Date of Paper/Work


Type of Paper/Work

Doctor of Nursing Practice Project

Degree Name

Doctor of Nursing Practice



First Advisor

Dr. Alice Swan


Doctor of Nursing Practice


Patient centered care guided by the nurse patient relationship is at the heart of nursing. The current healthcare environment places greater value on the nurses’ technical competencies over their behavioral competencies. Nursing must show the value behavior competencies have on the patient experience. Foundational to the profession is that nurses provide holistic care that embraces being present for the patient. The aim of the study was to determine what impact an education activity “Nurse Presence through Attunement” had on the patient experience. Mixed methods were used to investigate the impact of an educational intervention using Koloroutis and Trout’s (2012) model of Nurse Presence through Attunement. Methods used to teach the concept incorporated didactic content, reflection of “proudest moment as a nurse," and review of the story “I had a Great Nurse Last Night.” The sample included nurses from the staff development and practice committees in a medical cardiology unit that received the education and patients on the medical cardiology unit. Outcome measures included: pre- and post-surveys, a learning contract completed by the nurses, and patient pre- and post-surveys implemented by the nurse manager in nurse leader rounding. Quantitative and qualitative measures were used to express the impact of education. Comparisons of responses between the pre- and post-nurse surveys were evaluated using Wilcoxon Rank Sum Tests. The patient pre-and post-survey results showed overall improvement in the patient’s experience. The qualitative measures identified themes that reflected elements of nurse presence through attunement. The process of Nurse Presence through Attunement can be taught. Moreover, the nurse’s ability to attune and be present greatly affects the patient experience. The education activity on the Attunement Model of Nurse Presence merits further study.