical considerations without compromising the quality of training.

61-EBP. Generational Differences in the Nursing Workforce: Strategies for Recruiting, On-boarding, and Retaining the Younger Generation (Millennials and Gen Z) of Nurses

Todd Tussing, DNP, RN, CENP, NEA-BC, EBP-C, FNAP; College of Nursing at The Ohio State University; Columbus, Ohio

9/27/2024, 3:00pm - 3:50pm, Breakout: 17

Today’s nurse leaders are challenged by generational differences within a team. Leaders must understand those differences to capitalize on the generational cohort’s strengths, integrating the best characteristics of individual members to form a high-functioning team. Differences in generational characteristics between Baby Boomers and Generations X, Y (Millennials), and Z (Gen Z) include attitudes toward work (e.g., norms, values, rules, and management), orientation toward technology, and appreciation for work-life balance. A growing body of research suggests distinct differences in attitudes toward work between generations. Nurse leaders who understand those differences are better equipped to recruit, on-board, retain younger generation of nurses to their teams. This review aims to identify the generational cohort beliefs towards work, work-life balance, communication, technology, and professionalism to inform nurse leaders as they prepare for recruiting, on-boarding, and retaining nurses from the younger generational cohorts (millennials and Gen Z). A search of the evidence was conducted, and it revealed that generational cohort differences exist in relation to views on work, work-life balance, communication, technology, and professionalism. Results of the search revealed that younger generational cohorts (millennials and Gen Z) prefer a work setting that matches their purpose in life and demonstrates social responsibility. They prefer a more balanced work-life routine that affords them the opportunity to pursue interests away from their professional roles. They embrace technology and prefer on-boarding materials to be personalized and have frequent “check-ins” with their immediate supervisor. Additionally, they prefer face-to-face communication in contrast to impersonal virtual methods. Nurse leaders who understand the preferences of the generational cohorts will be better equipped to recruit, on-board, and retain these cohort members for their teams.

62-R. Prepare for Disaster or Contribute to One: Inadequate Preparedness of Nurse Leaders in Times of Disaster

Mary Holstein, RN, MSN, AGACNP-BC; United Critical Care; Las Vegas, Nevada

9/27/2024, 12:00pm - 1:50pm, Breakout: Poster Showcase

Objective: The aim was to replicate a nurse leader emergency preparedness study and make recommendations. Background: The National Academies of Sciences, Engineering, and Medicine (NASEM) (2021) reported that for 20 years, no integration of public health emergency preparedness and response (PHEPR) content was found in curriculums of traditional nursing education programs. A survey of nurse leaders’ confidence in disaster preparedness conducted in 2022 through the Northwest Organization for Nurse Leaders was replicated through the Texas Organization for Nursing Leadership. Methods: An exploratory, cross-sectional survey from 86 TONL member RNs. Results: Results replicated comparable effects showing lack of nurse leaders’ confidence across roles, experience, and disaster-related education. Conclusions: Nurse leaders in Texas lack structured education for emergency and disaster management with the call for mandatory training and disaster preparedness remaining unmet. Keywords— disaster, emergency nursing, emergency preparedness, emergency response

63-EBP. Vibrant Community of Nursing Leaders Creating Future Nurse Leaders: National DNP Conversations

Jeannie Corey, DNP,RN,NEA-BC; James Madison University; Cobbs Creek, Virginia

9/26/2024, 3:10pm - 4:00pm, Breakout: 6

The importance of ongoing dialogue and action focused on creating competent nurse leaders of the future is critical due to rapid changes in the healthcare industry. Notwithstanding high variability in DNP programs of study and DNP project development, as well as accreditation standards, challenge both seasoned and novice educators teaching in DNP programs. These concerns led to exploration by key DNP faculty stakeholders, which eventually became the National DNP Think Tank that later transformed into the National DNP Conversation. The Think Tank offers a platform for DNP leaders, educators, practitioners, and researchers to share ideas and best evidence-based practices for educating, mentoring, and coaching DNP students and faculty. Successful Think Tanks use a proactive approach to problem-solving. They seek out the latest problems and suggest creative, dynamic solutions before they are needed (de Boer, 2015). The DNP National Think Tank has been a powerful advocate for nursing and healthcare policy reform in the spirit of collaboration, engagement, and coming together as a community of practice. By leveraging the expertise and influence of its members, the think tank shapes policy discussions, advocates for evidence-based practices, and promotes initiatives that improve patient outcomes and advance the nursing profession. Like-minded DNP program directors and faculty saw the opportunity to gain experience in their professional networks, increase and strengthen collaborations, and access resources to enhance resources and expertise to support their professional growth and development. Through regular meetings and ongoing conversations, DNP Think Tank members encourage creativity, collaboration, and partnerships in addressing challenges that all face in their day-to-day work with students and faculty. This can take the form of sharing resources (references, resources), consultation (providing lectures and information to classes), and collaborating on changes and new policies that impact DNP education and practice. Trust, transparency, and accountability are essential to the ongoing work of the National Think Tank in promoting diversity, equity, and inclusion. The action initiative of The National DNP Conversation is focused on providing real-time leadership content and dialogue that will strengthen DNP faculty, students and practicing DNP’s leadership acumen. Creating competent nurse leaders of the future is crucial to impact quality, create innovative solutions to system, organizational and clinical challenges, influence health policy and build a stronger healthcare system for the future.

64-EBP. Breaking DNP and PhD Barriers to Successful Practice

Rebecca Miller, PhD, MHSA, RN, NE-BC; Baylor Scott & White; Bastrop, Texas

9/28/2024, 11:10am - 12:00pm, Breakout: 23

Using a PhD/DNP collaborative dyad, described by one pair of researchers as a “paradigm war”, drew on each of their strengths to develop activities across seven hospitals and nearly 100 clinics to engage clinical nurses, nurse leaders, and non-direct care nurses in promoting a spirit of inquiry. The activities they developed included a journal club, nurse shark tank, and nursing grand rounds (specific topics tied to continuing education). These activities, conducted as a unified front, engage nurses at all levels and mitigates risk for organizational attrition. Additionally, the PhD/DNP collaborative models the constructs synonymous with the AACN Synergy theoretical framework that is the basis of our professional practice model. Through the engaging activities created and led by the PhD/DNP dyad, nurses at all levels experience opportunities to learn about the most up-to-date research related to their practice, engage in research activities, contribute to the Magnet® journey, present their innovations, and integrate their learning into practice.

65-R. Nurses’ perceptions of transformational leadership, authentic nurse leadership and healthy work environment

Joyce Fitzpatrick, PhD, RN, FAAN, FNAP,; CWRU Bolton School of Nursing; Cleveland, Ohio

9/27/2024, 2:00pm - 2:50pm, Breakout: 15

Nurses’ perceptions of transformational leadership, authentic nurse leadership and healthy work environment Background/Significance There is a recent attention to delineating relationships among and between the relational leadership models in nursing. Transformational leadership is the most predominant model guiding nursing professional practice and research; authentic nurse leadership is a recently developed model, one that is specific to nursing leadership. In this research we were interested in determining the relationships between the two relational leadership models and their relationship, individually and collectively, to nurses perceptions of their work environment. Purpose and Aims The primary objective of this research was to add to our understanding or relational leadership models guiding nursing research and professional practice. 1. Describe the relationships among nurses’ perception of the transformational leadership (TL) and authentic nurse leadership (ANL) of their leader, and their perception of the healthiness of their work environment (HWE), and the relationships between these variables. 2. Inform future strategies for research on leadership models in nursing. Methods: A convenience sample of registered nurses was obtained by snowball sampling, with collaboration from The DAISY Foundation to access nurses through their database of United States hospitals. The sample included registered nurses, nurse managers and advanced practice nurses in any setting. Nurses in executive roles and per diem nurses were excluded. The survey instrument included the Leadership Practices Inventory, the Authentic Nurse Leadership Questionnaire, the Healthy Work Environment Assessment Tool 2.0, and demographic questions employment status, practice area, years in position, years as a nurse, gender, race, ethnicity, and highest education). Data collection took place over two months in early 2024. Informed consent was included in the recruitment email. Opportunity to participate in a raffle for three $50 Amazon gift certificates was offered to the participants. Results/Outcomes/Implications The sample included more than 3000 nurses, with direct care, nurse leaders, and advanced practice nurses represented from a wide variety of practice settings. Less than half of the participants were DAISY awardees. The mean age was 42 years and the mean years of experience was 15 years. Both transformational and authentic nurse leadership were significant predictors of perceptions of healthy work environment among the nurses at all levels. Research on relational leadership models in nursing, particularly the nurse-centric models, is in the early stages of development. There is not only much potential for future research, but important applications for leadership preparation and skill development for nurses at all levels.

