Rosanne Raso - Academia.edu (original) (raw)
Papers by Rosanne Raso
If you can't measure it
Nursing Management, Mar 1, 2015
Find your courage
Nursing Management, Mar 1, 2014
It's all connected! Patient experience and healthy practice environments
Nursing Management, Aug 1, 2016
Nurse leader wellness: What's changed in 3 years?
Nursing Management, Feb 1, 2021
Where are the leaders?
Nursing Management, Jun 1, 2019
Nursing Management, Feb 1, 2018
American Journal of Preventive Medicine, Jun 1, 2020
The objectives of this study were to investigate an association between the risk of patient falls... more The objectives of this study were to investigate an association between the risk of patient falls and self-reported hearing loss and to examine whether self-reported hearing loss with versus without hearing aids predicts patient falls in an inpatient setting. Methods: This retrospective cohort analysis was conducted in 2018 in a large, urban, academic medical center. Participants included unique inpatients (N=52,805) of adults aged >18 years between February 1, 2017, and February 1, 2018. Outcome measures were falls in the inpatient setting and hearing loss with versus without hearing aids as predictors for patient falls. Results: Self-reported hearing loss was associated with falls in the inpatient setting (OR=1.74, 95% CI=1.46, 2.07, p<1.43 £ 10 À9). Among patients with hearing impairment, a lack of hearing aids increased the risk for falls in the inpatient setting (OR=2.70, 95% CI=1.64, 4.69, p<1.41 £ 10 À5). After accounting for the risk of fall using the Morse Fall Scale (which does not include hearing impairment) and controlling for age and sex, patients with hearing loss and no hearing aids were significantly more likely to fall (OR=2.44, 95% CI=1.002, 5.654, p<0.042), but patients with hearing loss who did have hearing aids were not significantly more likely to fall (p<0.889). Hearing loss together with the Morse Fall Scale better predicted falls than the Morse Fall Scale alone (p<0.017). Conclusions: In the inpatient setting, there was a positive association between hearing loss and falls. However, among patients with hearing loss, only those without hearing aids were significantly more likely to fall, accounting for the Morse Fall Scale score and demographics characteristics. These findings support adding hearing loss as a modifiable risk factor in risk assessment tools for falls and exploring the use of amplification devices as an intervention.
Who comes first?
Nursing Management, Mar 1, 2016
No, I’m not asking about the chicken or the egg, but rather patients or staff. At a time when pat... more No, I’m not asking about the chicken or the egg, but rather patients or staff. At a time when patient experience scores rule the C-suite—and when patient-centeredness is a national movement—it seems logical that patients come first. Who can argue with that premise? It’s our purpose. However, we may put forth another foundational element of the puzzle: your staff members come first, too. Staff engagement is popular in the nursing literature—how to measure it, the negative effects of its absence, what elements are needed to have it, and how it correlates to our patients’ experience. Are we truly committed to positive work environments? Or are we still turning our heads away from dysfunction, systems issues, and disrespect, thinking they’re too hard to change? The failure to push forward with a staff engagement agenda does trickle down and can result in increased turnover, absenteeism, errors, and, of course, a poor patient experience. On the positive side, engaged staff members have purpose, are less stressed, and are at their best—another one of our goals as leaders. In fact, it seems that the principles driving both staff engagement and the patient experience are similar. Avoiding blame and improving systems are basic examples of successful leadership. What about effective communication and responsiveness? We can’t have a positive work environment or a great patient experience without these building blocks. As a leader, you show that you care, listen, acknowledge, recognize, value, and respect your staff. Isn’t that the same message we drive home to staff members about their relationships with patients? Our staff members want to feel valued, and our patients want to feel like they’re a real person to us with individual needs. It’s all about acknowledgment of people as people no matter the angle, either the patient or staff perspective. Another fundamental element is developing collaborative relationships at all levels. We teach it to new managers as a key to success, and we teach it to our staff in working with patients and families. Relationship building is central to patient care and leadership. Again, it works for patients as it does for staff. Patients can tell when staff members are dissatisfied. Invest in your staff. Commit to them. Get them the resources they need to do the job. Truly make patient-centered decisions and systems. Unmet patient needs tend to focus on information, listening, and caring. It wouldn’t surprise me if staff needs are similar. Research tells us that they also need growth, respect, and recognition. So it’s all connected. We can’t fall into the trap of only focusing on patients. Sustainable change in your patients’ experience won’t occur without an engaged workforce. If we focus on staff and organizational values, then patients and families will feel the positive effects in a real and substantial way. Of course, this assumes that the entire organization is behind patient-centeredness. Maybe it is the chicken or the egg conundrum. Without staff engagement and true purpose, we won’t see an extraordinary patient experience; with engagement, it’s almost guaranteed. We can’t focus on one without the other and we must use equivalent strategies to promote success. So let’s make the environment special for our patients and our staff, using the same principles for both and never losing sight of either one. NM
Nurse leader wellness: What's changed in 3 years?
