Susan Kennerly

Influence of Work Role and Perceptions of Climate on Faculty Organizational Commitment

The purpose of this study was to examine how organizational commitment is influenced by organizational climate and nurse faculty work role in departments/colleges of nursing. The research was based on Meyer and Allens Multidimensional Model of Organizational Commitment. The sample was comprised of full-time tenure track, doctorally prepared nurse faculty. Descriptive analyses were used to summarize institutional and nursing program data. ANOVA and t-tests were performed to determine differences between faculty information and study variables. A significant difference was found between teaching work role, and role ambiguity, role conflict and organizational climate. Pearson correlation analyses examined relationships between nurse faculty work role balance, role ambiguity, role conflict, and affective, continuance, and normative organizational commitment. A moderately strong negative relationship was present between role ambiguity and role conflict, and affective and continuance organizational commitment. Significant relationships were observed between subscales of organizational climate and role ambiguity and role conflict. The studys findings offer interesting insights into the dynamic relationships between organizational commitment and climate, work role balance, role ambiguity, and role conflict.

Leadership Behavior and Organizational Characteristics: Implications for Faculty Satisfaction

The purpose of this investigation was to examine the relationships among administrative leadership behaviors, organizational characteristics, and faculty job satisfaction in baccalaureate nursing programs of private colleges. A two-part survey technique included 1) the collection of organizational data from the dean/chair of each nursing program, and 2) the rating of leadership behavior of the dean/chair and faculty job satisfaction by nurse faculty. Fifty-three percent of eligible programs and 77% of nurse faculty participated in the study. The findings indicated that the leadership behaviors of consideration and initiating structure were positively related to nurse faculty job satisfaction. The number of nurse faculty and the number of students in the college were identified as variables moderating the relationship between leadership behavior and job satisfaction. The emergence of a unique pattern of high consideration and high initiating structure leadership behaviors provides a basis for reexamining alternatives to promote the overall job satisfaction of nurse faculty.

Perceived worker autonomy: the foundation for shared governance.

The popular notion that worker autonomy is an outcome of shared governance is challenged in this critical analysis of the authors research and selected literature. Growing evidence is presented that environment, expectations, and clarity of meaning play important roles in fostering and supporting personal autonomy. Staff and administrators can use this valuable information about autonomy to refocus partnership models and team-based strategies for enhanced team effectiveness.

Predictors of turnover intention in nurse faculty.

Turnover of nurse faculty is an increasingly important issue in nursing as the available number of qualified faculty continues to decrease. Understanding the factors that contribute to turnover is important to academic administrators to retain and recruit qualified nursing faculty. The purpose of this study was to examine predictors of turnover intention in nurse faculty working in departments and schools of nursing in Carnegie Doctoral/Research Universities-Extensive, public and private, not-for-profit institutions. The multidimensional model of organizational commitment was used to frame this study. The predictor variables explored were organizational climate, organizational commitment, work role balance, role ambiguity, and role conflict. The work roles examined were research, teaching, and service. Logistical regression was performed to examine the predictors of turnover intention. Organizational climate intimacy and disengagement, affective and continuance organizational commitment, and role ambiguity were shown to predict turnover intention in nurse faculty.

Building a Community of Research Practice: Intragroup Team Social Dynamics in Interdisciplinary Mixed Methods

This article explicates the intragroup social dynamics and work of a nursing and education research team as a community of research practice interested in organizational cultures and occupational subcultures. Dynamics were characterized by processes of socialization through reeducation and group social identity formation that enabled members to cross discipline-bordered traditions and produce interdisciplinary mixed methods combinations. Combinations were achieved at the paradigm level through the generation of a shared viewing position and theoretical model. At methods and technique levels, such achievements were accomplished through methodological capitalization and prioritization and the development of a quantitative culture assessment tool that can be used in combination with complementary qualitative observation and interview protocols. Recommendations for other teams are provided.

Multidimensional Team-Based Intervention Using Musical Cues to Reduce Odds of Facility-Acquired Pressure Ulcers in Long-Term Care: A Paired Randomized Intervention Study

To test the effectiveness of a pressure ulcer (PU) prevention intervention featuring musical cues to remind all long‐term care (LTC) staff (nursing and ancillary) to help every resident move or reposition every 2 hours.

Development and Psychometric Testing of the Nursing Culture Assessment Tool

A valid and reliable nursing culture assessment tool aimed at capturing general aspects of nursing culture is needed for use in health care settings to assess and then reshape indicated troubled areas of the nursing culture. This article summarizes the Nursing Culture Assessment Tool’s (NCAT) development and reports on a cross-sectional, exploratory investigation of its psychometric properties. The research aims were to test the tool’s psychometric properties; discover its dimensionality; and refine the item structure to best represent the construct of nursing culture, an occupational subset of organizational culture. Empirical construct validity was tested using a sample of licensed nurses and nursing assistants (n = 340). Exploratory and confirmatory factor analysis (CFA) and logistical regression yielded a 6-factor, 19-item solution. Evidence supports the tool’s validity for assessing nursing culture as a basis for shaping the culture into one that supports change, thereby accelerating, improving, and advancing nursing best practices and care outcomes.

