Nursing Administration Quarterly最新文献

An ST-segment elevation myocardial infarction is a life-threatening condition within the spectrum of acute coronary syndrome, with well-recognized implications for short-term and long-term health outcomes. Retrospective review of our institutional electronic health records identified patterns of inaccurate acute coronary syndrome diagnostic assignment, including the presence of erroneous ST-segment elevation myocardial infarction diagnoses in discharge records. Such erroneous diagnoses in the durable health record may increase risk to patients through inadequate risk assessment and inappropriate follow-up care. Misapplication of a shortcut in our electronic health record system for rapidly ordering emergent cases was identified as a potential cause of the quality gap. To address this issue, a nurse-led quality improvement project was developed by using the define, measure, analyze, improve, and control framework. The project intervention decreased the percentage of patients with erroneous diagnoses from 24% to 7% and marginally improved nursing staff satisfaction. Our project successfully addressed an institutional quality concern. Our goal of reducing erroneous discharge diagnoses with minimal disruption to our existing practice was achieved, positively affecting our patients. Including both nurse leaders and frontline health care workers ensured the success of our project.

This study evaluated the feasibility and acceptability of Ōura, a finger-worn sensor used to monitor heart rate variability (HRV) as a digital biomarker of stress among Korean-American home care workers caring for Korean-American individuals with dementia. This prospective, single-cohort study included 15 home care workers who wore Ōura for 21 days, with HRV data collected over a 14-day analysis period. Feasibility and acceptability were evaluated through quantitative and qualitative approaches. All participants were female, with a median age of 61 years, and each cared for a median of 1 Korean-American individual with dementia (range: 1 to 3 care recipients). We achieved an 88.24% retention rate and a 100% completion rate. Of the 210 potential daily HRV data points, 94.2% were valid. Participants reported high ease of use and comfort wearing the ring. Qualitative findings revealed themes of enhanced health awareness, variability in comfort and fit, and a need for more information about the health data provided by the ring application. The findings demonstrate the feasibility and acceptability of using a finger-worn sensor in Korean-American home care workers. Future studies should address data validity issues and explore the clinical utility of HRV monitoring via finger-worn sensors for stress management in this understudied population.

A virtual reality (VR) tour of the operating room (OR) can reduce parental anxiety by providing a realistic experience of an environment that may be unfamiliar or frightening. This study aimed to measure the impact of a 3-dimensional (3D) VR headset tour on parental anxiety. This quasi-experimental, 2-group, pre-post-test design study was conducted in Turkiye between October 2022 and July 2023. The State-Trait Anxiety Inventory (STAI) was used for parents' anxiety. Parents wеrе thеn randomly assignеd to thе control and intervention groups. In thе intervention group (n=30), parents received a tour of the OR with VR glasses for about 30 minutes on thе day bеforе surgеry. The control group (n=30) received routine hospital training about the surgical procedure. All children's parent completed the STAI scale before the day before surgery and again before immediate discharge, after 4 weeks, and 3 months. VR intervention did not impact anxiety scores before discharge and at 1 and 3 months after surgery. Parents in both groups experienced mild anxiety before surgery. The STAI trait anxiety score was higher in parents who had a daughter, lived separately, and worked part-time 1 month after surgery ( P =0.01). This study did not find a reduction in parental anxiety with VR headsets. A holistic approach should be taken to inform parents about OR, depending on their specific needs.

As health care delivery evolves through technological innovation and expanded support roles, concerns have emerged regarding the erosion of relational nursing practice. This manuscript explores the paradox of increased support for registered nurses alongside declining time spent in direct patient interaction. Drawing on recent literature and leadership dialogue, it examines the implications of diminished communication and connection, particularly among early career nurses, and proposes strategies to restore relational competencies as a core element of professional nursing practice.

Dissemination of member work including projects and studies is a common component of professional nursing organization conferences. Members typically submit an abstract and are selected as presenters through a peer reviewed process. Presenters may have the option of a podium or poster presentation, and conference planners provide requirements such as length of podium presentations or size of posters. The purpose of this article is to describe an initiative by a state nursing leadership organization, Association of California Nurse Leaders (ACNL), to improve the alignment of abstracts with organizational strategic priorities, and the quality of posters at the annual conference. Conference planners set improvement goals, revised the call for abstract and selection criteria, offered poster development webinars, and evaluated posters for key design elements. This article will describe goals, abstract criteria, webinar content, evaluation method, and outcomes including improvement data for two years. The methods described in this article may be duplicated by organizations wishing to establish or improve the quality of conference dissemination.