Nursing Management, 2021
Good trouble
Nursing Management, 2020
The evolution of evidence-based practice
Nursing Management, 2019
Be a thought leader
Nursing management, 2016
Nursing Management (Springhouse), 2016
Meaning and purpose in their work Meaning and purpose in their care Teamwork and collaboration Co... more Meaning and purpose in their work Meaning and purpose in their care Teamwork and collaboration Coordinated care Communication Communication Recognition/acknowledgment Recognition/acknowledgment Relationships Relationships Feeling safe Feeling safe Trust Trust Know me as a person Know me as a person Effective decision making Effective decision making
The art of being joyful
Nursing Management (Springhouse), 2015
S pring is in the air! With new blossoms come thoughts of fresh renewals and being joyful. There’... more S pring is in the air! With new blossoms come thoughts of fresh renewals and being joyful. There’s a surprising amount of nursing literature on joy at work from our sages like Marie Manthey to contemporary leaders such as Jo Manion. The question is typically framed as “how can we bring joy to work?” or, more disappointingly, “how can we regain joy at work?” implying that we’ve lost it. The lucky ones have a hard time imagining not being joyful at work, although this can sometimes take a high level of conscious and subconscious effort. It really isn’t about luck; it’s about finding joy and reframing situations with that attitude. Whether joy is a matter of survival, well-being, personality, or responsibility for others, it’s important for leaders. What are the elements of joy to embody and embrace? A sense of mission and related accomplishments immediately come to mind. The opposite is approaching work on a transactional basis, which isn’t inspiring for you or your staff. Work has to be connected to a greater purpose. Checking off rote tasks or attending supposedly meaningless meetings are typical transactional activities. But this isn’t a joyful attitude. These meetings can be an opportunity to learn and play a role in bringing patient-centeredness. Or there may be something new for you to pick up—a collegial relationship, another side of the story, or a better way to get something done. Bring value to it. Find the joy. Mission and purpose are best exemplified in those who are passionate about their work. When you have passion, it isn’t work at all and you can’t help but have positive energy and a transformational approach. Focus on what brings you enjoyment and get involved. Respect in every possible direction is a factor in joyful work—with each other, patients, families, staff, providers, colleagues, bosses, everyone. Being respected requires behaving respectfully; it’s a two-way street. Respect is an “always” issue; even one episode of disrespect is damaging. Expect respect from your staff at all times or it will affect engagement and morale. Unintentional disrespect isn’t uncommon; fix it when you see it or if you discover it in yourself. Professional pride internally and externally at every level from bedside care to national policy-making is cause for celebration. Being a nurse in and of itself brings joy. We’re the most respected profession in the country. Advanced nursing practice is becoming a cornerstone of American healthcare. We have a powerful future mapped out in the Institute of Medicine’s Future of Nursing report that needs proactive support from all of us. There’s delight in being proud of your profession. If you don’t have it, discover it. Being a leader is a great foundation for enjoyment. You make a difference in so many ways to so many people. The elements I’ve mentioned are only part of being successful; there are more and you know what yours are. Be joyful—it’s another essential component of your success and even your health. NM
Perceptions of US nurses and nurse leaders on authentic nurse leadership, healthy work environment, intent to leave and nurse well‐being during a second pandemic year: A cross sectional study
Journal of Nursing Management, Jun 21, 2022
Perceptions of Authentic Nurse Leadership and Work Environment and the Pandemic Impact for Nurse Leaders and Clinical Nurses
Journal of Nursing Administration, May 1, 2021
