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"Nursing, Supervisory"
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Modifying head nurse messages during daily conversations as leverage for safety climate improvement: a randomised field experiment
BackgroundRecent literature reviews lament the paucity of high-quality intervention studies designed to test safety culture improvement in hospitals. The current study adapts an empirically supported strategy developed for manufacturing companies by focusing on patient care and safety messages head nurses communicate during daily conversations with nurses.MethodsThe study was designed as randomised control trial coupled with before-after measurement of outcome variables. We randomly assigned 445 nurses working in 27 inpatient departments in a midsize hospital in Israel to experimental and control groups. Ten randomly chosen nurses in both groups filled a brief questionnaire referring to last conversation with head nurse. One month later, head nurses in the experimental group received individual feedback, comparing individual with mean hospital scores, coupled with self-set goals for the following feedback session. Head nurses in the control group received no feedback, except for a summary report by the end of intervention.ResultsPatient care messages increased by 16% and professional development messages by 12%, accompanied by 17% decline in nurse-blaming messages in the experimental group, remaining unchanged in the control group. Such changes led to statistically significant increase in patient care behaviours (17%), safety climate (13%), teamwork (9%) and supervisory leadership quality (18%). Rule-compliance messages and workaround behaviours remained unchanged in experimental and control departments.ConclusionsThese data support the utility of our intervention strategy for improving patient safety climate and resultant caring behaviours in healthcare organisations. The fact that our intervention used easy-to-deliver feedback requiring only two sessions minimised its organisational costs.
Journal Article
Impact of having a certified nurse specialist in critical care nursing as head nurse on ICU patient outcomes
This study evaluated the impact of the presence of a certified nurse specialist in critical care (CNS) as ICU head nurse in an open ICU on clinical outcomes.
The presence of a CNS as ICU head nurse was implemented in practice in April 2017. To evaluate the impact on patient outcomes before and after the implementation, patients were divided into two groups: before (April 2014 to March 2017; 1988 patients) and after (April 2017 to March 2019; 1664 patients). Patients' demographic data were collected from the ICU database.
Multivariable logistic regression analysis revealed that the presence of a CNS as ICU head nurse was associated with lower ICU mortality (odds ratio (OR): 0.52, 95% CI: 0.36-0.73, p < .001) and fewer patients receiving mechanical ventilation in the ICU (OR: 0.20, 95% CI: 0.15-0.26, p < .001).
CNSs are defined as one type of advanced practice nurses. Having a CNS as a head nurse in the ICU may have helped improve patient outcomes by leveraging these practical skills in nursing management.
Journal Article
Operational nursing managers’ experiences of clinical supervision at a Johannesburg Hospital
Background Clinical supervision is pivotal in supporting nurses in rendering quality, safe patient care. Therefore, it is essential to understand clinical supervision from operational nursing managers’ context to define existing challenges and propose suitable recommendations. Objectives This study aimed to explore and describe operational nursing managers’ experiences of clinical supervision within the context of an academic hospital in Gauteng province and propose evidence-based practice recommendations to improve patient safety and the quality of clinical supervision. Method An exploratory, sequential, mixed-method design was used and implemented over two phases to take advantage of the strengths of both the qualitative and quantitative research designs. Unstructured individual interviews were conducted to collect data in phase one, and an adapted Manchester Clinical Supervision Scale (MCSS) questionnaire was used to collect data in phase two. Results Operational nursing managers work in stressful conditions and environments with a gross shortage of staff and tools of the trade while being expected to deliver high-quality and safe nursing care. Of the sampled respondents, 36% (n = 17) were dissatisfied with the supervision they received, while 64% (n = 30) were indifferent in the sense that they did not think it was adequate or inadequate. Conclusion Clinical supervisors should be trained and supported in clinical supervision, with regular workshops on interpersonal relations. Contribution A clearer understanding of clinical supervision within the hospital context and evidence-based practice recommendations to improve patient safety and the quality of clinical supervision.
Journal Article
Preparing palliative home care nurses to act as facilitators for physicians’ learning: Evaluation of a training programme
Background:
Palliative care requires a multidisciplinary care team. General practitioners often ask specialised palliative home care teams for support. Working with specialised nurses offers learning opportunities, also called workplace learning. This can be enhanced by the presence of a learning facilitator.