66-R. Building Up Leaders for Evidence-Based Practice

Lindsey Patton, PhD, APRN, PCNS-BC; Children's Health System of Texas; Dallas, Texas

9/27/2024, 3:00pm - 3:50pm, Breakout: 16

This session will describe how nursing research and EBP leaders collaborated with other unit-level nursing leaders to evaluate a leadership behavior program designed to support clinical nurses' implementation of evidence-based practice. We will describe the framework of the leadership behavior program, discuss the program’s impact on nursing leaders and clinical nurses, and explain methods used to sustain the program.

68-R. Could a logic model framework assist in analyzing leadership-based qualitative data?

Ronda Mintz-Binder, DNP, RN, CNE; Texas Tech Health Science Center School of Nursing; Lubbock, Texas

9/27/2024, 3:00pm - 3:50pm, Breakout: 16

Researchers use various qualitative methods to investigate and explain the stories, experiences, and relationships of study participants. Within qualitative methods, researchers must engage with data in meaningful ways to successfully identify emerging themes. Qualitative data analysis often presents novice researchers with challenges because there are many ways to categorize and explore data. For novice qualitative researchers, coding and analyzing qualitative data can be confusing and time-consuming. Some qualitative analysis methods incorporate the use of a framework as a deductive approach to support examination within the context of a framework. Logic models are defined as tools that show relationships among the resources, activities, outputs, outcomes, and impact. With qualitative data that is focused on processes or outcomes, implementing a logic model framework to analyze data could be useful and efficient. The use of a logic model framework to assist with organizing and categorizing leadership- based commentary will be presented. This unique approach to data analysis is particularly helpful for those unfamiliar with non-numerical analyses, and would contribute to development of qualitative analytical skills. Originally the idea of a nursing PhD candidate, faculty from two different universities joined together to bring this innovative analysis technique to fruition. The logic model framework was applied for secondary analysis of focus group responses collected from DNP-prepared nursing leaders within one hospital. This framework allowed for organization of identified codes, categories, and themes. Using directed content analysis, the logic model framework captured the essence of the data using an intuitive process familiar to organizational leaders. The main questions and responses were categorized within the logic model structure in a table format that will be presented. The three main research questions were the “Situations” which were used to organize the DNP leader responses. The “Inputs” included the key words and codes from the collected data. The 3 main “Outputs” reflected specific respondent examples that demonstrated their impact, strengths, and challenges as a DNP nurse leader. The “Outputs” of our data were action-oriented, leading naturally to the “Outcomes” which were three themes encompassing strengths a) scholarly problem solving, b) enhanced communication leading to changes, c) mentoring and inspiring, and one improvement theme of marketing the benefit of the DNP role. For the logic model to be relevant in qualitative analysis, the process begins with data that reflect a concern, include active problem solving, and means to a resolution. Implementing a logic model framework to categorize and organize process or outcome responses in a study could be useful and efficient, particularly for leadership style questions posed in an institution. The stepwise process of a logical model provides a systematic approach for examining data related to leadership processes that are fluid and occurs over time, as with program evaluation, quality improvement, or translation of evidence into practice.

69-R. Leader Credibility: A bibliometric analysis

Vaska Jones, RN(EC) NP-Adult NP-PHC MScN PhD(student); Queen's University; Kingston, Canada

9/26/2024, 2:10pm - 3:00pm, Breakout: 2

Leader Credibility: A bibliometric analysis Background: Effective leadership is crucial to ensure optimal patient outcomes and organizational success in today’s evolving healthcare landscape. Leader credibility is an essential element of successful leadership in the nursing field, with considerable implications for nurse retention, job satisfaction, and patient outcomes. However, leader credibility is a complex and nuanced concept understood differently across various healthcare settings. Therefore, gaining a comprehensive understanding of current knowledge on this topic requires a systematic analysis of scholarly literature through bibliometric methods. Such an analysis would offer valuable insights into publication trends and lay the foundation for furthering nurse leader credibility research. Objective: To conduct a bibliometric analysis to explore the scholarly landscape surrounding the concept of leader credibility in nursing and identify comprehensive gaps in knowledge. Methodology: Bibliometric analysis, a computer-assisted scientific methodology, was employed to investigate leader credibility in nursing. A systematic search of Scopus, an electronic database, was conducted, and the keywords 'leader* credibility' and 'nurs*' were used. The inclusion criteria comprised peer-reviewed articles, conference papers, and books published between 1982 and 2024. Bibliometric performance techniques, including citation mapping, were utilized to analyze publication trends within the literature. The analysis aimed to identify patterns, trends, and gaps in the literature and offer valuable insights into the conceptualization and research landscape of leader credibility in nursing. Results: Using the key search term ‘leader* credibility’ in any bibliometric field, 385 documents were found between 1982 and 2024, of which 338 (88%) were published from 2010 to 2024. Publications were predominantly from the United States, the United Kingdom, Australia, and South Korea. Articles constituted the majority of the documents (82.3%). Social sciences (n=226) and business/management (n=213) were the primary subject areas that mentioned the key term. From a healthcare perspective, psychology (n=38) and medicine (n=20) lead in publications, with a minor contribution from nursing (n=4). Where applicable, publications were included in multiple subject fields (i.e. psychology and nursing). Review of Public Personnel Administration (n=8), Public Personnel Management (n=7), and Public Administration (n=8) were the top 3 journals, all peer-reviewed, publishing on the topic of interest. Only 15 documents had ‘leader* credibility’ in the article title, none of which were from nursing, and the first was published in 2000. When using the search terms ‘leader* credibility’ AND nurs* in any field, 47 documents were found, of which the first was published in 2000. The subject areas that led in these publications were social sciences (n=27) and business/management (n=25). Conclusion: In summary, these results shed light on the scholarly landscape of leader credibility broadly, and in nursing. This bibliometric analysis provides a comprehensive overview of the research on leader credibility, identifying gaps for future investigations. This study advances our grasp of leader credibility by consolidating current bibliometric knowledge, identifying the paucity of scholarly work focused on leader credibility overall, and publications in nursing. However, despite a growing publication trend and the importance of leader credibility in leadership sciences, more research is needed to deepen our understanding of leader credibility in nursing.

70-R. “Being Human First” and Adapting to the Unexpected as a Nurse Leader: Findings from Canada during the COVID-19 Pandemic

Sonia Udod, RN,PhD; University of Manitoba; Winnipeg, Canada

9/26/2024, 3:10pm - 4:00pm, Breakout: 4

The global onset of COVID-19 created an unprecedented and intense working environment for healthcare leaders around the world. Public health emergencies such as the COVID-19 pandemic have brought greater attention to crisis leadership and placed intense psychological stress and pressure on the healthcare leaders, managers, and staff to make difficult decisions in a demanding work environment. The destructive effect on nurses’ wellbeing and their capacity to be engaged and provide compassionate care compromises the quality of patient care. Health leaders have a duty to care for their workforce while simultaneously managing their own mental wellbeing and resiliency. The goal of this qualitative research study was to identify post-crisis strategies used by Canadian healthcare leaders to: a) promote nurses’ health and wellbeing, b) their own health and wellbeing, and c) organizational resilience. Project goals and objectives have included the construction and testing of a theoretical crisis leadership framework and the development of practical crisis leadership recommendations for different leadership levels within Canadian healthcare systems. Conceptual Framework To ground our work, we used a crisis leadership framework created by one of our research team during COVID-19. This theoretical framework requires further testing and validation, which is one of our research goals. The theoretical crisis leadership framework we are using consists of four progressive stages: 1) Escalation during rapid preparation; 2) Emergency management with treatment and containment/curtailment of the threat; 3) Recovery during a period of “limbo” and uncertainty; and 4) Resolution described as collating and sharing knowledge of what was adaptive, and what worked. Methods A 3-year multi-method study is being conducted to explore leaders’ crisis leadership roles at different healthcare systems’ levels within and across two purposefully selected hospitals in three Canadian provinces. Sample and Setting: The sample consisted of 3 senior leaders, 6 directors, and 3 frontline managers from two selected hospitals in one province. Data Collection: Semi-structured interviews were conducted based on questions that were developed and piloted to correspond to each of the crisis leadership framework stages. Data Analysis: The crisis leadership framework was used to deductively code themes based on questions corresponding to each of the four stages of the framework. Inductive coding was also used to capture any other themes from the interviews. Braun and Clarke’s8 six-phase approach to thematic analysis was used to enhance scientific rigour. Constant comparison was used to pay attention to how leaders promoted their own and nurses’ health and wellbeing as well as organizational resilience. Results and Implications Study findings will be used to refine and further validate the theoretical crisis leadership framework. Preliminary findings have yielded facilitator and barrier themes with specific leadership actions to overcome barriers and leadership actions based on identified opportunities and strengths, respectively. Key barriers have included staff shortages, rapidly changing policies and protocols, communications challenges, and limited resources with prioritization of finite resources. Facilitators have included “being human first,” being present and empathic, and funneling critical information. Nurse leaders are ideally situated to work with key knowledge users within organizations to mitigate crisis stressors.

