Nursing Administration Quarterly最新文献

Background: Centralized scheduling of nursing professionals is regarded as an effective strategy for optimizing workforce allocation and mitigating critical staffing shortages. The aim of this review is to (1) determine the effect of centralized scheduling on unit productivity (ie, overtime, contract labor, and floating), time savings for managers, and staff perceptions and retention and (2) discuss current approaches in the implementation of centralized scheduling in inpatient hospital settings.

Methods: This rapid review of the evidence follows methodological guidance from the Cochrane Rapid Reviews Methods Group. Four electronic bibliographic databases were searched for research published from 2013 to 2023. A total of 446 articles were identified and screened, with a total of 12 articles included. Studies and reports were included if they addressed the operational question and were conducted in an inpatient hospital within the United States.

Results: Case study reports describe improved labor productivity (ie. less overtime and less contracted labor), more consistently balanced staffing of frontline nursing professionals, less staff reassignment (ie, floating), and increased satisfaction and time savings for managers after transitioning to a centralized scheduling model. These findings were consistent with a computational, experimental study that found centralized scheduling resulted in less labor costs and fewer undesirable shifts from the frontline nurse's point of view compared to decentralized scheduling.

The COVID-19 pandemic introduced many new stressors to nurses in general, yet little is known about COVID-19-related stressors and resilience among nursing leaders. The aims of this study were to explore (1) the COVID-19-related stressor and resilience by personal and work demographics, (2) the relationship between COVID-19 stressors and resilience, and (3) resilience strategies used by leaders and their recommendations to other nurse leaders. This descriptive, cross-sectional study employed an electronic survey to measure COVID-19-related stressors and resilience and included qualitative open-ended questions. A total of 57 nurse leaders responded to the survey. Nurse leaders who were female, African American, chief nurse executive or nursing director, and had more than 10 years of experience reported highest COVID-19 stress in most of subscales. Nurse leaders who were male, African American, chief nurse executive or nursing director, and had more than 10 years of experience reported highest resilience scores. Nurse leaders with higher resilience levels had lower levels of COVID-19 stress in all subscales. Nurse leaders reported the top 3 resilience strategies as (1) prayer and faith, (2) social support, and (3) self-care and the top 3 recommendations to other nurse leaders as (1) disconnect, (2) positive and creative thinking, and (3) self-care.

A 341-bed Magnet® designated facility expanded its shared governance structure by incorporating a night shift council. The formation of this council allowed for more robust communication and collaboration between disciplines among night shift staff while increasing engagement scores. The council has established many initiatives to support night shift staff that can be adapted for use by other hospitals and health systems interested in expanding their shared governance structure.

Nursing is a profession with high rates of workplace injuries, hazards, and turnover. Improving the health and safety of nurses at work is vital to retain and grow the workforce to meet future demands. The purpose of this study was to describe the breadth of pain among American nurses and explore the relationships between this pain and modifiable work factors and perceived work performance. We used a cross-sectional descriptive design of 2312 nurses from across the United States. Nurses completed a survey containing questions about demographics, the presence of pain in the past week, the number of pain sites, pain locations, severity, and the impact on work performance. The median number of pain locations reported was 2, back pain was the most reported pain site, and average pain severity ranged from 4 to 5. Significant modifiable work factors associated with pain were average patient load and shift length. Many participants indicated that their pain impacted work performance, while a smaller proportion acknowledged that their pain impacted patient care. Pain among nurses spans multiple locations, is moderately severe, and impacts work performance. Addressing related modifiable work factors may decrease pain and the impact on the health, safety, and work performance of the nursing workforce.

Nurse retention remains a pivotal issue, necessitating urgent strategies aimed at the recruitment and retention of highly qualified nurses. However, there is limited knowledge regarding the influence of nurses' personal and professional values, along with work environment, on predicting intent to leave an organization. Utilizing a secondary analysis approach, this study employed logistic regression to predict intent to leave among registered nurses (n = 671) using results from the Short Schwartz's Value Survey, the Nurses Professional Values Scale-3, and the Practice Environment Scale of the Nursing Work Index. Regression analysis indicates that the work environment including "Participation in Hospital Affairs" (B = -.665, odds ratio = .514), "Nurse Manager Ability, Leadership, and Support" (B = -.448, odds ratio = .639), and "Staffing and Resource Adequacy" (B = -.589, odds ratio = .555) are significant predictors of nurses' intentions to leave. Establishing and maintaining supportive work environments is essential for retention, highlighting the importance of effective leadership.