OBJECTIVE The aim of this study was to determine the pandemic impact on the relationship between ... more OBJECTIVE The aim of this study was to determine the pandemic impact on the relationship between nurses' perception of the authentic nurse leadership (ANL) of their manager and their perception of the work environment. BACKGROUND Both ANL and healthy work environment (HWE) contribute to staff and patient outcomes. Our 1st study of these 2 variables revealed a positive relationship. Will this be upheld in a pandemic year? METHODS More than 5000 nurses from a national sample participated in a cross-sectional, correlational, descriptive study using the Authentic Nurse Leadership Questionnaire, the Critical Elements of a Healthy Work Environment Scale, and a pandemic impact on practice question. RESULTS Overall, nurses perceived ANL and HWE were present despite a high level of pandemic impact; however, when clinical nurses were separated from managers/directors, HWE was not present for frontline nurses. The moderate correlation of ANL and HWE was replicated in this larger study. CONCLUSIONS This is the 2nd study of the positive relationship between ANL and HWE using these models, supporting ANL as an essential standard of a HWE. ANL was present for clinical nurses in a pandemic year signaling that nurse leaders rose to meet frontline leadership needs. HWE was present overall, but not for clinical nurses. Leadership is essential to work environments and outcomes especially in times of crisis and significant change.
Nurses' Intent to Leave their Position and the Profession During the COVID-19 Pandemic
Journal of Nursing Administration, Oct 1, 2021
OBJECTIVE The aim of this study was to describe the relationships between perceptions of the pand... more OBJECTIVE The aim of this study was to describe the relationships between perceptions of the pandemic impact on clinical nurses' and nurse leaders' intent to leave their current position and the profession and the differences in pandemic impact and intent to leave variables based on background factors. BACKGROUND There is much discussion and concern about the COVID-19 pandemic impact on nurses' health and the nursing workforce. METHODS More than 5000 nurses from a national sample participated in a cross-sectional, descriptive study. Participants rated their perceptions of the pandemic impact on their practice and their intent to leave their position and profession. RESULTS Pandemic impact was rated high overall and was highest in nurses with 25+ years of experience and in managers/directors. Eleven percent of the total sample indicated they intended to leave their position, and 20% were undecided. Nurses who rated pandemic impact at the highest level had higher intent to leave their position. Of the respondents, less than 2% indicated they were leaving the nursing profession, whereas 8% were undecided. CONCLUSIONS This is the 1st quantitative report of perceived level of pandemic impact on direct care nurses and nurse managers/directors at the time of this writing. The combination of those who intend to leave and those who are uncertain about leaving their positions could cause instability in the workforce if not reversed. Organizational attention to nurse well-being, work environment and staffing is imperative.
Travel Nurse Perceptions of Work Environment, Authentic Leadership, Well-Being, and Pandemic Impact
Nurse Leader, Apr 1, 2022
Perceptions of Authentic Nurse Leadership and Work Environment and the Pandemic Impact for Nurse Leaders and Clinical Nurses
JONA: The Journal of Nursing Administration, 2021
OBJECTIVE The aim of this study was to determine the pandemic impact on the relationship between ... more OBJECTIVE The aim of this study was to determine the pandemic impact on the relationship between nurses' perception of the authentic nurse leadership (ANL) of their manager and their perception of the work environment. BACKGROUND Both ANL and healthy work environment (HWE) contribute to staff and patient outcomes. Our 1st study of these 2 variables revealed a positive relationship. Will this be upheld in a pandemic year? METHODS More than 5000 nurses from a national sample participated in a cross-sectional, correlational, descriptive study using the Authentic Nurse Leadership Questionnaire, the Critical Elements of a Healthy Work Environment Scale, and a pandemic impact on practice question. RESULTS Overall, nurses perceived ANL and HWE were present despite a high level of pandemic impact; however, when clinical nurses were separated from managers/directors, HWE was not present for frontline nurses. The moderate correlation of ANL and HWE was replicated in this larger study. CON...