71-QI. Trust Me: A Qualitative Evaluation on the Impact of a Trust-Focused Program on Leadership Development

Kylee Gerohristodoulos, MSN RN CPN; Johns Hopkins Hospital; Baltimore, Maryland

9/27/2024, 12:00pm - 1:50pm, Breakout: Poster Showcase

Introduction: Trusted nurse leaders empower staff nurses to excel, promote staff satisfaction and retention, and support engagement. However, nurse leaders often do not have the training and/or confidence to practice trust-building behaviors in their relationships with their staff and colleagues. A program evaluation was performed to assess the impact of a six-month trust-based leadership development initiative on the participating nurse leader’s leadership development skills and practice. Method: We conducted semi-structured virtual focus groups consisting of 12 nurse managers and 2 assistant nurse managers to evaluate the program. Semi-structured, virtual individual interviews were also conducted with 6 nurse directors and 6 assistant nurse directors. All individual and focus group sessions were recorded and transcribed. The primary investigator and two research colleagues performed a qualitative content analysis of each transcription in an iterative process. Thereafter, a deductive methodology was used to identify themes from the data. Results: In the preliminary analysis, we identified five themes related to perceived impact on leadership development. The themes are knowledge of the value of trust in leadership, utilization of trust-building tools and resources, impact on leadership practice, and relationship with front-line staff. A trend emerged from the comments that support the belief that trust in communication is critical among nurse leaders in developing safe and effective relationships in nursing. Survey question responses showed an increased awareness and appreciation for those trust-building behaviors that support transparency and accountability in leadership practice. Discussion: From the qualitative content analysis, it was concluded that nurse leaders recognize the value and importance of trust in their leadership role. Overall, the participants noted enhanced confidence in trust-building communication behaviors with their staff, specifically in giving and receiving feedback and managing expectations. The greatest barrier to engagement was the lack of time to devote to the training due to the existing workload and job responsibilities.

72-R. Psychometric Evaluation of the Human-Centered Leadership in Healthcare Assessment

Lucy Leclerc, PhD, RN, NPD-BC; uLeadership; Atlanta, Georgia

9/27/2024, 2:00pm - 2:50pm, Breakout: 15

Human-Centered Leadership in Healthcare (HCL-HC) is a contemporary, healthcare-specific, relational leadership theory developed using constructivist grounded theory. The 20-item HCL-HC instrument is used to assess the four dimensions of HCL-HC. The purpose of this study was to psychometrically test and identify discrete subscales of the Human-Centered Leadership in Healthcare self-assessment. Testing included item analysis, reliability analysis using Cronbach’s alpha, testing for both construct and discriminate validity. This psychometric study consisted of three phases: 1) generating scale items based on literature review and interviews using constructivist grounded theory; 2) pilot testing for face and content validity; 3) evaluating psychometric properties with 729 nurses at all levels of leadership from bedside to executive level roles. Data were collected from June 2021 – November 2023. Exploratory factor analysis and Cronbach’s alpha were used for construct validity and internal consistency reliability. The final instrument consists of 20 items in 4 dimensions. All factor loadings were above .40 and loaded in their respective factor which illustrates construct validity. Cronbach’s alpha was above .70 for all scales and subscales indicating adequate reliability. The HCL-HC assessment can be reliably used for nurse leaders' individual professional development. The assessment serves as a guide for the leader to identify strengths and opportunities to grow as a relational leader.

73-R. Effective Nurse Leadership in a Crisis: Lessons For Now and Next Time

Jaason Geerts, PhD; The Canadian College of Health Leaders; Ottawa, Canada

9/26/2024, 2:10pm - 3:00pm, Breakout: 1

Background The global threat of the COVID-19 pandemic was greater in scale and scope than any other health crises this century. Its various waves introduced a new phenomenon: a prolonged limbo-like, post-emergency but pre-final resolution stage, that included an anticipated imminent return to an emergency stage with little warning. No robust frameworks were available in the academic literature to guide leaders as they navigated the volatile, chaotic, and fearful waves of the pandemic. In response to this knowledge gap, we developed a novel four-stage model of leadership during a crisis: 1) Escalation, 2) Emergency, 3) Recovery, and 4) Resolution. Therefore, this study aims to achieve two purposes. The first is to validate the theoretical model and frameworks of key characteristics, leadership imperatives, and self-assessments for each of the four stages of leadership in a crisis. The second is to identify effective nurse leader practices during various stages of the pandemic. Methods We are undertaking a four-step process of data collection for this research. The first step (that overlaps into the other steps) is conducting literature reviews for the stages and emergencies overall. The second step is to validate the model’s key characteristics and imperatives for each stage with the project advisory team using a three-round modified Delphi technique until initial consensus is achieved. The third step is conducting pilot interviews with nurse leaders to create a coding framework. The fourth step is conducting interviews with nurse leaders on effective leadership practices during the pandemic. Results The four-stage model of leadership in a crisis will include defining characteristics and leadership challenges at each stage, as well as key leadership imperatives, and reflection questions that leaders and organizations can use to assess their readiness for future pandemics and/or performance during COVID-19. The Escalation Stage (Stage 1) is predominantly characterized by an increasing realization, often based on limited, erratic, or unsubstantiated information, that an external threat is encroaching, and by the need for rapid preparations. The Emergency Stage (Stage 2) focuses on leadership at the onset of a threat, when it is direct and local. The Recovery Stage (Stage 3) is highly capricious because although it is less acute than the previous phase, there may be widespread staff and community fatigue or burnout, along with a prolonged looming potential threat of reverting to an emergency state at any point in reaction to a resurgence. The Resolution Stage (Stage 4) involves addressing the repercussions of the crisis and subsequently setting priorities, ideally alongside a collective creative discussion of postcrisis opportunities and strategies to achieve a new (and hopefully) better reality. Implications and Conclusions Further research could explore the extent to which the frameworks could be customized according to region, sector, and level of leadership. Organizations and educators could experiment with how these frameworks could be applied optimally to prepare their people effectively for future crises and to be more adaptable generally. Leaders might reflect on their own and, through discussion, their teams’, performance during the pandemic to identify areas of strength and improvement.