Objectives:
To describe the development and evaluation of a training programme for nurses in primary care. The programme aimed to prepare palliative home care team nurses to act as facilitators for general practitioners’ workplace learning.
Design:
A one-group post-test only design (quantitative) and semi-structured interviews (qualitative) were used.
Methods:
A multifaceted train-the-trainer programme was designed. Evaluation was done through assignments with individual feedback, summative assessment through videotaped encounters with simulation-physicians and individual interviews after a period of practice implementation.
Results:
A total of 35 nurses followed the programme. The overall satisfaction was high. Homework assignments interfered with the practice workload but showed to be fundamental in translating theory into practice. Median score on the summative assessment was 7 out of 14 with range 1–13. Interviews revealed some aspects of the training (e.g. incident analysis) to be too difficult for implementation or to be in conflict with personal preferences (focus on patient care instead of facilitating general practitioners’ learning).
Conclusion:
Training palliative home care team nurses as facilitator of general practitioners’ workplace learning is a feasible but complex intervention. Personal characteristics, interpersonal relationships and contextual variables have to be taken into account. Training expert palliative care nurses to facilitate general practitioners’ workplace learning requires careful and individualised mentoring.
Journal Article
Improving Nurse Retention & Healthcare Outcomes
Empowering, engaging, and retaining qualified nurses are critical healthcare priorities. Why? Nurse retention is directly correlated to healthcare outcomes, and nurse turnover has a negative, multidimensional effect on healthcare organizations. Turnover affects job satisfaction among clinical nurses, which leads to burnout, making it harder for them to provide safe patient care and achieve overall organizational initiatives. Further, the high costs associated with nurse turnover can have a huge impact on a hospital's or health system's profit margin. Improving Nurse Retention & Healthcare Outcomes will help clinical nurses understand how to elevate their practice as frontline care providers and give executives a new, strategic approach to nurse retention. Authors Judy Thomas and Mellisa Renter outline the IMPACT Model they created to stimulate empowerment and professional growth. In addition to explaining the program, how it works, and what it has achieved, this book provides an implementation path to make an immediate impact on nurse empowerment, engagement, and retention.
eBook
The Nurse-Patient Assignment
OBJECTIVE:Identify purposes and decision factors of the nurse-patient assignment process.
BACKGROUND:Nurse-patient assignments can positively impact patient, nurse, and environmental outcomes.
METHODS:This was an exploratory study involving interviews with 14 charge nurses from 11 different nursing units in 1 community hospital.
RESULTS:Charge nurses identified 14 purposes and 17 decision factors of the nurse-patient assignment process.
CONCLUSIONS:The nurse-patient assignment is a complex process driven by the patient, nurse, and environment. Further study is needed to identify factors linked to patient safety, nurse, and environmental outcomes.
Journal Article
Nurturing Charge Nurses for Future Leadership Roles
Charge nurses are untapped leadership resources that can be groomed for future advanced leadership positions in healthcare organizations. The purpose of this study was to understand the development needs for the charge nurse role. This study demonstrates they receive little or no training for assuming positions of leadership and offers suggestions for enhancement of preparation.
Journal Article
The Innovation Handbook: A Nurse Leader’s Guide to Transforming Nursing
The global healthcare ecosystem is in chaos, caught in the convergence of pandemic-induced disruption, residual inequities, burnout, and turnover. Nurse leaders can either succumb to the churn or spot—and seize—a rare opportunity for true transfor¬mation. They must thoughtfully consider all aspects of their traditional roles and tack¬le trigger topics such as staffing, schedul¬ing, value-based care, outcome tracking, and more. Informed, empowered nurses can re-envision roles, integrate technolo¬gies, and develop new models to deliver the highest level of patient care. The Innovation Handbook is a pragmatic guide and toolkit that seeks to enlighten nurse leaders as they evolve through the current crisis. Author Bonnie Clipper explains concepts and equips nurses with a knowledge foundation that enhances their innovation skill set, spurs ideas and creativity, and challenges them to think differently and apply new concepts. On the cusp of a once-in-a-generation opportunity to create a better future for nursing and healthcare, this book gives nurses the tools to meet the moment!
eBook
The Nurse Manager's Guide to Budgeting and Finance
Updated to include details about key legislation that affects budgeting, The Nurse Manager's Guide to Budgeting and Finance, 3rd Edition, provides practical tools, tips, and strategies for running a unit that were not taught in nursing school.
eBook