NSG 301 Thesis Worksheet Revised

(NSG 301 Thesis Worksheet Revised)

NSG 301: Writing with Confidence, Clarity, and Style Thesis Worksheet

Name:

Instructions: Please write your answers directly into this document and do not delete the questions or instructions. I have highlighted wherever a response is required. You may wish to use a different font, text color, or boldface to make your answers more visible, although it’s not required. When completed, “Save as” and add your last name to the file name. (NSG 301 Thesis Worksheet Revised)

GATHERING THE PIECES

Go back to your Problem Statement Worksheet in LM3. Copy and paste the problem statement (the answer to L, the last question on that worksheet) here.

Problem Statement: Poor health-promoting self-care behavior impacts nurses’ health and well-being, contributing to overweight, obesity, and mental health issues. (NSG 301 Thesis Worksheet Revised)

NSG 301 Thesis Worksheet Revised

I still stand by this statement that “Poor health-promoting self-care behavior impacts nurses’ health and well-being, contributing to overweight, obesity, and mental health issues.” I have searched multiple databases and organizational publications such as the CDC, ANA, and other healthcare organization that offer statistical evidence and found concrete and valid evidence supporting the claim. However, most sources are also addressing root causes, and therefore, I decided to adjust the problem statement to include some of the identified root causes contributing to medication errors. The new statement reads, “Work related factors, including work-related stress, heavy workloads, shift work, poor engagement and communication, increasing patient health demands, and working overtime lead to poor health-promoting self-care behavior that impacts nurses health and well-being, contributing to overweight, obesity, and mental health issues.” (NSG 301 Thesis Worksheet Revised)

Now that you’ve done some research, do you still stand behind this statement? Did you find evidence to support the claim? If not, make a new supportable claim about the same problem below. (If you changed topics since the Problem Statement Worksheet, give your new problem statement below.) Remember, short and simple is best!

For example, I made the claim “Excessive wait times in the ED increase the likelihood that patients will become violent.” Let’s assume that I didn’t find any solid evidence of a causal relationship between wait times and patient violence in the ED, but I did find statistics showing that violence occurs more often in the EDs than any other healthcare setting. I see two possibilities for revision of this claim: 1. I could simplify the claim to remove the cause (e.g., “Violence is more common in the ED than in other healthcare settings.”), or 2. I could claim that wait times in the ED have some other bad effects worth avoiding (e.g., “Excessive wait times in the ED lower patient satisfaction.”), depending on what I discovered in my research and whether I am more interested in pursuing solutions that reduce violence or ones that reduce wait times. (NSG 301 Thesis Worksheet Revised)

Revised Problem Statement (if needed): Work related factors, including work-related stress, heavy workloads, shift work, poor engagement and communication, increasing patient health demands, and working overtime lead to poor health-promoting self-care behavior that impacts nurses health and well-being, contributing to overweight, obesity, and mental health issues.

Now let’s think about outcomes and solutions. Your Summary Table and any other research you’ve done will help you to complete these lists. Any intervention studies you’ve read will include specific actions taken (interventions) and results that were measured (outcomes) so list those! You shouldn’t need to make any of these up from scratch. (NSG 301 Thesis Worksheet Revised)

Examples of MEASURABLE outcomes

Increased satisfaction scores (Be specific: nurse job satisfaction, patient satisfaction, family satisfaction, provider satisfaction, etc. Each of these must be measured independently of the others and so are separate outcomes.)

Conserve a finite resource (Be specific: money, time, vehicle mileage, PPE, etc. Each of these must be measured independently of the others and so are separate outcomes.)

Reduced rates of something bad (such as falls, infections, sentinel events, mortality rates, etc. Each would need to be listed separately.)

Increased rates of something good (such as compliance with a policy, medication compliance, compassion satisfaction, etc. Each would need to be listed separately.)

Some outcomes are related! For exact opposites (e.g., decreased mortality and increased survival) use one, not both. Be careful with closely related outcomes, especially decreased turnover, increased retention, reduced intention to leave, reduced burnout, increased compassion satisfaction, reduced compassion fatigue! These are all related but NOT interchangeable! (Be specific. If more than one applies, list each separately.)

Too vague! Don’t use!

Improved outcomes

Happier nurses (or patients or whoever); Better experience

Address the problem

Examples of interventions

Training in a specific skill (manager training in X leadership style, online course for nurses on X, interdisciplinary workshop of X skill, etc. Be specific! You may include more than one specific training, but list them separately.)

A particular process change (moving handoff report to bedside, using a new cleanser for catheter insertion sites, add a particular checklist to the EMR, a specific kind of rounding, etc. Be specific! You may include more than one specific process change, but list them separately.)

A specific change to policy (new open bed alert system, longevity incentive pay, maximum patient:nurse ratios, etc.)

Any concrete, recommended action (purchase a new kind of monitor system, enforce an existing policy, hire for a particular role, install massage chairs in the break room, etc.)

Too vague! Don’t use!

Implement solutions

Address the problem

Improve X (Anything you want to improve, increase, or decrease is probably an outcome, not an action.)

For the two lists below, come up with at least 1 answer for each list. You should have at least 3 answers in ONE of the lists.

List positive MEASURABLE outcomes you would like to achieve in order to mitigate the problem: (There are many ways to measure outcomes. For instance, you might measure “reduced stress” through a pre-/post-intervention survey or by taking subjects’ BP and pulse. For this list, indicate outcomes which are possible to measure, not the methods of measurement.) Put only one outcome on each line. You may add as many lines as you need to. (NSG 301 Thesis Worksheet Revised)

Improved nurses’ health and well-being.
Reduced work-related factors contributing to poor health-promoting self-care behavior.
Improved healthcare quality, patient safety, and patient outcomes.