73-R. Effective Nurse Leadership in a Crisis: Lessons For Now and Next Time

Jaason Geerts, PhD; The Canadian College of Health Leaders; Ottawa, Canada

9/26/2024, 2:10pm - 3:00pm, Breakout: 1

Background The global threat of the COVID-19 pandemic was greater in scale and scope than any other health crises this century. Its various waves introduced a new phenomenon: a prolonged limbo-like, post-emergency but pre-final resolution stage, that included an anticipated imminent return to an emergency stage with little warning. No robust frameworks were available in the academic literature to guide leaders as they navigated the volatile, chaotic, and fearful waves of the pandemic. In response to this knowledge gap, we developed a novel four-stage model of leadership during a crisis: 1) Escalation, 2) Emergency, 3) Recovery, and 4) Resolution. Therefore, this study aims to achieve two purposes. The first is to validate the theoretical model and frameworks of key characteristics, leadership imperatives, and self-assessments for each of the four stages of leadership in a crisis. The second is to identify effective nurse leader practices during various stages of the pandemic. Methods We are undertaking a four-step process of data collection for this research. The first step (that overlaps into the other steps) is conducting literature reviews for the stages and emergencies overall. The second step is to validate the model’s key characteristics and imperatives for each stage with the project advisory team using a three-round modified Delphi technique until initial consensus is achieved. The third step is conducting pilot interviews with nurse leaders to create a coding framework. The fourth step is conducting interviews with nurse leaders on effective leadership practices during the pandemic. Results The four-stage model of leadership in a crisis will include defining characteristics and leadership challenges at each stage, as well as key leadership imperatives, and reflection questions that leaders and organizations can use to assess their readiness for future pandemics and/or performance during COVID-19. The Escalation Stage (Stage 1) is predominantly characterized by an increasing realization, often based on limited, erratic, or unsubstantiated information, that an external threat is encroaching, and by the need for rapid preparations. The Emergency Stage (Stage 2) focuses on leadership at the onset of a threat, when it is direct and local. The Recovery Stage (Stage 3) is highly capricious because although it is less acute than the previous phase, there may be widespread staff and community fatigue or burnout, along with a prolonged looming potential threat of reverting to an emergency state at any point in reaction to a resurgence. The Resolution Stage (Stage 4) involves addressing the repercussions of the crisis and subsequently setting priorities, ideally alongside a collective creative discussion of postcrisis opportunities and strategies to achieve a new (and hopefully) better reality. Implications and Conclusions Further research could explore the extent to which the frameworks could be customized according to region, sector, and level of leadership. Organizations and educators could experiment with how these frameworks could be applied optimally to prepare their people effectively for future crises and to be more adaptable generally. Leaders might reflect on their own and, through discussion, their teams’, performance during the pandemic to identify areas of strength and improvement.

76-R. Enhancing Resilience and Well-being Among Nurse Leaders: A Randomized Controlled Trial of Mindfulness and Narrative Interventions

Minjin Kim, PhD, RN; University of Cincinnati College of Nursing; Cincinnati, Ohio

9/27/2024, 10:10am - 11:00am, Breakout: 7

Background: The COVID-19 pandemic has significantly impacted healthcare workers’ mental health. Nurse leaders face challenges such as staffing shortages, quality care assurance, nurse retention, and well-being promotion. Strategies at individual, unit, and system levels are vital for enhancing nurses’ resilience and well-being. The 3-minute mindfulness breathing space (3MBS) intervention effectively promotes self-regulation among clinicians—a critical factor for resilience. Additionally, Narrative Nursing (NN) empowers nurses and nurse leaders by recognizing the significance of their work and offering peer support. Aims: The study aimed to explore the effects of a 3MBS and/or a NN video intervention on enhancing well-being and resilience among nurse leaders in acute care settings. The research involved a three-arm randomized controlled trial with the following groups: 1) 3MBS group, 2) NN intervention group, and 3) Combined 3MBS/NN intervention group. The study was guided by the following hypotheses: • H1: The combined 3MBS and NN interventions will have a significant positive impact on the level of resiliency among nurse leaders, compared to the 3MBS-only, NN intervention-only, and baseline data. • H2: The combined 3MBS and NN interventions will significantly enhance the level of well-being among nurse leaders, compared to the 3MBS only, NN intervention only, and baseline data. • H3: These positive changes in resiliency and well-being will be sustained over time among nurse leaders, compared to the 3MBS only, NN intervention only, and baseline data. Methods: In a three-arm randomized trial, the effects of a 3MBS and NN intervention on nurse leaders’ well-being and resilience were assessed over two weeks. The study, conducted online via Qualtrics Survey Platform, recruited participants through peer-to-peer channels and ALSN member newsletters. Data collection involved an online consent form and baseline survey. The 3MBS and NN interventions were accessed via YouTube links within Qualtrics. Participants in the 3MBS group engaged in practice sessions twice daily, while the NN group received weekly videos and surveys for feedback. Quantitative analyses compared resilience and well-being scores at baseline, one-week post-intervention, and two weeks post-intervention using Repeated Measures ANOVA. Results, Outcomes, and Implications: In a study of nurse leaders (N=157), well-being and resilience scores were analyzed across three intervention groups: 3MBS (n=55), NN (n=56), and a combined 3MBS/NN (n=46) over three timelines. First and second follow-up surveys had response rates of N=115 and N=96, with retention rates at 73% and 61%, respectively No significant differences in resilience or well-being scores were found between the groups, suggesting that intervention type may not be crucial—receiving any intervention matters. All groups exhibited similar well-being improvement over time. A significant temporal effect was observed for both well-being and resilience scores, emphasizing the benefits of practice. Unexpectedly, resilience scores decreased from the first to the second follow-up, warranting further exploration of contributing factors. These results highlight the potential need for longer or more intense interventions and call for additional research to fully understand the complex dynamics of these outcomes.

77-R. The Relational and Structural Components of Innovativeness Across Academia and Practice for Healthcare Progress Scale

M.Lindell Joseph, PhD, RN, FAAN, FAONL; The University of Iowa College of Nursing; Iowa City, Iowa

9/27/2024, 10:10am - 11:00am, Breakout: 9

Limited theoretically grounded evidence exists to provide strategic direction for healthcare innovation across practice and academia. Utilizing two phases, we developed a measure. In Phase 1 of the analytical strategy involved scale development using 16 subject matter experts. Phase 2 involved pilot testing the scale. The final Innovativeness Across Academia and Practice for Healthcare Progress Scale (IA-APHPS) consisted of 7 domains: 3 relational domains, 2 structural domains, and 2 impact domains. The confirmatory factor analysis model fits well with a comparative fit index of 0.92 and a root-mean-square error of approximation of 0.06 (n = 477). As the 1st validated scale of healthcare innovation, the IA-APHPS allows nurses to use a diagnostic tool to facilitate innovative processes and outputs across academic-practice partnerships.

78-ASP. Leadership in an Academic-Practice Collaborative: Evaluation of an Ambulatory-based Academic Clinical Coordinator Model

Mary Dolansky, PhD, RN, FAAN; Case Western Reserve University; cleveland, Ohio

9/27/2024, 12:00pm - 1:50pm, Breakout: Poster Showcase

Ambulatory care nursing opportunities for new graduates are increasing as the value of the registered nurse in the ambulatory and community setting is emerging. Unfortunately, there are few academic-practice models to guide precepted out-patient and community clinical experiences that are very different than inpatient clinical experiences. Academic-practice partnerships that collaborate on solutions to ensure that students obtain competencies are enhanced are needed. To close this gap, the Academic Clinical Coordinator (ACC) model was developed and piloted in the VA health system as part of a previous HRSA grant. The ACC Model consists of a school of nursing faculty member who is permanently assigned to an organization to coordinate ambulatory/community integration of BSN students to enhance competency development and contribute to organizational goals of improving patient and system outcomes. Purpose: The purpose of the academic-clinic partnership was to implement, test, and further refine the ACC model in a large community health system across multiple ambulatory care clinics in order to enhance BSN Students’ population health and systems-based practice competency development, strengthen the organizational relationship between the school of nursing the community health system, and enhance preceptor development/retention in the ambulatory care setting. Methods: The ACC Model was implemented in a senior level precepted capstone course and tested across several ambulatory care clinics over the course of 2 semesters (Spring and Fall, 2023). The spring semester consisted of 5 students in 1 clinic and the Fall semester consisted of 12 students in 6 clinics. Handbooks were created for both clinical faculty who took on the ACC role and the ambulatory care preceptors. Program evaluation was conducted using both qualitative and quantitative approaches and included student, preceptor, clinical faculty, and leadership perspectives. Quantitative data were obtained using established instruments (Quality Improvement Knowledge Attitude Tool and Nursing Preceptor’s Perceived Rewards and Benefits Questionnaire). Focus groups were conducted with each group of students, preceptors, and clinical faculty who served as ACC, while open-ended questions were sent to the nurse managers. Results: We found that students in the ACC group had greater quality improvement knowledge and attitude and demonstrated enhanced competency in population-based health and systems-based practice through competency assessment and project accomplishments. Preceptors reported overall satisfaction with the model but identified that their workload needs to be reduced when functioning as a preceptor and focus on improving relationships with academic faculty needs to be emphasized. Clinical faculty reported satisfaction with the model and were satisfied with their assignments, although there was variation in how they viewed the role of ACC. Managers of the clinics and community settings appreciated the increased communication and involvement of the students in quality improvement projects. Implications: The continuous testing, evaluation, and refinement of the ACC Model is needed through leadership involvement to ensure strong collaboration in the academic-practice partnership. Future work includes enhancing ambulatory care preceptor recruitment and training, enhancing implementation fidelity among clinical faculty who take on the ACC role, adding additional community observations outside of the clinic, and ensuring that clinical faculty have competency in ambulatory care nursing.