If you can't measure it
Nursing Management, Mar 1, 2015
Find your courage
Nursing Management, Mar 1, 2014
It's all connected! Patient experience and healthy practice environments
Nursing Management, Aug 1, 2016
Nurse leader wellness: What's changed in 3 years?
Nursing Management, Feb 1, 2021
Where are the leaders?
Nursing Management, Jun 1, 2019
Nursing Management, Feb 1, 2018
American Journal of Preventive Medicine, Jun 1, 2020
The objectives of this study were to investigate an association between the risk of patient falls... more The objectives of this study were to investigate an association between the risk of patient falls and self-reported hearing loss and to examine whether self-reported hearing loss with versus without hearing aids predicts patient falls in an inpatient setting. Methods: This retrospective cohort analysis was conducted in 2018 in a large, urban, academic medical center. Participants included unique inpatients (N=52,805) of adults aged >18 years between February 1, 2017, and February 1, 2018. Outcome measures were falls in the inpatient setting and hearing loss with versus without hearing aids as predictors for patient falls. Results: Self-reported hearing loss was associated with falls in the inpatient setting (OR=1.74, 95% CI=1.46, 2.07, p<1.43 £ 10 À9). Among patients with hearing impairment, a lack of hearing aids increased the risk for falls in the inpatient setting (OR=2.70, 95% CI=1.64, 4.69, p<1.41 £ 10 À5). After accounting for the risk of fall using the Morse Fall Scale (which does not include hearing impairment) and controlling for age and sex, patients with hearing loss and no hearing aids were significantly more likely to fall (OR=2.44, 95% CI=1.002, 5.654, p<0.042), but patients with hearing loss who did have hearing aids were not significantly more likely to fall (p<0.889). Hearing loss together with the Morse Fall Scale better predicted falls than the Morse Fall Scale alone (p<0.017). Conclusions: In the inpatient setting, there was a positive association between hearing loss and falls. However, among patients with hearing loss, only those without hearing aids were significantly more likely to fall, accounting for the Morse Fall Scale score and demographics characteristics. These findings support adding hearing loss as a modifiable risk factor in risk assessment tools for falls and exploring the use of amplification devices as an intervention.
Who comes first?
Nursing Management, Mar 1, 2016
No, I’m not asking about the chicken or the egg, but rather patients or staff. At a time when pat... more No, I’m not asking about the chicken or the egg, but rather patients or staff. At a time when patient experience scores rule the C-suite—and when patient-centeredness is a national movement—it seems logical that patients come first. Who can argue with that premise? It’s our purpose. However, we may put forth another foundational element of the puzzle: your staff members come first, too. Staff engagement is popular in the nursing literature—how to measure it, the negative effects of its absence, what elements are needed to have it, and how it correlates to our patients’ experience. Are we truly committed to positive work environments? Or are we still turning our heads away from dysfunction, systems issues, and disrespect, thinking they’re too hard to change? The failure to push forward with a staff engagement agenda does trickle down and can result in increased turnover, absenteeism, errors, and, of course, a poor patient experience. On the positive side, engaged staff members have purpose, are less stressed, and are at their best—another one of our goals as leaders. In fact, it seems that the principles driving both staff engagement and the patient experience are similar. Avoiding blame and improving systems are basic examples of successful leadership. What about effective communication and responsiveness? We can’t have a positive work environment or a great patient experience without these building blocks. As a leader, you show that you care, listen, acknowledge, recognize, value, and respect your staff. Isn’t that the same message we drive home to staff members about their relationships with patients? Our staff members want to feel valued, and our patients want to feel like they’re a real person to us with individual needs. It’s all about acknowledgment of people as people no matter the angle, either the patient or staff perspective. Another fundamental element is developing collaborative relationships at all levels. We teach it to new managers as a key to success, and we teach it to our staff in working with patients and families. Relationship building is central to patient care and leadership. Again, it works for patients as it does for staff. Patients can tell when staff members are dissatisfied. Invest in your staff. Commit to them. Get them the resources they need to do the job. Truly make patient-centered decisions and systems. Unmet patient needs tend to focus on information, listening, and caring. It wouldn’t surprise me if staff needs are similar. Research tells us that they also need growth, respect, and recognition. So it’s all connected. We can’t fall into the trap of only focusing on patients. Sustainable change in your patients’ experience won’t occur without an engaged workforce. If we focus on staff and organizational values, then patients and families will feel the positive effects in a real and substantial way. Of course, this assumes that the entire organization is behind patient-centeredness. Maybe it is the chicken or the egg conundrum. Without staff engagement and true purpose, we won’t see an extraordinary patient experience; with engagement, it’s almost guaranteed. We can’t focus on one without the other and we must use equivalent strategies to promote success. So let’s make the environment special for our patients and our staff, using the same principles for both and never losing sight of either one. NM
Nurse leader wellness: What's changed in 3 years?