List some of the interventions that have been studied as potential solutions to your problem: Keep in mind that an intervention is a specific solution action, not just a reversal of the problem. Think of each action as a command that someone has to carry out. “Go enforce nurse autonomy!” would be far too open-ended, but “Train providers to respect the scope of nursing practice!” conveys what should be done. Put only one solution action/intervention on each line. You may add as many lines as you need to.

Improve the working environment to be more engaging and coordinated, less stressful, and have manageable workloads: (nurse leaders and nurse staff) A, B, C.
Adopt self-care strategies such as emotional regulation, self-compassion, mindfulness, healthy eating patterns, regular physical activity, staying connected, and continued individual and professional growth to minimize adverse effects of poor health promoting behavior. (nurses). A, C.
Provide stress management workshops and self-care education sessions during lunch and off-work periods (Hospital administration, nurses, and nurse leaders) A, C. (NSG 301 Thesis Worksheet Revised)

Look at each of your interventions and decide WHO would have the power to make that change happen. Some changes nurses can make themselves, such as adopting bedside handoff or meditating to relieve stress. Other changes require management to get involved, such as adopting or enforcing a bedside handoff policy or bringing in a meditation instructor to offer training. Some changes can only be done by hospital or system administrators, such as adopting a patient:nurse ratio policy or adding incentive pay. In the INTERVENTION list above, next to each intervention, write the appropriate audience in parentheses. If more than one could apply, feel free to indicate that. Ultimately, you will pick just ONE audience capable of the entire proposal, whether it has just one recommended action or three. (NSG 301 Thesis Worksheet Revised)

Match up each intervention with the measurable outcomes associated with it, as shown in the literature. You’ve got a list of interventions with a number assigned to each. You’ve got a list of outcomes with a letter assigned to each. In the list of interventions, after the audience, write the letters for ALL the outcomes that come from doing that action.

For example, if my outcome list looks like this:

New nurse retention
New nurse competency
New nurse satisfaction

My intervention list might look like this, once completed:

Nurse residency program (management) A, B, C
Mentorship (management) A, C
Civility training for all staff (management) C

This indicates that I found correlations in the literature between NRPs and all 3 outcomes, between mentorship and both retention and satisfaction of new nurses, and between staff civility training and new nurse satisfaction. (NSG 301 Thesis Worksheet Revised)

For this paper, you want to have a 3-part thesis. You may choose 3 interventions which all have the same outcome OR 1 intervention that has 3 distinct outcomes. Which you choose depends on your research; pick the option that lets you use the best of the studies you already have. It’s also OK if you discover that you’ll need to do more research to connect all the pieces you want to include. Pay attention to the audiences you have for each intervention! You should write for only one audience

In my example, there are 2 obvious choices: I could choose 1 intervention (NRP) and 3 outcomes (retention, competency, and satisfaction), or I could choose to write about all 3 interventions, but focus only on how each of them increases the same shared outcome (satisfaction). But I do have other options! Maybe I’m really passionate about retention, and I’d rather write about 3 interventions (NRPs, mentorship, and another TBD by further research) focused on that 1 outcome (retention). (NSG 301 Thesis Worksheet Revised)

Write your choices below. Keep in mind that if you have 3 interventions, you must have only 1 outcome; if you have only 1 intervention, you must have 3 outcomes. You may use up to 1 “placeholder” (such as TBD) that indicates a need to do more research.

My audience: Nurses

My intervention(s):

Improve the working environment to be more engaging and coordinated, less stressful, and have manageable workloads.
Adopt self-care strategies such as emotional regulation, self-compassion, mindfulness, healthy eating patterns, regular physical activity, staying connected, and continued individual and professional growth to minimize adverse effects of poor health promoting behavior.
Provide stress management workshops and self-care education sessions during lunch and off-work periods.

My outcomes(s): Improved nurses’ health and well-being.

NSG 301 Thesis Worksheet Revised

WRITE YOUR DRAFT/WORKING THESIS STATEMENT

Use one of the templates below to draft your working thesis statement. (“Working” just means that it may still change.) Make sure your thesis statement is a single sentence and grammatically correct. You might need to add some verbs to your interventions (create, implement, enforce, adopt) and outcomes (increase, decrease, improve). Use punctuation, check your spelling, proofread. (NSG 301 Thesis Worksheet Revised)

3 Actions, 1 Outcome:

Since [Problem Statement] , [audience] should [1^st intervention], [2^nd intervention], and [3^rd intervention] , in order to [1 positive outcome] .

1 Action, 3 Outcomes:

Since [Problem Statement] , [audience] should [1 intervention] in order to [1^st positive outcome], [2^nd positive outcome], and [3^rd positive outcome] .

My working thesis statement:

Since work-related factors, including work-related stress, heavy workloads, shift work, poor engagement and communication, increasing patient health demands, and working overtime lead to poor health-promoting self-care behavior that impacts nurses health and well-being, contributing to overweight, obesity, and mental health issues, nurses should improve the working environment to be more engaging and coordinated, less stressful, and have manageable workloads, adopt self-care strategies such as emotional regulation, self-compassion, mindfulness, healthy eating patterns, regular physical activity, staying connected, and continued individual and professional growth, and provide stress management workshops and self-care education sessions during lunch and off-work periods to improve nurses’ health and well-being. (NSG 301 Thesis Worksheet Revised)

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5536335/#:~:text=Nurses%20may%20not%20follow%20recommended,as%20obesity%20and%20sleep%20disturbances.

NSG 301 Thesis Worksheet Revised