Date of Conferral

8-22-2025

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Robert Anders

Abstract

The purpose of this doctoral project was to improve charge nurse leadership competencies through education on the tiered skills acquisition model (TSAM), addressing challenges of high turnover, limited orientation, and compromised care quality in an inpatient psychiatric facility. The background reveals a two-year financial loss of over $1.8 million tied to staff attrition, highlighting the urgent need for a structured training framework. TSAM, a progressive, competency-based model, offers a pathway for deliberate skill acquisition, leadership growth, and enhanced role clarity. A staff education program was implemented with ten charge nurses, incorporating a pretest, PowerPoint training, scenario-based roleplays, and a posttest. A paired t test revealed a statistically significant improvement in knowledge (p = .02), with an average score increase of 7 points and a mean percentage gain of 8.33%, despite a ceiling effect. Results suggest TSAM benefits nurses across experience levels and supports improved retention, confidence, and job satisfaction. This initiative demonstrates that standardized frameworks like TSAM can reduce orientation waste and financial loss while fostering safer, more consistent care. Limitations include a small sample size and high baseline pretest scores, which may limit generalizability. Nonetheless, the findings align with prior studies emphasizing TSAM’s role in structured learning, identity formation, and role autonomy. The project indirectly addresses social justice by promoting equitable training access for all charge nurses, reducing disparities in role readiness, and improving patient care quality through competent leadership. Integration of TSAM into onboarding and continuing education is recommended to sustain impact and promote a more stable and inclusive workforce.

Download

Included in

Nursing Commons

Share

 
COinS