DOI
https://doi.org/10.25772/0QJN-3V86
Defense Date
2020
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Health Administration
First Advisor
Jan Clement
Abstract
Interruptions create a complex challenge in health care. Because some interruptions are necessary in health care, they cannot be completely eliminated. Thus, their effects must be appropriately mitigated. To better understand predictors and consequences of interruptions, as well as factors that may mitigate their negative effects, I employed Job Demands-Resources (JD-R) theory, supplemented by additional constructs from organizational behavior and psychology to develop a model of predictors and mitigators of interruptions. Twenty registered nurses providing care on a progressive acute care unit with single- and double-occupancy patient rooms volunteered to participate in this study. The study incorporated nurse-level questionnaires, event-level surveys, observation, and medical record review to test a mediated, moderation multi-level model. Double-occupancy rooms were a significant predictor of interruptions. Interruptions mediated the effect of room-type on perceived stress, but not on the other five dependent variables (task completion rate, medication administration errors, positive affect, and negative affect). While the full mediated, moderation models were not supported, the individual nurse characteristic of conscientiousness was found to have a significant moderating effect on the effect of room-type on perceived stress. Other nurse characteristics tested, but not found to have a significant effect, were stress mindset and psychological resilience. This study fills significant gaps in interruption research by using theory to develop a single conceptual model that identifies predictors of interruptions and nurse characteristics that may mitigate their effects. Future applications of this research should expand this approach to support nurse selection and training for working in interruptive patient care environments
Rights
© The Author
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
4-15-2020
Included in
Health and Medical Administration Commons, Nursing Administration Commons, Other Nursing Commons