Dissertations, Theses, and Capstone Projects

Date of Degree

5-2019

Document Type

Dissertation

Degree Name

Ph.D.

Program

Nursing

Advisor

Donna M. Nickitas

Committee Members

Martha V. Whetsell

William Gallo

Timothy Clapper

Daniel Raemer

Subject Categories

Nursing

Keywords

rapid response system, psychological safety, personal sense of power, nursing agency, Orem

Abstract

When patients show signs of clinical deterioration, nurses should activate the rapid response system (RRS) to summon specialized help to the bedside. Failure or delay to activate the RRS is associated with increased length of stay and increased mortality. Currently, nurses only activate the RRS 21-57% of the time. Nurses’ fear of criticism for making the wrong call has been identified as a reason or avoiding or delaying activation. Currently, only limited individual level factors affecting nurse RRS activation has been identified, but team-level barriers or facilitators or nurse RRS activation has not been systematically studied. A cross-sectional study was conducted to investigate the relationships among team psychological safety, nursing agency, and nurse RRS activation. Findings suggest that nurses’ personal sense of power, which may be a foundational disposition of nursing agency, is a predictor of nurse RRS activation. Strategies to develop nurses’ personal sense of power may be key to ensure nurses can exercise their full agency to overcome barriers and act on behalf of their patients.

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