Nursing Administration Quarterly最新文献

In the face of ever-evolving shifts in health care, the demand for advanced practice providers (APPs), including nurse practitioners and physician assistants, continues to grow as the nation faces provider shortages and increased patient complexity. Because of different educational backgrounds and previous professional experience, there is a gap in readiness for practice following completion of academic programs, leading to high rates of turnover and financial implications for health care institutions. The creation of APP fellowship programs is a strategy many health institutions implement to provide enhanced support for new graduate APPs. These programs offer fully licensed and credentialed nurse practitioners and physician assistants additional experience within medical specialty areas. The establishment and operational cost associated with an APP fellowship program is a significant barrier health systems face. This article discusses how Saint Luke's Health System developed an APP fellowship program to address these barriers. The model addresses specific fellow needs and has contributed to improved employee retention rates, increased clinical competency, and overall provider satisfaction within Saint Luke's Health System. The evolution of the model, successes, barriers, and opportunities for future program growth are discussed within this article.

Ensuring a smooth transition from education to practice for new nurses is essential in helping stem the flow of nurses out of the profession. However, traditional nurse residency education has only included didactic education sessions. In a novel new graduate emergency Nurse Residency Program, simulation-based education was ranked as the best part of the new graduate Nurse Residency Program. The result of incorporating simulation experiences was increased satisfaction by program participants and a decrease in turnover.

The System-transforming, Patient centered Longitudinal Interprofessional Community-based Education (SPLICE) Initiative was a Health Resources and Services Administration (HRSA) funded project designed to educate and train health professions learners in team-based primary care within a clinical environment. The SPLICE project team developed multiple learning activities including case studies and simulations that integrated the IPEC Core Competencies within clinical scenarios. The interprofessional aspects were also modeled by faculty facilitators from different professions. Each activity was thoroughly evaluated by the learners using mixed methods processes including data from retrospective pretest-posttest self-assessments, open-ended surveys, and focus groups. Faculty, staff, and learners invested countless hours of volunteer time due to the enthusiasm and passion for the work supported with HRSA funding to implement and evaluate the SPLICE initiative. Outcomes include the development of an enhanced primary care simulation template; the creation of 21 unique primary care simulations that integrated the IPEC competencies; improved confidence and competence in over 700 learners; over 110 faculty trained in simulation and debriefing skills; clinical skills training for Federally Qualified Health Center (FQHC) staff; improved quality improvement processes at a local FQHC; and a high rate of retention of the graduates in primary care. This project demonstrated a significant return on the investment beyond the initial HRSA funding.

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.