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Implementing a Shared Governance Model to Support Nursing Departmental Functionality During a Complex Multi-University Merger
Background
Following the merger of three state universities in a large geographic region, a nursing department recognized the need to develop a cohesive, functional structure to effectively manage the complexities of the newly formed department.
Method
A quality improvement initiative was enacted to establish a departmental structure that empowered faculty to participate in decision making by implementing a shared governance model.
Results
The nursing department successfully formed a structure that provided uniformity among multiple nursing programs and resulted in approval from the State Board of Nursing and other accrediting bodies.
Conclusion
Adopting a shared governance model during a multi-university merger facilitated a nursing department's ability to develop a cohesive, functional nursing department structure. Use of the shared government model empowered faculty, enhanced collaboration, and contributed to the successful development of a functional nursing department that met accreditation requirements.
Journal Article
European nurses' life and work under restructuring
An examination of nurses' professional work and life in the context of the ongoing institutional restructuring of health care systems in seven European countries, England, Finland, Greece, Ireland, Portugal, Spain and Sweden. Professional experience and expertise is discussed from the nurses' perspective and focuses on how they deal with restructuring measures caused by changes in policy and administration.
Book
Nursing Administration Research Priorities
OBJECTIVE:The aim of this study is to determine the priorities for nursing administration research (NAR) in the United States.
BACKGROUND:Previously known as the Council of Graduate Educators in Administrative Nursing, CGEAN provides an avenue for researchers and educators focused on NAR to partner, dialogue, obtain funding resources, and present their findings at a biennial International Nursing Administration Research Conference (INARC). In late 2013, with a goal of building consensus, CGEAN convened an INARC postconference to initiate the process of establishing critical NAR priorities for the future.
METHODS:Data from a 3-staged Delphi study were used to identify relevant research topics and determine administrative research priorities.
RESULTS:Eight final categories of NAR were determined.
CONCLUSIONS:This study found economic valuing of nursing and designing effective future healthcare delivery systems to be high priorities for NAR.
Journal Article
Informatics Competencies for Nurse Leaders: A Scoping Review
OBJECTIVETo consolidate informatics competencies for nurse leaders.
BACKGROUNDNurses in leadership positions with financial and human resource responsibilities have the capacity to shape how technologies are selected, implemented, and used. Many nurse leaders are not equipped with the essential informatics competencies to do so effectively. There have been efforts to identify a set of standard informatics competencies that should be core to every nurse leaderʼs suite of capabilities; nonetheless, these efforts have yet to be disseminated widely.
METHODSA scoping review was conducted by1) identifying the research questions; 2) identifying relevant studies; 3) selecting studies; 4) extracting collected data; and 5) reporting the results.
RESULTSFifteen articles were found, and 11 competency themes related to informatics knowledge, informatics skills, and others were identified.
CONCLUSIONFindings of this review can be used to support nursing leaders in their identification of gaps in their informatics knowledge and skill.
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
Lessons Learned From 10 Years of Research on a Post-Baccalaureate Nurse Residency Program
OBJECTIVES:The aim of this study was to examine outcomes from 10 years of research on a post-baccalaureate new graduate nurse residency program and to report lessons learned.
BACKGROUND:Transition to practice programs are recommended by the Future of Nursing report, the Carnegie Foundation study, the Joint Commission, and the National Council of State Boards of Nursing.
METHODS:Data from new graduate residents who participated in the University HealthSystem Consortium/American Association of Colleges of Nursing residency from 2002 through 2012 are presented. Analysis of variance results from the Casey-Fink Graduate Nurse Experience Scale and outcomes from the graduate nurse program evaluation instrument are provided.
RESULTS:Retention rates for new graduates in the residency increased considerably in the participating hospitals. Residents’ perception of their ability to organize and prioritize their work, communicate, and provide clinical leadership showed statistically significant increases over the 1-year program.
CONCLUSION:The recommendations for new graduate nurse residency programs are supported by the findings.