Nursing Management, 2021
Good trouble
Nursing Management, 2020
The evolution of evidence-based practice
Nursing Management, 2019
Be a thought leader
Nursing management, 2016
Nursing Management (Springhouse), 2016
Meaning and purpose in their work Meaning and purpose in their care Teamwork and collaboration Co... more Meaning and purpose in their work Meaning and purpose in their care Teamwork and collaboration Coordinated care Communication Communication Recognition/acknowledgment Recognition/acknowledgment Relationships Relationships Feeling safe Feeling safe Trust Trust Know me as a person Know me as a person Effective decision making Effective decision making
The art of being joyful
Nursing Management (Springhouse), 2015
S pring is in the air! With new blossoms come thoughts of fresh renewals and being joyful. There’... more S pring is in the air! With new blossoms come thoughts of fresh renewals and being joyful. There’s a surprising amount of nursing literature on joy at work from our sages like Marie Manthey to contemporary leaders such as Jo Manion. The question is typically framed as “how can we bring joy to work?” or, more disappointingly, “how can we regain joy at work?” implying that we’ve lost it. The lucky ones have a hard time imagining not being joyful at work, although this can sometimes take a high level of conscious and subconscious effort. It really isn’t about luck; it’s about finding joy and reframing situations with that attitude. Whether joy is a matter of survival, well-being, personality, or responsibility for others, it’s important for leaders. What are the elements of joy to embody and embrace? A sense of mission and related accomplishments immediately come to mind. The opposite is approaching work on a transactional basis, which isn’t inspiring for you or your staff. Work has to be connected to a greater purpose. Checking off rote tasks or attending supposedly meaningless meetings are typical transactional activities. But this isn’t a joyful attitude. These meetings can be an opportunity to learn and play a role in bringing patient-centeredness. Or there may be something new for you to pick up—a collegial relationship, another side of the story, or a better way to get something done. Bring value to it. Find the joy. Mission and purpose are best exemplified in those who are passionate about their work. When you have passion, it isn’t work at all and you can’t help but have positive energy and a transformational approach. Focus on what brings you enjoyment and get involved. Respect in every possible direction is a factor in joyful work—with each other, patients, families, staff, providers, colleagues, bosses, everyone. Being respected requires behaving respectfully; it’s a two-way street. Respect is an “always” issue; even one episode of disrespect is damaging. Expect respect from your staff at all times or it will affect engagement and morale. Unintentional disrespect isn’t uncommon; fix it when you see it or if you discover it in yourself. Professional pride internally and externally at every level from bedside care to national policy-making is cause for celebration. Being a nurse in and of itself brings joy. We’re the most respected profession in the country. Advanced nursing practice is becoming a cornerstone of American healthcare. We have a powerful future mapped out in the Institute of Medicine’s Future of Nursing report that needs proactive support from all of us. There’s delight in being proud of your profession. If you don’t have it, discover it. Being a leader is a great foundation for enjoyment. You make a difference in so many ways to so many people. The elements I’ve mentioned are only part of being successful; there are more and you know what yours are. Be joyful—it’s another essential component of your success and even your health. NM
Perceptions of US nurses and nurse leaders on authentic nurse leadership, healthy work environment, intent to leave and nurse well‐being during a second pandemic year: A cross sectional study
Journal of Nursing Management, Jun 21, 2022
Perceptions of Authentic Nurse Leadership and Work Environment and the Pandemic Impact for Nurse Leaders and Clinical Nurses
Journal of Nursing Administration, May 1, 2021