79-R. Empirically Testing the Theoretical Tenets of the Organizational Learning in Model: A Cross-Sectional Survey

Bret Lyman, PhD, RN; Provo, Utah

9/28/2024, 10:10am - 11:00am, Breakout: 19

Purpose: To empirically test several theoretical tenets of the Organizational Learning in Hospitals model. Design & Methodology: A cross-sectional survey was distributed to direct care nurses licensed in Utah and New Mexico. The instruments used were the Organizational Learning Instrument-Context, the Organizational Learning Instrument-Mechanisms, and the Organizational Learning-Continuous Improvement from the Hospital Survey on Patient Safety Culture 2.0. Also collected were nurse-reported job satisfaction, burnout, intent to leave, and quality of care data. Findings: The results empirically support several tenets in the Organizational Learning in Hospitals Model. Empirical support was found for the proposed relationships among and between the contextual factors and mechanisms associated with organizational learning. Also supported was the proposed relationship between contextual factors, mechanisms, and outcomes of organizational learning (i.e. job satisfaction, burnout, intent to leave, and quality of care). Research Limitations/Implications: Nurse researchers can use the Organizational Learning in Hospitals Model and its corresponding research instruments to study organizational learning in hospitals. Future research could benefit from using longitudinal data, and more objective measures of quality of care. Practical Implications: Organizational learning is associated with important organizational outcomes in hospitals, including job satisfaction, burnout, intent to leave, and quality of care. Nurse leaders can use the Organizational Learning in Hospitals model to guide their thinking and decision-making related to organizational learning.

81-R. The Effectiveness of Resilience Training on Nurse Leader Burnout

Terra Reed, RN, BSN, MSN (June 2024); Silver Hill Hospital; New Canaan, Connecticut

9/27/2024, 12:00pm - 1:50pm, Breakout: Poster Showcase

Problem: Healthcare workers have long suffered from high rates of burnout, which has significantly increased since the Covid pandemic. The World Health Organization recently recognized burnout as a serious health issue and declared it as an occupational phenomenon (Woo et al., 2020). Among healthcare workers, nurses are known to struggle with burnout symptoms the most (Sampson et al., 2019). Negative healthcare cultures that include workplace bullying negatively impact team mental health and reduces nurses’ ability to cope with high stress environments, which can lead to burnout (Peng et al., 2022). Nursing leaders are challenged to find ways to help improve their nursing units so that they can improve the workplace culture and improve nurse moral and retention. Purpose: This project will offer resilience and emotional intelligence training to nursing leaders. Resilience is a personal resource skill that can be used to navigate stressful work situations and life events. Resilience training has been shown to improve professional quality of life, resulting in decreased bullying and increased staff retention rates (Peng et al., 2022). Expanding knowledge and insight of one’s own morals and values allows a leader to build awareness of how they impact the work environment and if changes need to be made to maintain a culture of accountability and collaboration (Frias et al., 2021). Leaders who improve their own ability to deal with workplace stress, bullying behaviors, and who improve their understanding of others will be better prepared to lead their teams to be happy at work. Methods: This project will propose a psychological resilience and self-care program for nursing leaders that includes topics of emotional intelligence, self-awareness, self-regulation, motivation, effective leadership characteristics, communication techniques, stress reduction, and good sleep hygiene. The class will be led by a resilience coach and will be part lecture and part workshop. The project will take place in a large, suburban teaching hospital in the northeast. Two nursing units will have each of their managers, assistant managers, and clinical leaders attend the 8-hour training class. Outcomes and Implications: The attendees will fill out the Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF) instrument before the session and at 2 months after the session. The TEIQue-SF includes 30 statements encompassing the four areas of emotional intelligence: well-being, self-control, emotionality, and sociability (Petrides, 2009). Additionally, existing data for staff satisfaction (press ganey annual surveys) and staff retention statistics will be collected to compare the 1 year before and after the classes to observe for any change in staff satisfaction, unit culture scores, and retention.

84-R. Nurse Satisfaction and Interprofessional Interactions: The Impact of Nurses’ Professional Relationships on Job Satisfaction

Katrina Robinson, MSN, RN, CCRN; Wellstar Kennestone; Marietta, Georgia

9/27/2024, 12:00pm - 1:50pm, Breakout: Poster Showcase

The purpose of this study was to identify the relationship between nurses’ interprofessional interactions and nurses’ job satisfaction. The study design utilized was a cross sectional retrospective analysis of survey results within a healthcare system. Scales from the National Database of Nursing Quality Indicators (NDNQI) survey were the instruments used as variable measures. The Job Enjoyment Scale (JES) provided a mean score for nurses’ job satisfaction and the Interprofessional Scale provided rollup score means for interactions between nurses and specific disciplines (nursing, physicians, Advanced Practice Registered Nurses [APRN’s], pharmacists, therapists, and social workers) as well as a total rollup score for all interprofessional interactions. A Pearson correlation analysis was performed between JES and interprofessional variables. Findings reflected a significant positive correlation between nurse satisfaction and overall interprofessional interaction, as well as significant positive correlation between nurse satisfaction and each specific discipline except for APRN’s, for which no correlation was found. It was noted that the data in this study was collected during the COVID-19 pandemic, so the findings support the value of positive interprofessional interactions during that challenging time, suggesting that amidst the pandemic, the interprofessional interactions among team members still impacted the job satisfaction of nurses. Conclusively, as positive interprofessional interactions increase, the nurses’ job satisfaction increases also.

85-EBP. Understanding Return on Investment (ROI) to Drive Collaborative Change

Todd B. Smith, PhD, MSHA, MBA, RN, NEA-BC; The University of Alabama; Tuscaloosa, Alabama

9/27/2024, 12:00pm - 1:50pm, Breakout: Poster Showcase

The Return on Investment analysis is an essential accounting tool that will provide you with essential information quantifying cost and benefits of both financial and non-financial metrics to identify the feasibility, efficacy or efficiency of a proposed project. This information is invaluable in evaluating competing proposals and resources allocation to support the organizations financial health and viability.

86-R. Assessing Wellbeing of Pediatric Nurse Leaders Using a Mixed Methods Approach

Elaine Beardsley, MN, ACCNS-P; Children's Health; Dallas, Texas

9/27/2024, 2:00pm - 2:50pm, Breakout: 13

Nurse leaders provide support at an individual, team and system level, working to improve outcomes at a patient/family and staff level. In recent years, the staffing shortage and intention to leave has increased for nurse leaders. This can have detrimental effects on patients and staff, including decreased effectiveness in alleviating stress of team members, effective decision-making and creating a healthy work environment. Although the contributing factors are many, it is important for all healthcare organizations to identify systemic barriers that contribute to healthcare teams. Currently, there is a gap of existing wellbeing research specific to clinical nursing leaders, so additional empiric studies are needed to help inform leader and system wellbeing. The purpose of this study was to report the prevalence of wellbeing within pediatric nursing leaders, compare the well-being index scores between variables (national benchmark, years of leadership experience, practice settings, role), and identify contributing factor themes. This explanatory sequential two-phase design study used a mixed methods approach involving two phases of data collection. Eligibility criteria included employment as a registered nurse with at least one direct report, in the current role for a minimum of six months, employed at the organization sponsoring this study. In phase one, participants responded to a survey using the Well-Being Index – a nine-item questionnaire which evaluated wellbeing through meaning and connection, work-life balance, suicidality, and overall energy. Phase two included qualitative interviews to further explore themes around clinical nursing leader well-being. Interviews were conducted using open-ended questions derived from an interview guide based on the aggregate data for the phase one analysis. Naturalistic inquiry was used to guide this portion in which interviewing is open-ended with no prompting or manipulation to further describe the research. Interviews were conducted virtually and audio-recorded using the TranscribeMe application. Sampling continued until thematic saturation was reached. The research team analyzed the qualitative data using a conventional, inductive content analysis to provide knowledge and understanding of clinical nursing leaders’ well-being. Quantitative results showed that the overall nurse leader well-being was lower than the national average for nurses (regardless of role). Factors supporting well-being included the ability to use cognitive reframing – the ability to identify a feeling or thought and then changing one’s view to a more positive one. Nurse leaders identified many situations where reframing was used, including shifting their mindset about leader fulfillment or nursing identity to connect to one’s values, meaning, and purpose. It was also identified as a way to detach from work to replenish and establish an identity away from the workplace. In the qualitative interviews, nurses who said they could reframe had a more positive mindset about being a leader and engaging in internal motivation for proactive support and learning. Those who struggled with reframing felt more powerless to manage the expectations. Implications for nursing leadership education include the need for robust, supportive training programs for future leaders, as well as support for current leaders. Practice implications should include nurse leaders in recognition and rewards programs alongside those at the bedside.

