Nursing Administration Quarterly最新文献

Healthcare leadership requires adaptability, emotional intelligence, and the ability to lead through complex organizational challenges. Executive and team coaching have emerged as strategic tools that build these capacities by enhancing self-awareness, leadership effectiveness, and team performance. This column examines the role of coaching in healthcare leadership development through three evidence-based lenses: coaching outcomes, supporting neuroscience, and the impact on frontline nurse leaders. Drawing from recent peer-reviewed studies, it explores how coaching supports neuroplasticity, strengthens emotional regulation, and contributes to cultural transformation within healthcare systems. The findings emphasize that coaching is not a remedial tactic, but a critical investment in leadership excellence and organizational resilience. As healthcare systems continue to morph, integrating coaching into leadership development strategies offers a scalable, sustainable approach to cultivating adaptive and reflective leaders prepared to navigate complexity with confidence.

This study explored nurses' perspectives on the adoption and utilization of artificial intelligence (AI) in clinical practice within a large university-affiliated health system in the southeastern United States. Through a survey enriched by open-ended questions, we captured the unique concerns and suggestions of nursing professionals regarding the deployment of AI technologies in a range of clinical settings. The majority of nurses have limited exposure to and experience with generative and predictive AI tools. In addition, they have concerns about the availability of related training opportunities, AI process integration, and ethical implications of AI implementation. There are critical workforce development needs and substantial opportunities for enhanced training to incorporate both ethical considerations and technical skills. This research illuminates the perspective and experience of nurses using AI. Specifically, it provides insights into the nursing workforce's readiness to adopt and utilize AI in clinical practice. This research also informs the integration of AI-focused curriculum and professional development for nurses. Specifically, more structured training is needed for nurses to use AI responsibly. Nurse administrators should be aware of the hesitations and concerns of this large population, as nurses are ultimately the front-line end users.

Health care workers (HCWs) have shouldered the burdens during the COVID pandemic (eg, working longer hours with less community support) resulting in significant burnout, stress, anxiety, depression, direct trauma (eg, fear for own safety) and indirect trauma exposure (eg, working with trauma patients). As such, it is necessary to strengthen resilience and reduce the likelihood of burnout. This evaluation used utilization focused evaluation to understand the extent staff experience affective responses, mental health outcomes, and frequency of coping skills at this stage of the ongoing pandemic. Professional Quality of Life Scale-Health (ProQoL), Outcomes Questionnaire-30.2, and Brief COPE Scale to evaluate professional quality of life, moral distress, coping skills and mental health outcomes. Units' staff members (n = 30), comprised of nurses (80%) and nurse technicians (20%), with 1 to 25 years' experience, participated in the needs assessment (approximately 30.9% of units). Study findings revealed 59% would participate in external individual counseling services, 32% internal individual counseling, and 32% monthly support group. Moreover, 93% feel their work makes a difference and 71% report they are rarely unhappy at work. However, 96% say work sometimes exhausts them. One third of participants significantly struggle with mental health concerns reporting stress of 59% as moderate range and 32% severe range. Furthermore, 50% indicated various coping measures and 61% reported having someone to talk to about their struggles. Therapeutic services offered to nurses and medical professionals may improve staff psychological wellness, increase compassion satisfaction, and reduce burnout. Needs assessment yielded a need for coping strategies which are unique to intensive care and developed, led, and facilitated by staff, nurse champions, or small teams, with the goal to reduce "taking home" feelings of anxiety and for staff to "leave work at work."

This article examines how a large public health system in New York City leveraged transformational leadership and systems thinking to drive nursing excellence and meaningful recognition. The health system successfully transformed its nursing culture by developing operational plans, establishing specialized committees such as the Positive Practice Committee, and aligning with national accreditation standards like American Nurses Credentialing Center (ANCC) Pathway to Excellence®, the American Association of Critical Care Nurses Beacon, the Emergency Nurses Association Lantern, and Association of periOperative Registered Nurses (AORN) Excellence in Surgical Safety. Detailed planning, role delineation, and targeted leadership recruitment were critical in addressing organizational gaps and achieving multiple excellence designations across acute and post-acute facilities. This case study emphasizes the critical importance of systems thinking and transformational leadership in fostering a resilient and high-performing health care environment. By integrating these leadership principles, health care organizations can cultivate a culture of appreciation and continuous development, motivating nursing staff to excel in their roles. The initiative provides a replicable model that empowers nurses, not only by offering opportunities for growth but also through the recognition of their contributions, which drives both personal and organizational success in delivering outstanding patient care.