Journal Article
Unit Leadership and Climates for Evidence‐Based Practice Implementation in Acute Care: A Cross‐Sectional Descriptive Study
Purpose The purposes of this study were to (a) describe nurse manager (NM) leadership behaviors for evidence‐based practice, NM evidence‐based practice competencies, and unit climates for evidence‐based practice implementation in acute care, and (b) test for differences in NMs’ and staff nurses’ (RNs’) perceptions. Design A multisite cross‐sectional design was used to collect data from a sample of 24 NMs and 553 RNs from 24 adult medical‐surgical units in seven U.S. community hospitals. Methods Responses were collected using electronic questionnaires, inclusive of the Nurse Manager Evidence‐Based Practice Competency Scale (NM only), Implementation Leadership Scale, and Implementation Climate Scale. E‐mail reminders and gift card lottery drawings encouraged response. Descriptive statistics described total and subscale scores by role. Differences in perceptions were evaluated using independent t‐tests with Bonferroni correction (α = .05). Findings 23 NMs and 287 RNs responded (95.8% and 51.9% response rates, respectively). NMs reported they were “somewhat competent” in evidence‐based practice (M = 1.62 [SD = 0.5]; 0–3 scale). NMs and RNs perceived leadership behaviors (NM: M = 2.73 [SD = 0.46]; RN: M = 2.88 [SD = 0.78]; 0–4 scale) and unit climates for evidence‐based practice implementation (NM: M = 2.16 [SD = 0.67]; RN: M = 2.24 [SD = 0.74]; 0–4 scale) as evident to a “moderate extent.” RN and NM perceptions differed significantly on the Proactive (p = .01) and Knowledgeable (p < .001) leadership subscales. Conclusions Evidence‐based practice competencies and leadership behaviors of NMs, and unit climates for evidence‐based practice were modest at best and interventions are needed. To close the research to practice gap, future studies should investigate the interplay between social dynamic context factors and implementation strategies to promote uptake of evidence‐based practices. Clinical Relevance Critical attention is needed to build organizational capacity for evidence‐based practices through development of unit leadership and climate for evidence‐based practice to accelerate routine use of evidence‐based practices for improving care delivery and patient outcomes. The three instruments described herein provide a foundation for nurse leaders to assess these dynamic context factors and design interventions or programs where there is opportunity for improvement.
Journal Article
Effects of a fixed nurse team in the orthopaedic surgery operating room on work efficiency and patient outcomes: a propensity score-matched historically controlled study
Background
The work value of operating room (OR) nurses is directly reflected in nursing quality. However, evaluating the work value of these nurses has not been sufficiently investigated. This study evaluated the effects of a fixed nurse team (FNT) in an orthopaedic surgery OR on work efficiency and patient outcomes.
Methods
A propensity score-matched historically controlled study conducted from 1 July 2015 to 30 June 2018 was used to investigate the difference in nursing quality between an FNT period and a non-FNT period in the orthopaedic surgery OR at a tertiary care hospital in China. The primary outcome was surgical site infections (SSIs) during in-hospital visits, and as a secondary outcome, other nursing-sensitive quality indicators were assessed with historically controlled data. A multifactor logistic regression model was constructed to examine the primary outcome differences between the FNT and non-FNT periods before and after propensity score matching.
Results
In total, 5365 patients and 33 nurses were included in the final analysis. The overall SSI rate was 2.1% (110/5365; the non-FNT period 2.6% [64/2474], the FNT period 1.6% [46/2891]). A lower incidence of SSIs in patients (odds ratio 0.57, 95% CI 0.36 to 0.88,
P
=0.013), a lower turnover time of the surgical procedure (odds ratio 0.653, 95% CI 0.505 to 0.844,
P
<0.001), and improvement in surgeon satisfaction (odds ratio 1.543, 95% CI 1.039 to 2.292,
P
=0.031), were associated with the FNT period compared with the non-FNT period. However, we did not find significant differences between the FNT period and the non-FNT period in terms of the other indicators.
Conclusions
The presence of an FNT in an OR reduces the incidence of SSIs in surgical patients and the turnover time of surgical procedures and improves surgeon satisfaction. Further implementation of an advanced-practice nurse model with nurse specialists is encouraged.
Journal Article