Nursing Administration Quarterly最新文献

Nurses are uniquely positioned to significantly impact organizational and system improvement through improving quality and reducing costs. Using an evidenced based tool to identify costs and the financial benefit involved in any quality improvement project is invaluable in developing and evaluating proposals and allocation of resources to support the organization's financial health and viability. The return on investment analysis is an essential accounting tool that will provide nurse leaders with critical information quantifying costs and benefits of both financial and nonfinancial metrics to identify the feasibility, efficacy, risk or efficiency of a proposed project.

Nurse leaders have an important opportunity to develop and support nurses' participation in public policy and advocacy. Many issues today are healthcare related and would benefit from a nurse's perspective. There are many opportunities for nurses to engage in policy but voting is the most basic and important action we can take.

The United States health care system is facing an unprecedented nursing shortage, increasing complexity of care, and fewer experienced nurse mentors. These factors contribute to a cycle of burnout, turnover, decreased quality and safety, and a worsening financial bottom line. Improving these contributing factors depends on our ability to mitigate the structural causes of burnout and turnover. The clinical nurse specialist role is essential to improving the work environment, advancing evidence-based nursing practice, reducing turnover, and stabilizing the bottom line.

Nursing has always been a cost for the institutions within which nurses work. This fact has influenced almost everything that affects how nurses are utilized and valued. As a cost, nurses are closely managed on the margin, always constrained by the resource machinations of organizations and systems with little determination or enumeration of the contributions nurses make to the service and financial value represented by algorithms and metrics that enumerate and demonstrate nurse's impact and contribution to service and financial value. This article further pushes the boundaries of this circumstance, challenging nurse and health leaders to reconceptualize nursing contribution and recalibrate the determination and calculation of nursing value as a sustainable baseline for nursing leadership for the future.

This paper introduces the concept of leadership communities of practice (COP) as a strategy to enhance succession planning and leadership development within the Canadian healthcare context. Drawing upon Prosci's ADKAR methodology as a foundational change management framework, this paper explores the adaptation of COP, originally developed by Lave and Wenger in 1991, to foster collaborative learning. While COP have a long history in business and education sectors, their formal integration into healthcare, specifically leadership development is relatively recent. This paper highlights the necessity of a robust change management approach to effectively introduce COP as a mechanism to enhance leadership development in healthcare settings, highlighting their potential to facilitate knowledge exchange and support social learning among healthcare leaders.

Nursing research provides knowledge that advances nursing science, practice, and health care with the vision to optimize the health and well-being of the population. In a medical center setting or health care organization, nurse scientists are needed to demonstrate new knowledge, innovation, and scholarship. Nursing research in health care organizations or medical centers are led mainly by nurse leaders with a Doctorate in Philosophy (PhD) or a Doctorate in Nursing Practice (DNP). The purpose of this report is to provide examples of the role nurse scientists and nursing research plays nationally in Kaiser Permanente, an integrated health care system. In addition, this report will: (1) define the term "research" in the clinical setting and the role of the nurse research scientist in an integrated health care system and impact on the Magnet® Designation journey, and (2) discuss strategies for a successful role as a nurse research scientist in an integrated healthcare system.

Patient falls within the hospital setting continue to be a significant challenge globally with almost one million hospital falls occurring in the U.S. annually. Recent calculations showed that the average total cost of a hospitalized patient fall was $62,521. One evidenced-based tool that has been shown to be effective is a colorful laminated poster, Fall TIPS poster, that was designed to engage and involve the patient in their fall prevention. One academic medical center utilized this implementation showing a successful return on investment (ROI). This project used a pre-post implementation design. After a successful pilot using the poster on one unit, the implementation was spread to all Adult Acute Care units (n = 10) within the institution. The outcome measures were fall and fall with injury counts and rates. The process measure was the completion of the fall prevention poster measured via audits. The calculation of ROI was completed using a four-step framework. The outcome data of fall and fall with injury showed a decrease from the pre-intervention months with both the fall count and rate decreasing by 23% and the fall with injury count and rate decreasing by 40%. The overall ROI calculation estimated an ROI of $982,700. The successful results from this project support the evidence that shows this program and the use of the Fall TIPS poster helps reduce patient falls within the hospital and yields a favorable ROI.

Health care leaders need to measure their workforce and operational performance in a more comprehensive manner to fully understand the interplay of the many variables that influence performance and the employee experience in health systems. Nurse leaders have an opportunity to leverage that understanding to provide the clinical workforce with a measurably improved workplace.

Health care is a complex and ever-changing environment for nurse leaders and other health care industry decision-makers. The prevailing leadership and decision-making models, rooted in Industrial Age principles, often struggle to adapt to the complexities of modern health care. This article explores the foundations of complexity science and its application to health care decision-making, highlighting the importance of understanding systems dynamics and embracing complexity. Drawing from systems knowledge, the Cynefin Sensemaking Framework, and understanding how to develop enabling constraints, nurse leaders can navigate the complexities of health care by identifying the nature of the problem and applying appropriate decision-making strategies, fostering agility and innovation. By embracing complexity and adopting adaptive leadership approaches, nurse leaders can pragmatically navigate the complexities of modern health care and drive transformative change. This manuscript provides methods for nurse leaders to enhance decision-making within the dynamic landscape of health care as a complex adaptive system.