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theses

Literature about the charge nurse claims that they are frontline nurse leaders who contribute to quality and patient safety; however in the United States there is a lack of research regarding how the acute care hospital charge nurse keeps patients safe. This two-phase focused ethnography study explored the charge nurse role and safety practices through the perspectives of charge nurses, nurse managers and clinical nurses. The Nurse Manager Leadership Partnership Learning Domain Framework guided this study, operationalized as the American Organization of Nurse Executives (AONE) Nurse Manager Competencies (AONE, 2015). Rutgers the State University of New Jersey Institutional Review Board approval was obtained. Participants in phases one and two signed informed consents and completed demographic forms. In phase one, charge nurses, nurse managers and clinical nurses rated competencies on the AONE Nurse Manager Competencies as relevant to the charge nurse role then participated in audio recorded individual interviews to clarify the ratings. Data from phase one informed the questions for phase two. Nurse managers and charge nurses participated in in-depth individual audio recorded interviews in phase two using an interview guide while clinical nurses participated in focus groups using a focus group guide. Audio recordings were transcribed verbatim and thematic analysis occurred.
Three charge nurses, three clinical nurses and three nurse managers, all female, with an average age of approximately 48 participated in phase one. In phase two fifteen charge nurses, thirteen clinical nurses and eleven nurse managers, males and females, with an average age of 40 participated. Two charge nurse models emerged: Permanent and rotating. An overarching theme of shift resource and traffic director included go-to resource, manage the flow, safe patient assignment/staffing and regulatory readiness, shared responsibilities among all charge nurses. Permanent charge nurses were unit shift leaders, an extension of the nurse manager who manage information flow and human resource management. Rotating charge nurses have the role of clinical nurse plus. The two charge nurse models differ in methods to keep patients safe with permanent charge nurses being the safety officer and rotating charge nurses putting out fires.

ETD_9888

doi:10.7282/t3-2fgv-vw56

Ph.D.

Includes bibliographical references

ETD doctoral

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