Nursing Administration Quarterly最新文献

Repercussions from the COVID pandemic and a depleted nursing workforce demand more robust support to assure successful new graduate nurse transitions. Clinical learning in the real-world patient care setting is widely regarded as the essential element for preparation to practice. An academic-practice partnership established an apprenticeship program offering student nurse's greater exposure to real-world clinical experience to evaluate the value of a student nurse apprenticeship on new graduate nurse readiness for practice. Students complete 180 apprenticeship hours over 3 semesters. Satisfaction with the apprenticeship program was expressed by 100% of leaders/mentors and 93% of students. Most students also expressed an interest in a wider variety of clinical settings. This apprenticeship program is a demonstration of academic and practice partners leveraging their combined resources to invest in nursing student preparation to accelerate readiness to practice. An apprenticeship program offered in partnership with academia and practice can support the nursing workforce and may decrease the time required to prepare novice nurses for independent practice.

The purpose of this three-part, mixed-methods study is to mitigate patient risk by understanding and describing the current and future state of pediatric telehealth (TH) care delivery. As the COVID-19 pandemic emerged, an unprepared clinical workforce mobilized to quickly transition patients to TH to mitigate the risk of infection and maintain access to care. Optimizing digital health care delivery requires an understanding of the current models of care, the identification of best practices, and opportunities for improvement to mitigate patient/family, provider, and institutional risk. Aim 1 used descriptive, qualitative inquiry to understand and explore the experience of cardiology providers utilizing TH through structured interviews. From the 6 providers interviews conducted, 6 themes emerged: the experience of TH Care Delivery, Conflicting Expectations of Parents/Patients vs. Providers, Regulatory, Ethical, and Legal Concerns, Knowledge Gaps, Data Burden, and Moral Distress. Hearing providers' voices and experiences can guide the integration of TH and digital technologies into health care. These findings describe the need to develop evidence describing the significance and inter-relatedness of TH and the concepts of psychological safety, the healthy work environment, and thriving.

Virtual nursing has swept the country as an acute care model solution amidst unresolved clinical workforce shortages, shrinking margins, increased acuity, and capacity pressures. Nurse leaders and professional associations cite the value of virtual nursing; however, model adoption appears lower than projected need and perceived impact. Virtual nurse models vary and the prevalence of model pilots versus full scale implementation should be noted, along with opinions regarding short term versus permanent utility. Questions surrounding virtual nurse roles, standards of practice, competencies, certification, and regulation are escalating and warrant careful discussion. Decisions are needed to move beyond the organizational and professional crossroads we face with virtual nursing.

In the post-pandemic era, nursing workforce constraints continue to foster concerns for the future of health care among nurse leaders worldwide. Causal factors attributing to disparity between workforce supply and demand are well documented in literature while operational outcomes from comprehensive solutions are scarce. Nurse leaders seeking to meet the operational demands of a constrained workforce must embrace innovative care delivery models aimed to meet the generational needs of the workforce. Operational outcomes measured in fiscal year 2023, defined as July 1, 2022-June 30, 2023, include: a total savings of 30 million dollars in premium labor spend, an increase in the organization's fill rate to 86%, a 62% reduction in agency spend, 8% reduction in turnover, including a 9% reduction in first-year turnover, a 4% reduction in vacancy rate, and 20% less time spent on staffing and scheduling tasks.

Nurse leaders are obligated to ensure that nurses are prepared to engage in the provision of safe high-quality nursing care by creating a learning environment where their clinical knowledge and critical reasoning can be safely developed and refined. Simulated educational experiences can accelerate learning and provide nurse's the ability to confidently and competently deliver clinical care in a highly efficient manner.

Tabletop simulation can be used to support and test system processes for clinical workflows. This paper will describe an innovative approach to testing change in clinical workflows for direct admissions to the operating room and interventional radiology departments in a 700-bed urban hospital in the Pacific Northwest and will highlight the specific benefits to nurse leaders. The simulation exercise involved key stakeholders and subject matter experts from various departments and aimed to evaluate the process workflow, provoke discussion on gaps, uncover improvement opportunities, and formulate recommendations. The simulation experience was broadly acknowledged by those involved as novel, engaging, suitable for complex process changes in health care settings and promoting valuable collaboration.

This systematic review aims to evaluate the effectiveness of simulation in enhancing the knowledge and skills required for preventing, managing, and treating pressure injuries (PIs) among nursing students. A systematic review of English articles published between January 1, 2014, and March 31, 2024, was conducted to determine the effectiveness of simulation in PI education. PubMed, Cochrane Library, Medline (OVID), Scopus, Web of Science, CINAHL, and Science Direct databases were searched using the keywords "simulation", "pressure ulcer", "pressure injury", "nursing", and "nursing education". The study data were analyzed using the content analysis method. Of the 101 articles retrieved from the databases, 5 met the eligibility criteria. The study found that simulation in PI prevention and management education increased students' knowledge and skill levels, enhanced their satisfaction and communication skills, and was more effective than traditional didactic education. This systematic review supports the use of simulation as an educational tool for nursing students in preventing, implementing protective interventions, and managing PI. Furthermore, it encourages further research to explore the role and effectiveness of different formats of simulation, particularly high-fidelity simulation, in PI management education and their impact on student achievement and clinical practice.

Delivering simulation across a health system can engage the entire workforce by moving beyond traditional educational delivery and focusing on broader organizational needs specific to a particular organization. The commonly known use of simulation as a form of life support education has progressed to include fully immersive simulation experiences focusing on team-based communication, leadership, fellowship, and clinical care. It continues beyond this point with the inclusion of patient safety strategies, root cause analysis investigation, leadership, and management training, and recently, it has included environments that catalyze innovation in complex healthcare systems. The focus on pure fiscal elements of simulation-based approaches does not give a health system the accurate nontangible benefits simulation can provide, and importantly, acknowledging that each location has differing needs is essential when considering what investment should be made and where. A small community hospital will have vastly different needs from specialty hospitals that deliver specialist care. It must also be understood that every simulation center, to some extent, will always be unique, as it should. The commonly quoted statement "when you have seen one simulation center, you have seen one simulation center" really does reflect the reality of this established and rapidly growing specialty. In this article, we reflect on the traditional use of simulation and discuss some wider uses that may engage a wider audience and, importantly, provide a greater return on investment for your facility, making the case for investment more reasonable and impactful to each part of a busy health system.