To build a resilient and sustainable nursing workforce, health care institutions must prioritize supportive leadership, well-being, inclusivity, and innovation. Key strategies include fostering open communication, encouraging collaboration, involving nurses in decision-making, and offering flexible staffing options. Recognizing nurses for their contributions and addressing burnout and moral distress are essential for maintaining job satisfaction and improving patient care. This article, presented by members of the Association of California Nurse Leaders Healthy Work Environment Committee, will share a novel perspective for consideration that integrates concepts from the American Nurses Association Code of Ethics and the American Association of Critical Care Nurses. Using this intersectional perspective directs nurse leaders to employ strategies that enhance job satisfaction and nurse retention, reduce feelings of burnout and moral distress, leading to a healthier, more engaged workforce ready to optimize care outcomes.

The Association of California Nurse Leaders (ACNL) Health Policy Committee (Committee) plays a vital role in advancing the political competency and policy engagement of nurse leaders throughout California. The Committee promotes informed, skilled, and empowered nursing professionals prepared to influence health policy through strategic initiatives grounded in education, competency development, legislative monitoring, and advocacy. Aligned with ACNL's strategic priorities, the Committee operates through specialized subcommittees dedicated to developing policy competencies, educational offerings, and legislative updates. Evidence underscores the persistent underrepresentation of nurses in policy arenas and highlights the urgent need for structured development pathways to cultivate leadership and advocacy skills. Case examples demonstrate the Committee's success in supporting nurses' progression from novice participants to influential policy leaders. The work of the ACNL Health Policy Committee illustrates how nursing organizations can serve as effective vehicles for health policy engagement, ultimately strengthening the profession's impact on health care systems. Nurse leaders are called upon to actively engage in policy advocacy, leverage their expertise, and guide the next generation of nurse advocates. This manuscript aims to showcase the impact of the Committee and serve as a model for other professional organizations to mobilize resources to empower nurse leaders. A call to action is issued to engage nurses at all levels of leadership in shaping equitable, effective health policy.

Background: Compassion fatigue (CF) is an emotional condition affecting health care workers/nurses due to prolonged exposure to patient care. It is costly and associated with profound individual and organization consequences such as health care workers leaving their profession.

Purpose: This study explored the facilitators, risk factors, barriers, and strategies contributing to CF among inpatient nurses.

Methods: This data set was part of mixed-method multisite/multisystem descriptive study among nurses in 14 hospitals within an integrated health care organization and 2 hospitals within a university system. Participants responded to open-ended questions via SurveyMonkey addressing coping strategies, barriers, and facilitators. Descriptive thematic analysis was conducted.

Results: A total of 6 main themes emerged including Harmonizing Work Demands, Compassion Maintenance, Motivation to Continue in Nursing, Compassion Satisfaction Facilitators, Strategies to Reduce Stress, and Compassion Barriers. Participants shared key strategies focused on personal factors such as sleep and nutrition, spiritual practices, recreation, and time with loved ones. They emphasized the importance of venting, self-reflection, socialization, and spiritual activities.

Implications for practice: Understanding CF and its contributing factors is crucial for developing effective interventions to support nurses. Promoting work-life balance, providing opportunities for spiritual and recreational activities, and fostering a supportive work environment can help mitigate CF, improve nurse retention and job satisfaction.

Nurse well-being is vital for health care, affecting performance, retention, and patient outcomes. Poor well-being may lead to burnout, medical errors, and reduced care quality. This issue is a major concern in health care systems. Organizations such as the American Nurses Association, the American Association of Critical-care Nurses, and the National Institutes of Health provide guidelines to reduce nurse stress and improve well-being. This study aimed to examine California nurse leaders' perceptions of factors contributing to burnout, the extent of implementation of national well-being strategies within their institutions, and the effectiveness of various approaches to enhancing well-being in the workplace. A descriptive, cross-sectional study was conducted using a questionnaire developed by the researchers and distributed via Qualtrics to members of the Association of California Nurse Leaders. The survey collected demographic data and responses about organizational practices related to well-being. This study confirms that nurse burnout and reduced well-being continue to hinder the post-COVID-19 era. California nurse leaders cite workload as the primary contributor, followed by staffing shortages and personal issues. Although strategies from national bodies exist, more than half of the institutions have not implemented any of the recommended programs. This study highlights the need for health care organizations to adopt systemic interventions for nurse well-being, beyond individual-based solutions. Nurse leaders must advocate for structural changes to reduce workloads and staffing shortages. Institutions should invest in formal well-being programs aligned with national standards and ensure these resources are accessible to safeguard the nursing workforce and guarantee high-quality patient care.