Journal of Nursing Administration最新文献

To succeed in the face of recent challenges, healthcare organizations need highly trained, educated, and competent staff. Nursing professional development (NPD) practitioners and departments are a key component to achieving this goal. Little evidence exists on the most efficient and effective way to organize NPD departments in the hospital setting. This article describes 1 hospital's journey through centralization of an NPD department, which resulted in high satisfaction, cost savings, and enhanced quality outcomes.

Objective: This article presents the design, development, and implementation of a novel and innovative virtual reality (VR) simulation aimed at increasing nursing skills in identifying, managing, and deescalating workplace violence (WPV) incidents and mitigating the effects after critical incidents.

Background: The ANA reports that 1 in 4 nurses in the United States experience workplace assault annually, highlighting the novel role of VR simulations in educating and preparing nurses to recognize, address, and minimize the impact of WPV.

Methods: A multidisciplinary team designed and implemented a VR simulation based on real WPV incidents reported by nurses in an urban health system, enlisting a film and video company's expertise to bring scenarios to life, addressing a critical gap.

Conclusions: This article discusses the collaborative creation of simulations using VR as a novel strategy for educating nurses on identification, management, and deescalation of incidents of WPV and mitigating the effects of WPV after critical incidents.

Nurses are leaving the profession because of stress, burnout, and retirement. An integrative nursing fellowship pilot program was designed to enhance well-being, professional engagement, and development among new and experienced nurses. A hospital-based return-on-investment model is provided, and implications are discussed for nurse leaders to enhance retention using an integrative framework.

Objective: The aim of this study was to develop a consensus model of required preceptor competencies to inform preceptor selection, development, support, and assessment.

Background: The preceptor role is complex and multifaceted, requiring knowledge and skills beyond the typical RN role; however, no nationally developed standards for preceptor competencies exist.

Methods: A mixed-method approach (national survey of preceptors, electronic Delphi, expert panel) was used to develop consensus on required preceptor competencies.

Results: This study identified and validated definitions for the preceptor role domains (role model, teacher/coach, facilitator, protector, socialization agent, leader/influencer, and evaluator), essential attributes for preceptors, core competencies spanning all role domains, and competencies in each role domain-components that together form the preceptor competency model.

Conclusion: The evidence provided from this study delineates the complexity of the preceptor role and provides a consensus model of preceptor competence that can be used to select, develop, assess, evaluate, and support preceptors.

Objective: This scoping review describes findings from published literature, evaluates the association between hospital accreditation or certification and patient outcomes, and identifies gaps.

Background: Healthcare accreditation and certification organizations set standards and evaluate whether the standards are met. Despite the extensive efforts of both parties to improve healthcare delivery, poor patient health outcomes still exist in the United States.

Methods: A comprehensive search of published peer-reviewed literature in English, utilizing the databases OVID MEDLINE, EMBASE, and CINAHL, addressing hospital accreditation or certification and patient outcomes, was conducted.

Results: There was inconclusive evidence to support a relationship between hospital accreditation and outcomes in US hospitals, except for bariatric accreditation and stroke specialty certification studies for mortality and length of stay. The heterogeneous reporting of measures made it difficult to draw meaningful conclusions.

Conclusion: Understanding the extent to which accreditation is associated with patient outcomes is required. Future research is needed to establish scientific connections between hospital accreditations or certifications and patient outcomes.

Objective: Survey newly licensed nurses (NLNs) with respect to burnout, resilience, perception of the work environment, and intended short- and long-term job plans.

Background: NLN retention is a significant contributing factor to the nursing shortage.

Methods: A 126-item survey measuring demographics, burnout, resilience, work environment, and job plans distributed via email, using Listservs to recruit nurses licensed for 5 years or less.

Results: Participants (N = 547) reported moderate burnout, specifically emotional exhaustion, and resilience. Overall scores on perception of the work environment were positive. Multiple logistic regression suggests odds of 1-year intended job flight are positively associated with emotional exhaustion (odds ratio [OR], 1.77; P < 0.001), resilience (OR, 1.07; P = 0.003) and non-White racial identity (OR, 2.99; P < 0.001) and negatively associated with staffing and resource adequacy (OR, 0.63; P = 0.038).

Conclusions: Retaining NLNs requires mitigating burnout, addressing the experience of non-White NLNs in clinical practice, and improving support and resources for NLNs.

Nurses comprise the largest group of health professionals yet are underrepresented in health news media, depriving the public of important perspectives on health and healthcare and undermining the public's perceptions of nurses as experts. The George Washington University School of Nursing's Center for Health Policy and Media Engagement partnered with the American Organization for Nursing Leadership to invite a small group of chief nursing officers to participate in a workshop aimed at building an organization-specific strategy for sharing nurses' expertise with the public through media engagement. Participants completed a preworkshop survey, participated in two 4-hour workshops to explore the factors that contribute to nurses' invisibility as media sources, and developed a strategic plan for ensuring that their healthcare organizations are able to recognize and share their nurses' expertise with media. This article describes the initiative, its outcomes, and the implications for nurse leaders.

Objective: The aim of this study's phase 1 was to determine the current wellness levels of RNs in rural America settings, including barriers to maintain and recommendations for wellness.

Background: Nurses are experiencing more anxiety and burnout currently than prepandemic. A review of literature revealed a gap in describing nurses' wellness and strategies to maintain wellness in rural American healthcare settings.

Methods: The Integrative Health and Wellness Assessment (IHWA) V2 2022 holistically measured participants' wellness. The survey was deployed in 2023 to 6989 clinical nurses, nurse leaders, and advanced practice nurses.

Results: The IHWA V2 2022 mean was 134.72. Significant findings included age, years of experience, and role. Barriers of insufficient time, work environment, and family responsibilities were identified. Recommendations involved the work environment, stress management, and healthy boundaries with suggestions to implement in rural settings.

Conclusion: Study findings can assist leaders to implement interventions that positively impact nurse wellness in rural settings. Interventions promoting wellness are essential for nurses to meet these same needs of their patients.

Objective: The purpose of this cross-sectional descriptive study was to examine the relationship of professional governance, resilience, and empowerment among RNs in clinical practice in 1 healthcare system.

Background: Given the emotional and physical demands of nursing, especially in recent years, exploring ways that hope-inducing and resilience-building models can support professional practice is vital to the current and future nursing workforce.

Methods: An anonymous survey consisting of demographic questions, the Adult Hope Scale, Connor-Davidson Resilience Scale, and the Conditions for Work Effectiveness Questionnaire II was offered to 1450 RNs in a nonprofit community-based healthcare system for volunteer participation.

Results: Nurses who formally participated in professional governance nursing councils reported higher hope, resilience, and work effectiveness scores compared with nurses who did not participate in professional governance.

Conclusions: Based on these initial results, encouraging and creating avenues for the participation of RNs in professional governance are paramount to build a resilient, hopeful, and empowered workforce.

Person-centered coaching provided by clinical nurse specialists (CNSs) is an effective, acceptable, and feasible evidence-based intervention. Psychosocial distress experienced by older adults and their families during transitions of care can contribute to adverse events. CNS coaching demonstrated increased self-reported preparedness for healthcare transitions and knowledge-of-care options. CNS coaching promoted engagement and self-efficacy. Nurse administrators can incorporate this intervention in a variety of care settings to improve outcomes related to transitions of care.