An Evidence-Based Cue-Selection Guide and Logic Model to Improve Pressure Ulcer Prevention in Long-term Care.

Pressure ulcers have consistently resisted prevention efforts in long-term care facilities nationwide. Recent research has described cueing innovations that—when selected according to the assumptions and resources of particular facilities—support best practices of pressure ulcer prevention. This article synthesizes that research into a unified, dynamic logic model to facilitate effective staff implementation of a pressure ulcer prevention program.

Using the Nursing Culture Assessment Tool (NCAT) in Long-Term Care: An Update on Psychometrics and Scoring Standardization

An effective workforce performing within the context of a positive cultural environment is central to a healthcare organization’s ability to achieve quality outcomes. The Nursing Culture Assessment Tool (NCAT) provides nurses with a valid and reliable tool that captures the general aspects of nursing culture. This study extends earlier work confirming the tool’s construct validity and dimensionality by standardizing the scoring approach and establishing norm-referenced scoring. Scoring standardization provides a reliable point of comparison for NCAT users. NCAT assessments support nursing’s ability to evaluate nursing culture, use results to shape the culture into one that supports change, and advance nursing’s best practices and care outcomes. Registered nurses, licensed practical nurses, and certified nursing assistants from 54 long-term care facilities in Kentucky, Nevada, North Carolina, and Oregon were surveyed. Confirmatory factor analysis yielded six first order factors forming the NCAT’s subscales (Expectations, Behaviors, Teamwork, Communication, Satisfaction, Commitment) (Comparative Fit Index 0.93) and a second order factor—The Total Culture Score. Aggregated facility level comparisons of observed group variance with expected random variance using rwg(J) statistics is presented. Normative scores and cumulative rank percentages and how the NCAT can be used in implementing planned change are provided.

Comparison Study of Braden Scale and Time-to-Erythema Measures in Long-term Care.

PURPOSE: The Braden Scale for Predicting Pressure Sore Risk is used to assess risk, and the Centers for Medicare & Medicaid guidelines suggest the use of a tissue tolerance procedure that detects time-to-erythema (TTE) to further refine tissue tolerance, a component of the Braden Scale. The aim of this study was to compare the Braden Scale and TTE as risk classification methods and their utility in identifying care planning interventions. DESIGN: Descriptive study using retrospective chart review. SUBJECTS AND SETTING: Participants were a convenience sample of 89 adults 65 years or older residing in a long-term care facility in the Midwestern United States. The sample was drawn from a facility-generated list of 90 residents who had both Braden Scale and tissue tolerance testing performed within 24 hours of admission from any setting, readmission after a hospital stay, or performed as part of a routine annual reassessment. METHODS: Results of staff performance on the Braden Scale and TTE were compared as risk classification methods and based on their utility for identifying care planning interventions. Data were collected during 1 session when TTE and the Braden Scale were completed. Agreement between the 5 risk categories from the Braden Scale and 5 TTE risk categories was analyzed via the kappa statistic and Kendall tau-c statistic. Spearman or Pearson correlation coefficients were calculated as appropriate for ordinal and continuous risk, intervention, and severity measures. RESULTS: The mean Braden Scale score was 17.5 ± 3 (mean ± SD); the mean TTE-Bed was 2.35 ± 0.57 hours and the mean TTE-Chair was 2.18 ± 0.52. Using a Braden Scale score of 18 or less as a cut point for identifying clinically relevant risk for pressure ulcer development, 55 participants were deemed at risk, 62 had mobility subscale scores less than 4, 76 had activity subscale scores less than 4, and 73 were incontinent. The weighted kappa statistic demonstrated weak agreement between TTE-Bed and the Braden Scale Total Score (&kgr; = 0.04; 95% CI: 0.002-0.07). Agreement was not significant for TTE-Chair and the Braden Scale Total Score (&kgr; = 0.01; 95% CI: −0.01 to 0.04), TTE-Bed and Braden Scale-Mobility (&kgr; = 0.09; 95% CI: −0.05 to 0.23) and between TTE-Chair and Braden Scale-Activity (&kgr; = 0.07; 95% CI: −0.05 to 0.19). The TTE-Chair and TTE-Bed assessment demonstrated fair agreement (&kgr; = 0.37; 95% CI: 0.19-0.55). The Braden Scale cumulative score where a lower score equates to higher risk was found to be correlated with the total number of interventions observed in the care plan (r = −0.62; P < .0001). Correlation between the Braden Scale-Mobility subscale score and in-bed mobility specific interventions was r = −0.64 (P < .0001), whereas correlation for TTE-Bed category and specific in-bed mobility interventions was r = 0.21 (P = .05). CONCLUSION: Study findings provide little support for tissue tolerance testing versus assessment using the validated Braden Scale for assessment of pressure ulcer risk. Study findings support the use of the Braden Scale to develop an individualized care plan based on the areas of risk.