88-EBP. Is There a HUman in There? Evaluating the Implementation of the Nurse Leadership Theory, Human-Centered Leadership

Kassandra Meadows, MSN, MBA-HA, RN, NEA-BC; Christus Children's Hospital; San Antonio, Texas

9/27/2024, 12:00pm - 1:50pm, Breakout: Poster Showcase

This project utilized the four dimensions of Berkel et al. (2011) Integrated Model of Program Implementation: fidelity, adaptation, quality of delivery, and participant responsiveness to evaluate the educational training of a leadership program based on the principles of Kennedy et al. (2022) Human-Centered Leadership in Healthcare: Evolution of a Revolution. Using a standardized approach to evaluate the implementation provided insight into the perceived value of content and delivery methods and the opportunity to achieve HCL’s predicted department-level results. These measures identified adherence to the HCL founders' intended program implementation and considered the facilitator and participants' influence on the program outcome. The program's implementation demonstrates the nursing theory’s success of focusing first on personal transformation (“it starts with you”) and the team’s development and ability to sustain positive cultures of excellence, caring, and trust (“but it’s not about you”) (Kennedy et al., 2022, p. 25 & 64).

89-EBP. Excess Body Weight Screening in Children: Evidence-Based Quality Improvement Initiative

Cheryl Abersold, DNP, FNP-C; Live Oak, Florida

9/27/2024, 11:10am - 12:00pm, Breakout: 11

Problem, Background, and Significance Excess body weight (EBW) trends in pediatrics increase annually, leading to earlier onset of related comorbidities. Children with EBW are at increased risk for early onset of chronic diseases, psychological disorders, and increased obesity in adulthood creating more complex patients at younger ages. This significantly decreases the lifespan of these patients (Anderson et al., 2023; Gauthier et al., 2013; Hill et al., 2019). Recommendations by the Centers for Disease Control, World Health Organization, and the Patient-Centered Medical Home (PCMH) model call for annual body mass index (BMI) screening for patients ages 2-19, with quarterly BMI follow-up for high-risk patients (CDC, 2022; WHO, 2022; Hill et al., 2019). Organizations struggle with EBW screening and follow-up compliance due to a lack of understanding of the problem, provider bias, discomfort with discussing weight-related topics, improper collection and recording of anthropometric data, and lack of compliance with scheduling patients for screening and follow-ups. Nursing leadership can reverse this negative trend and reduce healthcare costs associated with EBW by leading evidence-based quality improvement (EBQI) initiatives to bring the science around best practices to primary care. Purpose The purpose of this EBQI initiative is to empower nursing leaders in pediatric primary care organizations to lead initiatives surrounding the identification and implementation of best practices to improve compliance with screening and follow-up for children diagnosed with or at high risk for developing EBW. Methods An EBQI initiative driven by the Johns Hopkins EBP nursing (JHEBNP) model and plan-do-study-act (PDSA) was undertaken by a nurse leader/nurse practitioner in a private, for-profit, pediatric primary care organization. After a review of current processes, the nurse leader identified a need for an amendment of current processes and practices. A practice change driven by the literature was created and implemented in collaboration with key stakeholders across the organization. Outcomes measured included screening rates and three-month follow-up scheduling rates. Results After an exhaustive search of the literature and critical appraisal, 29 articles informed this initiative. Literature revealed BMI is the most appropriate screening tool for pediatric patients ages 2-19 years. Follow-up should be done on patients diagnosed with or at risk of having EBW. A multitude of provider- and patient/family-centric barriers were also identified in the literature. Implementation of this EBQI initiative resulted in an average increase of 56% for BMI screenings and an average increase of 1100% in BMI follow-up visits scheduled over the 5 months when compared with baseline data. Conclusion Nursing leaders have the opportunity to bring science to primary care practice through leading EBQI initiatives that promote collaboration across the healthcare team to address key healthcare issues impacting our nation’s health.

90-QI. ELECTRONIC STANDARDIZED HANDOFF FOR ANESTHESIA PROVIDERS: AN EVIDENCE-BASED QUALITY IMPROVEMENT INITIATIVE

Tina Dalzell, DNP, APRN-CRNA; Ohio State University Wexner Medical Center; Columbus, Ohio

9/27/2024, 2:00pm - 2:50pm, Breakout: 14

Communication errors have been identified as a contributing cause of patient harm and death in healthcare. Handoffs of care are error prone and a source of risk. The host site reports an average of four communication errors per month related to intraoperative handoff of care. The literature identified that intraoperative handoff of anesthesia care is associated with worse patient outcomes and that standardization of the process can improve quality of handoff as well as provider satisfaction. The purpose of this initiative is to implement an intraoperative standardized handoff for anesthesia providers; with the goal to decrease variation in handoffs, improve communication, and improve provider satisfaction. This evidence-based quality improvement initiative was designed as a staged roll-out for intraoperative anesthesia providers to use an organizational derived handoff tool at ten anesthesia sites. Participants included certified registered nurse anesthetists, anesthesia residents and anesthesia assistants. Participants filled out a pre-implementation and post-implementation Qualtrics survey. Improvements were shown in provider satisfaction with the new hand off process, as well as increased use of a standardized handoff process. Zero communication errors were reported in the data collection period for the implementation site. Initiative findings show an increase in the use of a standardized handoff, improved satisfaction, and decreased communication errors. This initiative was well received and has the potential to lead to improvements in intraoperative anesthesia handoff of care once implemented to more anesthesia sites with improved compliance. Keywords: anesthesia, communication, handoffs, intraoperative, quality improvement, intraoperative, standardized handoff, satisfaction, standardization

91-R. What do nurses want? An interpretive descriptive study of acute care nurses in Manitoba’s work preferences across generations

Wendy Ducharme, RN MN; University Of Manitoba (WINNIPEG); Winnipeg, Canada

9/27/2024, 12:00pm - 1:50pm, Breakout: Poster Showcase

What do nurses want? An interpretive descriptive study of acute care nurses in Manitoba’s work preferences across generations The issue: The current nursing shortage has contributed to challenges in health service delivery across all sectors resulting in delays in access to care for clients and negatively impacting work environments, contributing to retention issues. Effective workforce planning is essential to address current and future human resource capacity to meet the health needs of Manitobans. The literature demonstrates the emergence of multiple models and frameworks for health workforce planning that incorporate capacity and demand however nurses’ work preferences are not explicitly addressed, and the default planning assumption is directed to full-time employment. This is contrary to literature highlighting decreasing organizational commitment with increased fatigue, burnout, and desire for work-life balance in a predominantly female-gendered workforce. Failing to account for nurses’ employment preferences negatively impacts planning assumptions, priorities, and operational decisions. Purpose: This study aims to investigate nurses’ work preferences and explore generational influences on retention in acute care facilities in Manitoba to inform future health workforce planning considerations. The research questions to be addressed are:  What are the work preferences expressed by cohort-specific groups?  To what extent are the work preferences similar or different within and between cohorts?  Are the work preferences related to workplace or personal factors?  To what extent are workplace factors mutable by employer interventions?  To what extent can employers create enabling workplace conditions that are responsive to personal circumstances? Methodology: This mixed methods study will be conducted using Thone’s interpretive descriptive methodology which was selected for its suitability to describe and account for the significance of topics when little is currently known about the phenomena being explored. Participants who were employed in acute care facilities in Manitoba between 2020 and 2024 will be recruited d using social media, regulatory body mailouts, and snowball sampling. Data collection will use two methods: 1) an online questionnaire containing demographic, nursing experience, work satisfaction, and workforce participation intention questions and 2) distinct and mixed cohort focus groups. Data collection and analysis will occur simultaneously to enable the integration of emerging knowledge. A culminating policy dialogue activity with key stakeholders will be conducted after the completion of the preliminary analysis to support the interpretation of findings and engage the parties in both knowledge generation and early knowledge translation. Results Work preferences and contributing factor findings may offer pragmatic insight into nursing capacity which can inform planning and operational activities. Current planning assumptions exclude nurses’ preferences and may contribute to supply gaps. This study aims to inform decision-makers of this potential risk and provide insight into considerations for leadership actions in work environments, collective agreement negotiations, and funding of educational institution capacity to create the required nursing workforce.

