Date of Conferral

5-9-2024

Date of Award

May 2024

Degree

Ph.D.

School

Health Services

Advisor

Cheryl Cullen

Abstract

The social phenomenon institutional memory loss (IML) negatively impacts patient safety and quality of care. As experienced labor and delivery (L&D) nurses retire, incoming novice nurses lack expert knowledge and are challenged with a more complex patient population. Unresolved, the vulnerabilities from IML will impact the healthcare organization’s competitive edge and hamper progression of the sustainable development goals regarding maternal, infant, and child health. IML in the labor and delivery unit has not been covered in the current literature. In this phenomenological study the perspectives of labor and delivery nurse managers on the impact of IML on care delivery of novice labor and delivery nurses were explored. Donabedian’s conceptual framework was integrated with the general essence of Benner’s novice to expert theory with the aim of providing insight on IML and the impact on care delivered by novice L&D nurses. Using purposeful sampling, seven L&D nurse managers within the southeastern region of the United States were selected. Open-ended questions were used in recorded semi structured, one-on-one, virtual and telephone interviews that yielded rich data. Transcribed narratives were analyzed using Colaizzi’s process and NVivo software revealing three overarching themes supported by current literature: (a) IML reduces the quality of care through loss of skills and experience; (b) IML makes it difficult to support novice nurses and maintain quality of care; and (c) IML impedes the ability to mentor, train, and observe novice nurses to improve quality of care. Implications for positive social change include informing policy for the improvement of maternal fetal outcomes and patient care processes that can impact population health.

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