Nursing Administration Quarterly最新文献

Ambiguity and confusion persist around the goal and purpose of clinical experiences in nursing education. As a result of this ambiguity and confusion, the potential exists to waste valuable clinical time, to create ineffective learning objectives, to focus on the tasks of nursing rather than the competencies required for nursing practice, and to perpetuate a mismatch of in-person clinical experiences with simulation decreasing the ability to achieve clinical practice readiness. Nurse leaders across academia, regulation and accreditation agencies, and practice settings must establish consensus about the purpose and goals of clinical education in order to align learning outcomes and expectations of clinical practice readiness. This article synthesizes Dr Patricia Benner's vast body of writings to create a universal "North Star" to align and guide all nurse educators and clinical education on appropriate learning outcomes, andragogies, and expectations for nursing students and new graduates to support clinical practice readiness and the formation of nurses' skilled know-how, notions of good practice, clinical reasoning and more that are required for excellent nursing practice. Leaders in academia, regulation, accreditation, and practice should adopt the goals delineated in this "North Star" as being the end-points of practice formation, create learning experiences to support practice formation from novice to expert, and create meaningful evaluation strategies that go beyond traditional psychometric testing. When academia, regulation, accreditation, and practice all adopt these goals of clinical education, we contend that there will be congruence and more seamless transitions across the academic-regulation-accreditation-practice spectrum.

The post-pandemic healthcare landscape significantly impacted the professional nursing workforce by exacerbating existing challenges, including the academic-practice gap of new nurse graduates. Transition to practice (TTP) programs have been proven effective in supporting newly licensed registered nurses as they move into practice. A well-designed TTP program empowers new nurses to become resilient and competent, enhancing patient care and contributing to a healthier work environment. While these programs have been instituted throughout the country, most are in acute care settings, primarily in urban areas. The authors present a model for creating a transition to practice program designed to address the unique challenges faced in rural areas. The step-by-step process the Arizona Hospital and Healthcare Association (AzHHA) used to set up a statewide transition to practice program geared towards small and rural facilities and those serving the underserved is presented. The critical partnership with OpusVi, who was contracted for a customized curriculum to address the unique needs of hospitals, such as critical access and behavioral health is outlined. Finally, concrete actions that can be taken and a roadmap for program assessment are offered.

Four stjpg CNOs can use to educate teams, to support organization(s), by ensuring financial strength, structures, and processes so we can continue to sustain, increase services, and provide access to care for those in need.

Nursing leaders are considering new models of patient care delivery to combat the continuing workforce challenges and an increase in patient acuity. The nurse manager is essential in the successful implementation of a new care model; however, little is known about their experience leading their team through such a significant change. A large health system in the mountain west successfully implemented a new team-based patient care model, called Partners in Care, on 11 medical-surgical units. The model's intention was to build effective teams and improve workforce outcomes through registered nurses (RNs) and unlicensed assistive personnel (UAP) functioning as partners in care delivery. The goal of the model was to ensure RNs were surrounded with the necessary support to empower top-of-scope practice. As a part of the project, 3 of the first nurse managers that implemented the new care model completed a question-guided reflection exercise of their journey. Through their reflections important aspects of resources, professional governance, communication, monitoring/adjusting/sustaining, celebration, and leadership support were highlighted. Recommendations for those beginning their journey include consideration of nurse manager workload and competencies, taking a phased approach, and including important partnerships.

Emotionally intelligent leaders make conscious efforts to evaluate employee satisfaction, retention, engagement, conflict resolution, quality patient care, and overall facility performance. Variances among generations like communication styles, technology preferences, promotability attitudes, and work ethic can affect day-to-day team behaviors. Highlighting the importance of daily interactions, the purpose and aim of this project are to determine whether the implementation of emotional intelligence (EQ) training will improve communication in a multigenerational workforce. EQ Appraisal training was implemented for a multigenerational staff in a long-term care setting to form a cohesive working team. Project results showed a 15% decrease in staff turnover and increased Patient Satisfaction from 2 to 4 stars over a 3-month period. Facilities committed to incorporating EQ Appraisal Programs as the foundation of a multigenerational work team will promote a safe and more manageable workplace. Nurse leaders of all setting types and structures willing to do so can empower nurses globally. Practice implications include a heightened awareness within multigenerational teams and an improved ability to recognize social cues. Increased job satisfaction, lower staff turnover, an enhanced skillset in conflict resolution, and a mutual employee-employer relationship, inclusive of patient engagement and trust, can only coincide.

A global nursing shortage necessitates innovative care models to mitigate burnout, turnover, and supply-demand mismatches. This mixed-methods pilot study assessed the impact of a technology-integrated nursing care model on workload and patient outcomes in a surgical-orthopedic unit. Following IRB approval and training, the integrated care model was piloted for 6 months. The model included integration of virtual nurses, LPNs, and delivery robots. Workload perception, quality and safety, and nurse satisfaction were monitored using a time-series design. Data analysis employed correlated t-tests, comparison of means over time, and statistical process control charts (Shewhart charts). The integrated care model yielded mixed results. Hospital Acquired Conditions remained stable, while average length of stay and falls decreased. The robots have made 615 deliveries and saved staff 377 640 stjpg and 415.8 hours. After an initial low utilization, virtual nurses completed 82% admissions and discharges by the end of the pilot. However, RNs reported increased workload, staffing concerns, and teamwork challenges. This integrated care model shows promise, but further research is needed to fully assess its impact. The findings underscore the importance of continued exploration and refinement of novel approaches to address the challenges facing the nursing profession.

The purpose of this publication is to inform others who can learn and benefit from the process used to leverage state legislation to address the nursing workforce shortage in the state of Arizona. As we emerged from a global pandemic, the nurse leaders in the state of Arizona leveraged relationships and legislation to advance policy. The authors discuss how multisectoral collaboration and organizational alignment secured significant funding to support the Arizona Nurse Education Investment Program.

The creation and sustainability of a Diversity, Equity, and Inclusion (DEI) Director of Nursing Practice is crucial in the pursuit of health equity and in creating inclusive environments that foster racially and ethnically diverse nursing workforce and ensuring culturally competent patient care. As institutions seek to achieve health equity, we have seen an increase in the rise of DEI practitioners in academic settings, although that has not been the same among DEI practitioners in nursing practice. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity Report (NAM, 2021) emphasizes the importance of recognizing diversity and calls for a new generation of nurse leaders who can champion this cause. To address the impetus for greater diversity, DEI practitioners must adopt a broader and more collaborative approach beyond mere diversity metrics. While problem-solving remains a significant aspect of the DEI practitioner role, it encompasses much more. Strategic leadership is essential in institutional strategic planning, diversity programming, education and awareness, new nurse graduate support, and developing community partnerships.