93-R. Facilitators and Barriers to Nurse Leader Well-Being in the United States: An Integrative Review

Asiah Ruffin, BSN, RN; University of Alabama at Birmingham; Birmingham, Alabama

9/27/2024, 2:00pm - 2:50pm, Breakout: 13

Background: Nurse leaders are an essential factor in steering the delivery of quality patient care, ensuring operational efficacy, and cultivating favorable work environment within their teams. However, the demanding nature of their roles, coupled with the evolving dynamics of the healthcare setting, often exact a toll on nurse leader well-being, posing significant challenges to their well-being, work-life balance, and work relationships with staff. Research Objective: Well-being is a multifaceted concept that can influence a nurse leader’s job performance and leadership effectiveness. This integrative review aims to synthesize evidence on factors that facilitate and prevent well-being in U.S. nurse leaders. Methods: The authors searched peer-reviewed literature using the following databases: PubMed, Scopus, and Academic Search Premier. The search yielded 1041 articles, with 928 titles and abstracts screened for eligibility. Fifteen articles, conducted in the U.S. and published between 2013 and 2023 were included in this integrative review following full-text review. This review was guided by the Whittemore and Knafl five step integrative review approach. Results: Findings from this integrative review highlight facilitators and barriers to U.S. nurse leader well-being. Resources such as social support, leadership support, and work-life balance are positively associated with nurse leader well-being. Personal traits such as resilience, grit, and happiness contribute to success in nurse leader roles, further supporting their well-being. On the contrary, increasing workloads, staffing challenges, lack of organizational support, and increasing spans of control increase the risk for poor well-being outcomes such as burnout, depression, anxiety, and stress in nurse leaders. Implications for Policy or Practice: Healthcare administrators must recognize the important role well-being plays in a nurse leader’s ability to carry out their functions. Well-being initiatives have become popular since the pandemic, but more research is needed to understand the long-term impact of well-being promotion strategies. Establishing well-being as an organizational priority is motivating to staff and raises organizational commitment. Findings from this review can inform policies to promote workload management, team building, and leadership development all of which can contribute to enhanced well-being for nurse leaders. Relevance to Conference Theme: Incorporating findings from this integrative review can include measures such as initiating team building strategies at work, providing access to professional development opportunities that aim to teach and promote trust, effective communication, and inclusive work climates for nurse leaders and their staff. Learning Objectives: 1. To assess facilitators and barriers to U.S. nurse leader well-being. 2. To identify gaps in knowledge associated with the well-being of U.S. nurse leaders.

94-ASP. The Art of Leadership: Students demonstrate their understanding in aesthetic ways

Laurie Clune, RN, BA, BScN, MEd, PhD, FCAN; University of Regina; Regina, Canada

9/28/2024, 11:10am - 12:00pm, Breakout: 24

Tradition evaluative approaches used in undergraduate nursing education have relied heavily on empirical, ethical, and reflective practice ways of knowing. In an undergraduate Leadership Course, students were asked to share their understanding of the domain of nursing leadership through an aesthetic assignment. Students were asked to draw on their inner, creative resources to answer the question: What is Nursing Leadership? Students were required to create an artifact and a 150-word description of their work. Initially, students were afraid of this unfamiliar assignment. This vulnerability resulted in stronger student-faculty relationships, more engagement with course content, increased efforts in the assignment, improved academic performance, and influential leadership pieces. This presentation will share the aesthetic leadership pieces of undergraduate year three students enrolled in a Leadership course with the audience. Student and faculty feedback specific to aesthetic ways of knowing will be shared.

Poster Presentations

Ordered by Abstract ID

Friday, Sep 27

• 12:00-12:50 lunch and poster showcase (poster presenters are not required to be present);
• 12:50-1:50, Poster Showcase (presenter are required be in attendance)

• Cassandre Milien, DNP, RN; St. Thomas University; Miami, Florida

Understand the significance of implementing HIV/STI screening guidelines for older adults. Explain how the AAFP guidelines were implemented and the study design used to evaluate the impact. Discuss the practical implications of the study's findings for healthcare providers, patients, and public health.

3-R. The Relationship Between Gratitude and Job Satisfaction in Nursing Leadership

• Tammy Aiken, DNP, RN; Bassett Healthcare System; Cooperstown, New York

An understanding of the definition of gratitude and job satisfaction and their significance Have an awareness of tools used to measure gratitude and job satisfaction Gain understanding of tactics to implement for nurse leaders, their team and organization.

8-QI. CLABSI Prevention: It Takes a Village

• QI, Berhanu; Nursing; Emory University Hospital, Georgia

Consider for either of the above Discuss the essential nature of interdisciplinary collaboration to help prevent ‘never events.’ Describe a multidisciplinary approach to mitigate CLABSI development.

13-R. The CNOs’ Experience in Hospital Incident Command Systems (HICS) during the COVID-19 Pandemic: Insights Gained

• Sarah McKinnon, MSN, RN; Barnes and Thornburg, LLP; Dallas, Texas
• Alexia Green, PhD, RN, FAAN; TTUHSC; Lubbock, Texas

Analyze the role of the chief nursing officer in the utilization of HICS during a pandemic. 2. Evaluate the relationship between chief nursing officer’s leadership and team effectiveness during crisis management.

16-R. An Examination of Innovation Competencies and Organizational Culture in a Sample of Texas Registered Nurses: A Pilot Study

• Linda Cole, DNP, APRN, CCNS, CNE, FCNS; Cizik School of Nursing, UT Health, Houston; Houston, Texas
• Francine Snow, DrPH, MSN, RN, CNE, NPD-BC; Cizik School of Nursing, UT Health, Houston; Houston, Texas
• Lisa Boss, PhD, EdD, RN, CNS, CEN, CNE; Tarleton State University; Stephenvill, Texas
• Susan Stafford, DNP, MBA, MPA, RN-BC, NEA-BC; Cizik School of Nursing, UT Health, Houston; Houston, Texas

Describe innovation competency among staff nurses Discuss the impact of organizational culture on innovation competency. Examine strategies to increase innovation competency.

27-ASP. Clinical Nurse Specialist Internship: Promoting an Academic and Health System Collaboration to Transition Registered Nurses to Advanced Practice Registered Nurses

• Karrie Boss, DNP, RN, APRN, ACCNS-AG, EBP-C, CCRN; Summa Health; Akron, Ohio
• Penelope Gorsuch, DNP, RN, NEA-BC, EBP-C, FACHE; Summa Health; Akron, Ohio

Identify the key components of a CNS Academy (Internship) program and describe how the CNS Academy fosters an EBP culture as a system strategy. Describe how a CNS internship program can increase the uptake of evidence-based practice and improve patient, clinician, and organizational outcomes.

34-EBP. NorthBay Health's Leadership Development Program - A Program Evaluation

• Heather Resseger, MSN, RN, CNL, CPHQ; NorthBay Health; Fairfield, California
• Greg Eagerton, DNP, RN, NEA-BC; University of Alabama Birmingham; Birmingham, Alabama

Identify the CDC framework and logic model utilized for program evaluation. Develop the ability to apply the CDC framework to conduct a leadership program evaluation at their institution. Identify the utilization of evaluation questions and a qualitative data analysis for a program evaluation.

35-ASP. Innovative Academic Leadership Prioritizing Wellness for Health Sciences Students

• Alice Teall, DNP, APRN-CNP, FAANP, FNAP; The Ohio State University; Colubmus, Ohio
• Kate Gawlik, DNP, APRN-CNP, FAANP, FNAP, FAAN; The Ohio State University; Columbus, Ohio

Review the need for wellness strategies, programming, and support for health sciences students, faculty, and clinicians. Identify methods for effectively leading wellness integration in academic programming. Evaluate teaching and learning strategies intended to improve all dimensions of student wellness.

37-QI. A Pilot Project Using the Creighton Competency Evaluation Instrument 2.0 (C-CEI 2.0) to Evaluate Nursing Leadership Simulations

• Shelly Luger Shelly Luger, RN, DNP, NE-A BC; Creighton University; Omaha, Nebraska
• Lucas Manning Lucas Manning, RN, DNP, CHSE; Creighton University; Omaha, Nebraska

Participants will identify how simulation offers learners the ability to practice nursing leadership skills. Participants will describe how the CCEI 2.0© could be used as an evaluation instrument for graduate level nursing leadership simulated experiences.

