Date of Graduation

Summer 8-7-2018

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)


School of Nursing and Health Professions


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First Advisor

Nancy Taquino, DNP, RN, CNL

Second Advisor



An area of concern for clinical nurse leaders (CNLs) is the increasing incidence of workplace injuries in integrated healthcare systems with call centers where repetitive stress injury (RSI) is among the leading causes of workplace injuries. Recurring pain and discomfort that call center Advice Registered Nurses (ARNs) experience hurts them and their teams, influences the operation of the call center, and decreases the quality of care provided to the healthcare system members. Due to high call volumes ARNs do not adequately use breaks or other measures to reduce physical strain. There is an opportunity to reduce RSIs through deployment of management support and existing resources utilizing small interventions that don’t interrupt workflow. To determine interventions for this evidence-based change of practice project an initial microsystem assessment was conducted using ARN safety report data to reveal the number and types of injuries. A subsequent microsystem assessment followed at six months, to identify any changes in the data. The assessments and safety report data suggested possible interventions, from which hotkeys, ForgetMeNot reminders, and microbreaks were chosen. The family of measures were completing ergonomic assessments, decreasing repetitive movements, and stretch break education. The ARNs benefited from the use of hotkeys and microbreaks and in contrast to the teams that do not use ForgetMeNot reminders, the project ARN team did not sustained any RSIs. This change of practice project showed that RSIs could be reduced through interventions specific to call center ARN work practices without interrupting workflow or decreasing productivity. Sustainability of the change of practice depends on leadership and manager support, safety pair engagement, and buy-in from the ARNs who benefit from a reduction in RSIs.

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