Workplace incivility can cause nurses to feel undervalued, which affects team dynamics and employee retention. While workplace incivility in nursing has been previously studied, the unique impact of COVID-19 on the nursing profession and current state of workplace incivility must be investigated. The objective of this study was to explore the incidence of incivility in the nursing workforce post-COVID-19 and to investigate the impact of leadership styles on the frequency of incivility. This study used a convergent mixed-method design. The Multifactor Leadership Questionnaire and Workplace Incivility Survey were administered to acute care nurses during hospital civility training. Transformational leadership was the most prevalent leadership style. Over 37% of surveyed nurses considered civility a moderate-to-severe problem in the workplace. Incivility was negatively correlated with transformational leadership and positive leadership outcomes. Strategies must be implemented to help facilitate a more civil workplace. Close monitoring of nurse leadership characteristics enables organizations to support and offer education/training to nurse leaders, thereby influencing the incidence of incivility.

As the healthcare landscape rapidly evolves, nurse leaders play a critical role in driving clinical practice transformation and fostering innovation. The increasing complexities of patient acuity, regulatory requirements, and workforce challenges necessitate leadership strategies that extend beyond traditional management to encompass systems thinking, advocacy, and organizational influence. This article examines the expanding role of nurse leaders in implementing and evaluating innovative models of care, such as virtual nursing and hospital-at-home programs. These models leverage technology and interdisciplinary collaboration to enhance care delivery and optimize operational efficiencies. Successful integration of these innovations requires strategic planning, resource allocation, and comprehensive evaluation frameworks that assess both quantitative and qualitative outcomes. Nurse leaders employ real-time analytics, performance dashboards, and shared governance structures to measure the impact of these models on patient outcomes, nurse engagement, and workflow efficiencies. Furthermore, engaging frontline nurses in continuous feedback loops ensures a well-rounded evaluation process that informs ongoing refinement. As the nursing profession adapts to emerging challenges and technological advancements, nurse leaders remain central to sustaining innovation. By fostering a culture of continuous improvement, they ensure that evolving care models align with patient needs, support workforce sustainability, and drive excellence in healthcare delivery.

In hospitals, the cost to replace 1 registered nurse (RN) can be quantified by considering costs in recruitment, hiring, and onboarding processes. Though the mean replacement cost of 1 RN will vary depending on geographic location and professional specialization, some have estimated this cost at $56 000. In addition to these direct costs, high turnover also contributes to broader organizational challenges, including disrupted communication, teamwork, and patient care. These challenges can contribute to adverse quality outcomes, such as increased inpatient falls. This article examines the organizational cost of RN turnover by analyzing its relationship to inpatient fall rates as an indicator of quality care.

For more than 45 years, the Tri-Council for Nursing (Tri-Council), representing nursing regulation, education, and practice, has advanced common policy goals and addressed shared concerns of its members-the American Association of Colleges of Nursing, American Nurses Association, American Organization for Nursing Leadership, National Council of State Boards of Nursing, and National League for Nursing. The Tri-Council's tradition of influencing public policy and decision makers continues at a crucial time in health care. The Tri-Council produces a legislative agenda annually to advance federal policies throughout the year and continues to emphasize workforce issues. In response to crises resulting from the Covid-19 pandemic, the Tri-Council convened a summit on December 3, 2020, to identify critical lessons and future opportunities for transforming nursing and health care. The Tri-Council committed to identify implications, opportunities, and actions for its member organizations, while engaging nurses, educators, policymakers, and health care experts in new ways to inspire focused action that delivers innovations in nursing practice, education, and regulation. The Tri-Council will continue to use its united voice to advance the nursing profession.

As the nursing shortage in the United States continues, many health care organizations are challenged with nurse retention for a myriad of reasons including the well-known academia-practice gap. One strategy that has proven successful to retain the next-generation of nurses is a Nurse Residency Program-a series of learning experiences and targeted support strategies throughout a nurse's first year of practice. Data from a national Nurse Residency Program reveal the significant impact nurse leaders play in successful transition of newly licensed nurses to practice. By understanding the challenges faced by newly licensed nurses and implementing effective strategies, nurse leaders can positively impact retention, mitigating the education-practice gap and promoting the delivery of safe and high-quality patient care.

As a prominent trend today, hospital consolidations/mergers impact nurses, their patients and communities. These evolving employer relationships also impact the nursing practice environment and the career trajectory of nurse leaders and staff. Nurse executives and their leadership team have essential roles in facilitating these changes and ensuring that the impact on nursing staff is given consideration and attention. Nurse leaders can also work to ensure that the promised benefits of these mergers are realized and are to the benefit of nurses and communities alike.