39-R. Tipping the Moral Resiliency Scale : Internationally trained nurses vs. United States trained nurses- who are more morally resilient?

• Shiny Edward, MSN, RN NPD-BC, CCRN-CMC-CSC, PCCN, CVRN -BC, MEDSURG-BC,ECG- BC; Baylor Scott & White The Heart Hospital Plano; Plano, Texas
• Lydia Karogo, MSN, RN, NPD-BC, CV-BC, PCCN; Baylor Scott & White The Heart Hospital Plano; Plano, Texas

Gain an understanding of the differences in moral resilience between internationally trained nurses and US-trained nurses at Baylor Scott & White East Region. Interpret the findings from the analysis of the Rushton Moral Resiliency Scale (RMRS) and its subscales, including Buoyancy, Personal Integrity, Moral Efficacy, and Relational Integrity. Recognize the implications of the observed differences in moral resilience for nurse retention, work environments, and patient outcomes, and evaluate the potential need for tailored interventions to enhance moral resilience among nurses from diverse training backgrounds.

43-EBP. Enhancing Nurse Manager Resilience with a Resilience-Enhancing Toolkit

• Rosarina Javier Pelikan, DNP, RN, CNS, CENP, RN-BC; Providence Saint John's Health Center; Santa Monica, California

Discuss how burnout impacts the role of the nurse manager in meeting operational goals. Describe 3 strategies to enhance resilience.

46-ASP. Developing a Structure of Engagement and Recognition in Clinical Scholarship

• Roberta Pawlak, PhD, RN, NEA-BC; University of Wisconsin - Madison; Madison, Wisconsin

Define nursing scholarship in the context of University Clinical Faculty activities. Describe process of Clinical Faculty scholarship recognition and support. Review identified categories of Clinical Faculty scholarship and structure of recognition and communication of activity.

51-EBP. The Effects of Human Centered Leadership in Healthcare Framework on Leader Engagement and Mindfulness

• Karen Steiner, MSN, RN, NE-BC, NPD-BC; Summa Health; Akron, Ohio

Participants will be able to describe HCL in HC framework. Participants will be able to describe how HCL in HC framework may affect leader engagement and mindfulness. Participants will be able to describe future implications of adopting HCL framework in a healthcare organization.

55-EBP. Level UP: Lifting healthcare system RN certification rates

• Annabelle Zakarian, MSN, RN, CPHRM, NE-BC; BSWH; Plano, Texas

List out strategic initiatives in increasing nursing specialty certifications. Leverage ANCC's Magnet & Pathway culture in optimizing efforts around nursing strategic plan for certifications. Implement a plan to increase nurse certification rate across 7 hospitals using collaborative approach among nurse leaders.

57-R. Enhanced Communication and Health Literacy Awareness to Decrease Heart Failure Readmission Rates

• Bria Hollingsworth, MSN, RN, CCRN-K; Baylor Scott & White Medical Center Plano; Plano, Texas

Define what is health literacy and be able to identify prevalence of low health literacy in their patients. Utilize strategies for communicating clearly after learning more about the Communicate Clearly Tool.

62-R. Prepare for Disaster or Contribute to One: Inadequate Preparedness of Nurse Leaders in Times of Disaster

• Mary Holstein, RN, MSN, AGACNP-BC; United Critical Care; Las Vegas, Nevada

Compare the self-reported knowledge and confidence levels of Texas nurse leaders regarding emergency management and disaster preparedness using a validated survey tool. Analyze the survey findings to identify gaps and areas for improvement in nurse leader preparedness for disaster management. Propose evidence-based recommendations to enhance disaster preparedness training for future nurse leaders based on survey findings.

71-QI. Trust Me: A Qualitative Evaluation on the Impact of a Trust-Focused Program on Leadership Development

• Kylee Gerohristodoulos, MSN RN CPN; Johns Hopkins Hospital; Baltimore, Maryland
• Todd Smith, PhD, MSHA, MBA, RN, NEA-BC; University of Alabama; Tuscaloosa, Alabama

The participants will develop an enhanced appreciation for the importance of trust in nursing leadership roles The participants will learn about a novel approach to using trust building knowledge and skills as part of nursing leadership development.

78-ASP. Leadership in an Academic-Practice Collaborative: Evaluation of an Ambulatory-based Academic Clinical Coordinator Model

• Mary Dolansky, PhD, RN, FAAN; Case Western Reserve University; cleveland, Ohio
• Rebecca Mitchell, DNP, RN; Case Western Reserve University; cleveland, Ohio
• Melissa Kline, DNP, RN; MetroHealth Medical Center; Cleveland, Ohio
• Mary Ann Lawlor, PhD, RN; VA North East Ohio Health System; Cleveland, Ohio
• John Sweetko, PhD, RN; VA North East Ohio Health System; Ohio, Ohio

Describe an Academic Clinical Coordinator Model to increase collaboration among academic and practice leaders. Identify two outcomes of an Academic Clinical Coordinator Model that enhance community and patient outcomes.

81-R. The Effectiveness of Resilience Training on Nurse Leader Burnout

• Terra Reed, RN, BSN, MSN; Silver Hill Hospital; New Canaan, Connecticut

Describe effectiveness of resilience training on staff retention rates. Describe effectiveness of resilience training on nurse leaders' emotional intelligence. Discuss how resilience building interventions positively impact the work environment.

84-R. Nurse Satisfaction and Interprofessional Interactions: The Impact of Nurses’ Professional Relationships on Job Satisfaction

• Katrina Robinson, MSN, RN, CCRN; Wellstar Kennestone; Marietta, Georgia
• Nancy Ballard, PhD, RN, NEA-BC; Kennesaw, Georgia

Describe which interprofessional groups were identified as part of the team and how interprofessional interactions were described/ measured. Describe how nurse satisfaction was measured. Identify how interprofessional interactions and nurse satisfaction are related.

85-EBP. Understanding Return on Investment (ROI) to Drive Collaborative Change

• Todd B. Smith, PhD, MSHA, MBA, RN, NEA-BC; The University of Alabama; Tuscaloosa, Alabama
• Teresa Welch, MSN, RN, NEA-BC; The University of Alabama; Tuscaloosa, Alabama
• Teresa Barry Hultquist, PhD, MSN, RN, PHCNS-BC, NE-BC; University of Nebraska Medical Center College of Nursing; Omaha, Nebraska
• Nancy C. Crider, DrPH, MS, RN, NEA-BC; The University of Texas Health Science Center at Houston; Houston, Texas
• Allison McHugh, DNP, MHCDS, MS, RN, NE-BC; Florida State University; Tallahassee, Florida

Define key constructs associated with Return on Investment. Identify key resources to support nursing leadership in quantifying intangible costs. Discuss Return on Investment as a decision-making tool. Apply return on investment as a standardized measurement tool to evaluate the financial efficacy of proposed projects. Utilize a case study approach to demonstrate application of the ROI to practice.

88-EBP. Is There a HUman in There? Evaluating the Implementation of the Nurse Leadership Theory, Human-Centered Leadership

• Kassandra Meadows, MSN, MBA-HA, RN, NEA-BC; Christus Children's Hospital; San Antonio, Texas

At the end of this presentation, learners will be able to discuss the importance of utilizing critical elements of program implementation when attempting to duplicate results of qualitative research. At the end of this presentation, learners will be able to define the four dimensions of program implementation.

91-R. What do nurses want? An interpretive descriptive study of acute care nurses in Manitoba’s work preferences across generations

• Wendy Ducharme, RN MN; University Of Manitoba (WINNIPEG); Winnipeg, Canada
• Dr.Sonia Udod, RN PhD; University Of Manitoba (WINNIPEG); Winnipeg, Canada
• Malcolm Doupe, PhD; University Of Manitoba (WINNIPEG); Winnipeg, Canada
• Em Pijl, RN PhD; University Of Manitoba (WINNIPEG); Winnipeg, Canada

Leaders will gain an understanding of generational work preferences impacting workforce participation. Leaders will gain an understanding of mutable factors in work environments that impact nurse retention. Mutable factors analysis by leaders will result in the ability to create site specific strategies to improve nurse retention.