Workplace violence (WPV) has become a crisis for health care workers, with a significant increase in violent events taking place in health care settings across the nation. Health care organizations should develop a comprehensive WPV program that includes recognition, management, and reporting of all types of WPV. A large health care system developed strategies and a program to address WPV. The health care system believes that a safe and respectful work environment is foundational to the goal of zero preventable harm. The "Safety in the Workplace" initiative was designed to raise awareness of concerning behaviors and to offer tools and resources for identifying, responding to, and reporting incidents of violence, aggression, or disruptive behaviors of WPV. During a 6-month pilot of a WPV bundle, there was a 44% reduction in physical violence reports and a 44% reduction in reported incidents of WPV. From June 2020 to June 2021, there was a 10% decrease in WPV overall.

The purpose of this article is to share the transformative vision of 2 nurse executives and how this vision paved the way for the development of a revolutionary model that changed care delivery. The CommonSpirit Health Virtually Integrated Care Team operationalized the vision by leveraging technology to develop a team-based care model that seamlessly integrates a virtual nurse as part of the care team. This article will discuss the spark that created the impetus for the creation of this metamorphic, interprofessional care delivery model and how this model unburdens the workload of the nurses to idealize the art and science of professional nursing practice.

Workforce shortages, increasing costs, decreased reimbursement, and focus on quality outcomes are crucial issues for health care leaders. To remain competitive, profitable, and productive, health care organizations need to provide structure, a safe working environment, and an acceptable leader workload to guarantee effective leader performance. Poorly designed work environments and interfaces can increase workload resulting in decreased performance and satisfaction. Excessive workload has led to reduced job satisfaction, productivity, and resilience. Due to leadership turnover and vacancy rates, leader workload was perceived to be unreasonable in the respiratory therapy (RT) department of an academic medical institution in central North Carolina. The aim of this quality initiative was to explore the workload of health care leaders in the RT department to identify the factors that influenced workload as well as implement strategies to decrease perceived workload. A workload assessment was performed, which identified inefficiencies and opportunities to partner with ancillary departments to align the workload with appropriate clinical teams. The redistribution of workload provided alignment, top of scope practice, and improved satisfaction among the RT department leaders. This article identifies the strategies utilized which can be translated to other institutions.

Objective: The purposes of this study were to determine whether positive work environments affect clinician wellbeing and mental health, and to identify participants' priority interventions to improve clinician wellbeing. This study was designed to determine the potential benefit of modifying the aforementioned factors for clinicians and hospitals to impact positive patient outcomes.

Background: The SARS-CoV-2 virus pandemic has become one of the leading causes of death in the United States and worldwide, and has exacerbated widespread burnout among health care professionals. This has resulted in negative collateral implications for the stability of the clinician workforce. A Clinician Wellbeing study (CWS) was launched in two Magnet®-designated hospitals in the southeast. The CWS was part of a multi-site collaborative research project led by the Center for Health Outcomes and Policy Research (CHOPR) at the University of Pennsylvania School of Nursing.

Method: A cross-sectional observational study design was implemented. Data were collected through anonymous surveys of 708 registered nurses (RNs) and advanced practice providers (APPs) working in two Magnet hospitals in the southeastern United States. Each participant completed 8 surveys.

Results: Clinicians' self-reported level of burnout was higher for both RNs and APPs at Emory University Hospital than Emory Saint Joseph's Hospital including intent to leave and dissatisfaction with their jobs. RNs and APPs self-reported their overall health to be good or excellent and they reported sleep quality as fair. Both groups in both hospitals indicated that they experienced anxiety, depression, and stress. The APPs reported a higher percent that their work did not leave enough time for personal and family life. Data also indicated that the primary work environment concern was related to inadequate nurse staffing.

Conclusions: The data illuminated opportunities for the two hospitals to employ continuous improvement interventions to positively transform the work environment.