Nursing Administration Quarterly最新文献

This study utilized a longitudinal quantitative design to investigate the psychometric measurements of the Carrington-Gephart Unintended Consequences of Electronic Health Record Questionnaire and the National Aeronautics and Space Administration Task Load Index instruments in emergency department nurses within the United States. This is the first study to our knowledge to examine these survey instruments' internal consistency reliability, test-retest reliability, and construct validity measurements in the emergency nursing population. The Carrington-Gephart Unintended Consequences of Electronic Health Record Questionnaire tool indicated good test-retest stability reliability and excellent internal consistency reliability. The National Aeronautics and Space Administration Task Load Index survey had moderate reliability for both the internal consistency reliability and the test-retest stability reliability. The findings related to the psychometric measurement of internal consistency reliability and test-retest stability reliability supported the use of the National Aeronautics and Space Administration Task Load Index and the Carrington-Gephart Unintended Consequences of Electronic Health Record Questionnaire in additional healthcare research studies of emergency department nurses. Further research related to nurses' cognitive load and unintended consequences of the electronic health record topics are recommended for knowledge acquisition to fill the profound literature gaps. Thus, this publication supports the use of measurement tools to conduct these studies.

Introduction: Nurses working in psychiatry, the Emergency Department, and pediatrics report the highest rate of assaults per 100 full-time equivalents (FTEs). In pediatrics, several unique factors contribute to workplace violence (WPV), including mistrust from the caregiver towards the health care clinician, complex or complicated medical circumstances, difficulty or delay in diagnosis, or the patient's behavioral and/or mental health.

Initiative: To address WPV, we implemented electronic aggression screening, weapons detection screening, and a personal duress system at a free-standing, academic pediatric hospital.

Outcomes: Aggression screening data show that the majority (>80%) of patients screened for low to medium-risk aggression. Weapons detection screening has resulted in a 62.82% decrease in weapons detected. The personal duress system improved security response times by 51%.

Discussion: Technological solutions can mitigate the risk of WPV, improve staff perception of safety culture, and lead to positive staffing changes.

Conclusion: These outcomes demonstrate the effectiveness of technological solutions to enhance workplace safety. However, these solutions are not a complete answer to WPV. The need for regulation and legislation protecting health care workers from WPV is urgent and pressing. Without such protection, health care workers will continue to be at risk of harm.

Commissioned by Health Education England, the country's organization for education and workforce development, the Phillips Ives Review on the Digital Future of Nursing highlighted the requisite priorities of person-centered care in digital health innovations and the required changes in nursing education to ensure competent practice in the digital age. Findings from this unpublished review, shared in the Health Service Journal and Nursing Times, bring attention to emerging care models such as virtual nursing and the critical importance of embedding person-centered nursing into the design and implementation of technology. Additionally, the importance of equipping nurses with skills in genomics, artificial intelligence, and data science was essential to delivering the benefits of these advancements. The review, along with other key policy initiatives including the International Council of Nursing (ICN) Position Statement on Digital Transformation illustrates increasing awareness amongst nurse leaders globally that these issues must be addressed. This article builds on the Phillips Ives Review, emphasizes new nurse-led innovations in various healthcare organizations, and examines key themes highlighted in these policy papers, namely person-centered care and the rise of virtual care. It further discusses implications for nurse education and clinical practice and examines how policies are emerging from professional nursing organizations including the American Nurses Association, the American Organization for Nursing Leadership, in addition to the ICN.

Due to demographic changes, the need for healthcare among older persons is expected to increase. Modern technologies, such as digital health applications and telecare solutions embedded into the care practice, offer potential solutions. Evidence on healthcare professionals' acceptance of digital technologies and their technological readiness is rather scarce. This study assesses the factors on technological readiness regarding a prototypical virtual healthcare assistant among nurses in Austria and Germany through an online survey (n = 289). Utilizing the extended Unified Theory of Technology Use and Acceptance model and structural equation modeling, the study shows that socioeconomic attributes influence views on technology beyond factors of technology acceptance. Technological affinity, skepticism, and views toward digitalization in healthcare are mainly relevant to explain certain attitudes toward virtual healthcare assistant solutions. The findings highlight the necessity to expand existing theoretical frameworks with social factors to better understand technological readiness in healthcare.

Registered nurses possess specialized knowledge and skills applicable to the ambulatory setting, including complex medication management. This enables clinicians and pharmacists to see patients who need their expert skill set; fully optimizing the role of each member of the team, including scope. This article details a nurse-led anticoagulation program demonstrating successful patient outcomes and cost-effectiveness. The program's success is attributed to the measurement of nurse-sensitive indicators along with a supportive organizational culture, efficient workflows incorporating team-based care, and expert registered nursing staff supported by a strong leadership team. This innovative model of care demonstrates the need for legislative reform to recognize nurses as able to independently bill for services within the scope of their licensure no matter the setting of the care provided (eg, telephone, face-to-face, video).

Mounting financial pressures continue to challenge health care institutions. Nurse executives with responsibility for efficient nursing resources must ensure the integrity of their staffing systems. Are your systems accurate? Are they connected with each other and the budget? Do all nurse managers have a strong grasp of the staffing systems? This article provides a guide for you to connect and improve staffing processes and tools. In this way, nurse executives ensure operational excellence and financial resilience.

This article addresses nursing leader-led innovative care disruption with implementation strategies to scale and spread the Age-Friendly Health Systems (AFHS) movement from acute and ambulatory settings into convenient care. Quality improvement and implementation science methods guided the translation of age-friendly 4Ms care, an evidence-based approach to safe, high-quality care for older adults: What Matters, Medication, Mentation, Mobility. Primary drivers included suggested standardization of workflow and creating a culture change about care of older adults in convenient care. Results included an increase in 4Ms care from 261 visits in Q4 of 2020 to 13,657 visits in Q4 2022, a 52-fold increase. This led to increased patient awareness of age-friendly care, identification of patients at risk for depression, dementia, inappropriate medications, and mobility issues, and integration of "What Matters" to the older adult in the plan. This article highlights the importance of age-friendly 4Ms care delivery in urgent care settings with innovative care disruption strategies to spread age-friendly care. Home care and community agencies can also adopt a scale up and spread approach to integrate the 4Ms into practice, reliably implement the 4Ms to improve safety and experience outcomes, become recognized as AFHS, and ensure translation of evidence-informed care into practice.

Nursing assistants (NAs) are essential health care team members; however, recruiting and retaining experienced individuals can sometimes be challenging. To address this issue, a Nursing Assistant Training Program was developed to provide on-the-job education and training for individuals with no health care background who wish to start a career in this field. The program includes didactic classroom education, mock simulated training and observation, and hands-on training in a patient care environment within an acute care hospital. This program aims to enhance NAs' recruitment, retention, and success rates by offering a comprehensive program tailored to meet various learner needs. It also aims to determine if incorporating this program will directly impact registered nurses' turnover and vacancy rates.