Nursing Administration Quarterly最新文献

There are approximately 90 000 lesbian, gay, bisexual, and transgender (LGBT) individuals in Orange County, California. LGBT individuals have significant health disparities, particularly if they are from racial or ethnic minority groups and/or have a disability. There are structural and access barriers in the health care system that increase these health disparities. These individuals experience discriminatory situations when accessing health care and mental health services, which may affect their health-seeking behaviors. The purpose of this pilot quantitative cross-sectional study was to gather information about the current health care experiences and needs of this LGBT population including priority health issues, physical and mental health care utilization, and perceived adequacy of LGBT-friendly physical and mental health care providers. These findings will inform organizational strategies for nursing administrators and other health care leaders when tailoring, planning, and redesigning structures that meaningfully address the service needs of this at-risk group. Seventy-five participants were recruited from 2 organizations serving the LGBT community to complete an online survey. Findings include trouble finding an LGBT competent provider, delays or being unable to access care, and worried about losing insurance. Most participants needed to visit multiple different locations to receive care and preferred a 1-stop shop.

Cedars-Sinai is a sixth continuous Magnet organization in Southern California that embodies inclusive leadership in support of diversity, equity, inclusion, and justice (DEIJ) principles. The organization adheres to a strategic model prioritizing staff sense of belonging, empowerment, engagement, curiosity, and creativity. Employing inclusive leadership, we have implemented strong programs of professional development and continuous learning, innovation, and research. This leadership and these programs have fostered a culture of inquiry, support evidence-driven practice, quality improvement, and staff engagement. Our organization is committed to creating a caring and healing environment that promotes performance. We believe in practicing loving-kindness toward ourselves and others as a core value. Executive leadership support has been a key element in our successful implementation of DEIJ strategies, including employee resource groups, Shared Leadership Councils, transition to practice programs, health equity research, and innovative solutions. These strategies have been shown to yield a significant return on investment.

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.

Frontline nurses are exiting the workforce, fueling a crisis in health care. Years of chronic staffing shortages, trauma experienced during the COVID-19 pandemic, and faculty shortages resulting in lessened ability to produce new nurses are complicating the ability of hospitals and health systems to provide high-quality care at a time when hundreds of thousands of nurses are predicted to leave the profession. A solution to this problem, which may produce internal "churn," can also create the opportunity for an internal pipeline of transition to specialty practice-recovering nurses who otherwise might be lost. An influx of experienced nurses to the perioperative setting from medical/surgical, telemetry, emergency departments, and intensive care units provides a unique opportunity to fill critical vacancies for a department that traditionally hires less experienced nurses and has expected vacancies due to nurses of retirement age leaving. Key components of a transition to practice arising from the desire to leave stressful, traumatic bedside roles and seek "safer" and perceived less stressful clinical positions involve assessing and promoting resilience and demonstrating self-efficacy. Creating the right environment and offering an evidence-based training opportunity for experienced nurses in a specialty transition to practice can leverage years of experience and skill, support new skill acquisition, stem outward migration of nurses, and potentially salvage the careers of nurses who have contributed to the profession.

A proposed nursing faculty workforce development project by a college of nursing within a research-intensive institution will increase the number of nurse faculty from the current population of BSN-prepared nurses from underserved communities in a state to earn a master of science in nursing (MSN) degree with a nursing education specialty. This project will be accomplished through partnerships between a college of nursing and academic institutions with large nursing student populations from underserved communities. In addition, the project will incorporate the employment of MSN students at academic partner institutions within a clinical nurse faculty role. The proposed project will continue after an initial federally funded grant to continue the project and address the nurse faculty shortage from diverse populations and advance health equity and culturally congruent health care in the state. The project will also enhance partnership building with stakeholders, such as statewide academic institutions, to impact underserved communities.

A 50% estimated increase in new cancer cases over the next few decades will significantly challenge health care systems already strained by a shortage of oncology providers. Radiation oncology (RO), 1 of 3 three primary pillars of oncology care, treats half of all new cancer cases. Workforce shortages, reimbursement changes, delays in patient treatment, and the lack of follow-up care all continue to increase pressure on RO centers to boost efficiency, improve patient and staff retention, and strive for service satisfaction. Nurse practitioners (NPs) can bring greater capacity, expertise, and profitability to RO, especially in light of the fact that demand is predicted to outstrip supply by as much as 10 times. It is critical, however, that NPs receive specialized training in RO's clinical, technological, and operational processes before assuming patient-facing roles.

This column is a call to action for health care leaders to ensure that their governing boards make workforce an important part of their governance responsibility and oversight. Health care leaders need to take an active role in educating their governing board, identifying and monitoring appropriate workforce metrics, and engaging the board in developing and implementing a workforce plan. Workforce development is an important leadership competency and essential to today's health care organizations success.

The purpose of this mini review is to (1) summarize the findings on the impact of night shift on nurses' health and wellness, patient and public safety, and implications on organizational costs and (2) provide strategies to promote night shift nurses' health and improve organizational costs. The night shift, compared with day shift, results in poorer physical and mental health through its adverse effects on sleep, circadian rhythms, and dietary and beverage consumption, along with impaired cognitive function that increases nurse errors. Nurse administrators and health care organizations have opportunities to improve nurse and patient safety on night shifts. Low-, moderate-, and higher-cost measures that promote night nurses' health and well-being can help mitigate these negative outcomes. The provided individual and organizational recommendations and innovations support night shift nurses' health, patient and public safety, and organizational success.

Nurse leaders need to continue to think innovatively and help improve the bottom line at their organizations and at the same time be concerned with nurse retention. Virtual nursing is one such approach that will help achieve both results. Nurse leaders must also know how to bring forth a return on investment in order to receive the funding to try innovative approaches to staffing.