Nursing Administration Quarterly最新文献

Merger and acquisition activities in health care are increasing in both the number and cumulative value of transactions in recent years, creating new and dynamic pressures on health care systems and current operating environments. These industry shifts, coupled with crises such as the COVID-19 global pandemic, create opportunities for innovation to increase capacity, improve productivity, achieve economies of scale, and positively impact health care quality, safety, access, and cost. However, neither consolidation nor innovation in and of themselves will yield sustainable clinical best practices nor achieve the desired quality, financial, efficiency, retention, or engagement outcomes. This article describes the approach used by one system-level Doctor of Nursing Practice prepared nurse executive to leverage evidence-based decision-making to guide, lead, and support the innovation needed to address first-year new graduate nurse turnover in a multistate not-for-profit health care system.

Inequities between nursing workforce supply and demand continue to challenge nurse executives in creating the vision for a postpandemic nursing workforce. Health system's workforce redesign strategies must prioritize the changing needs of the multigenerational workforce to maximize the available supply of nurses willing to remain in the workforce. A test of a newly designed flexible workforce framework, aimed to meet the needs of the multigenerational workforce, resulted in increased fill rates and decreased costs of labor.

Nursing professional practice models (PPMs) are known to have beneficial effects on nurse and patient outcomes. Determining what components should be present in a PPM, how to implement a PPM, and evaluating the outcomes associated with a PPM is less certain. Therefore, as part of a larger project to develop a nursing PPM for use within the United States Military Health System, this study aimed to conduct a systematic literature review on nursing PPMs. Specifically, the review sought to investigate components, implementation, and outcomes of PPMs in current literature. A total of 37 articles were included in the review. The literature supported the development of 12 recommendations for creating, implementing, and evaluating a nursing PPM. As health care facilities develop their own PPMs or reassess their current PPMs, findings from this review may assist hospital leadership by providing the most recent evidence on the strategic value of nursing PPMs in contemporary health care.

The COVID-19 pandemic impacted nursing education and health care systems alike. Increases in staff absenteeism along with increased hospitalizations have strained health systems across the globe. Postsecondary institutions (PSIs) were required to remove students from clinical placements, thus delaying nursing students' ability to complete their programs, and in turn, contributing to the nursing workforce challenges. Health care organizations and PSIs had to collaborate innovatively to support the health care response to the pandemic while continuing to educate and graduate students to expand the nursing workforce. In Alberta, the collaboration between the health system and PSIs led to the creation of an undergraduate nursing employee/student hybrid (UNE/Hybrid) role. This role was not only a response to the nursing workforce challenges created by the pandemic, but it provided nursing students with positive learning clinical placements ensuring that they completed their program in a timely manner. This role was designed to assist with the fourth wave of the pandemic (omicron variant), which was expected to be the most severe wave in terms of hospitalizations and increased staff absences. The UNE/Hybrid role allowed nursing students to complete the required learning for their final preceptorships and/or complete leadership placements in a paid role while being integrated into the unit culture and becoming part of the team. The initiative's results, including its successes, challenges, and lessons, are discussed.

Trust is foundational for all interpersonal communication and activities in an increasingly networked and interdependent world. Trust is also essential to the effective delivery of health care and for building collegial environments rich in innovation and readily adaptable to change. As the world's most trusted profession and vested peer collaborators across interprofessional health care teams, nurses are uniquely qualified to shepherd change and foster an innovation mindset across organizations and systems. Innovation requires creative teams that are appropriately resourced and supported, and team-based innovation requires time, space, and safety for groups to realize their full potential and maximize contributions. Appropriate staffing, resourcing, internal engagement, and external partnerships are essential to successfully conceive, launch, sustain, and deliver change initiatives that successfully challenge the status quo. Diverse teams are vital to enhancing the performance, effectiveness, and delivery of change and innovation. Effective change management and innovation practices require courage and imagination, skills that nurses have long possessed. Nurses are uniquely equipped to champion human-centered design through all phases of innovation while bringing knowledge of patients and communities to bear in ways that deliver innovation, are respectful of challenges, and mindful of opportunities to strengthen individuals and communities.

This article discusses the role of and need for nursing leadership in ambulatory care spaces. Challenges within health care and increasing complexity of patients exist, regardless of whether a nurse leader works in a traditional hospital setting or outside of that setting. Regardless of setting, nurse leaders want the same things for their patients and staff. The required skill set and characteristics for nurse leaders are the same, just used in a different venue. Traditional hospital nurse leaders must collaborate with nurse leaders in ambulatory to ensure each patient navigates through the continuum with as little disruption as possible. Nurse leaders in ambulatory can offer hospital leaders a fresh perspective on leadership, highlighting the value they bring to the table and how transferrable their skill set is to this setting, given the same support for success that is fundamental in the hospital setting. Strong nurse leadership is critical for driving innovation and inspiring transformative change in ambulatory settings.

Our city was significantly impacted by the initial COVID-19 outbreak in the United States. We describe how members of our Quality and Safety team were able to leverage skills in relational coordination and process improvement to respond to rapidly changing needs in a flexible and effective way.