OBJECTIVE The aim of this study was to determine the pandemic impact on the relationship between ... more OBJECTIVE The aim of this study was to determine the pandemic impact on the relationship between nurses' perception of the authentic nurse leadership (ANL) of their manager and their perception of the work environment. BACKGROUND Both ANL and healthy work environment (HWE) contribute to staff and patient outcomes. Our 1st study of these 2 variables revealed a positive relationship. Will this be upheld in a pandemic year? METHODS More than 5000 nurses from a national sample participated in a cross-sectional, correlational, descriptive study using the Authentic Nurse Leadership Questionnaire, the Critical Elements of a Healthy Work Environment Scale, and a pandemic impact on practice question. RESULTS Overall, nurses perceived ANL and HWE were present despite a high level of pandemic impact; however, when clinical nurses were separated from managers/directors, HWE was not present for frontline nurses. The moderate correlation of ANL and HWE was replicated in this larger study. CONCLUSIONS This is the 2nd study of the positive relationship between ANL and HWE using these models, supporting ANL as an essential standard of a HWE. ANL was present for clinical nurses in a pandemic year signaling that nurse leaders rose to meet frontline leadership needs. HWE was present overall, but not for clinical nurses. Leadership is essential to work environments and outcomes especially in times of crisis and significant change.
Nurses' Intent to Leave their Position and the Profession During the COVID-19 Pandemic
Journal of Nursing Administration, Oct 1, 2021
OBJECTIVE The aim of this study was to describe the relationships between perceptions of the pand... more OBJECTIVE The aim of this study was to describe the relationships between perceptions of the pandemic impact on clinical nurses' and nurse leaders' intent to leave their current position and the profession and the differences in pandemic impact and intent to leave variables based on background factors. BACKGROUND There is much discussion and concern about the COVID-19 pandemic impact on nurses' health and the nursing workforce. METHODS More than 5000 nurses from a national sample participated in a cross-sectional, descriptive study. Participants rated their perceptions of the pandemic impact on their practice and their intent to leave their position and profession. RESULTS Pandemic impact was rated high overall and was highest in nurses with 25+ years of experience and in managers/directors. Eleven percent of the total sample indicated they intended to leave their position, and 20% were undecided. Nurses who rated pandemic impact at the highest level had higher intent to leave their position. Of the respondents, less than 2% indicated they were leaving the nursing profession, whereas 8% were undecided. CONCLUSIONS This is the 1st quantitative report of perceived level of pandemic impact on direct care nurses and nurse managers/directors at the time of this writing. The combination of those who intend to leave and those who are uncertain about leaving their positions could cause instability in the workforce if not reversed. Organizational attention to nurse well-being, work environment and staffing is imperative.
Travel Nurse Perceptions of Work Environment, Authentic Leadership, Well-Being, and Pandemic Impact
Nurse Leader, Apr 1, 2022
Perceptions of Authentic Nurse Leadership and Work Environment and the Pandemic Impact for Nurse Leaders and Clinical Nurses
JONA: The Journal of Nursing Administration, 2021
OBJECTIVE The aim of this study was to determine the pandemic impact on the relationship between ... more OBJECTIVE The aim of this study was to determine the pandemic impact on the relationship between nurses' perception of the authentic nurse leadership (ANL) of their manager and their perception of the work environment. BACKGROUND Both ANL and healthy work environment (HWE) contribute to staff and patient outcomes. Our 1st study of these 2 variables revealed a positive relationship. Will this be upheld in a pandemic year? METHODS More than 5000 nurses from a national sample participated in a cross-sectional, correlational, descriptive study using the Authentic Nurse Leadership Questionnaire, the Critical Elements of a Healthy Work Environment Scale, and a pandemic impact on practice question. RESULTS Overall, nurses perceived ANL and HWE were present despite a high level of pandemic impact; however, when clinical nurses were separated from managers/directors, HWE was not present for frontline nurses. The moderate correlation of ANL and HWE was replicated in this larger study. CON...