Journal of Nursing Administration最新文献

The need to swiftly recruit new graduate nurses by offering higher salaries has placed experienced bedside nurses at risk of salary compression, a narrowing pay gap that has the possibility of undermining morale, retention, and organizational stability. Fueled by pandemic-era market shifts, recruitment incentives, and stagnant salary adjustments for long-tenured nursing staff, the result has been a workforce imbalance that threatens the loss of experienced nurses, nursing morale, and impacts on the quality of care. This column examines the causes and consequences of pay compression among clinical nurses and offers strategies for nurse executives to restore fairness while maintaining recruitment momentum. Valuing experienced nurses through market-competitive salary adjustments is both a leadership and operational imperative and is essential to sustaining workforce stability, clinical excellence, and outstanding patient outcomes.

Objective: This study examines collaborative relationships among nurses as the pathway through which nurse manager (NM) leadership influences fall rates.

Background: Research demonstrates that NMs play a critical role in fostering healthy work environments through leadership that fosters mutual trust and respect. By cultivating strong collaborative relationships among nurses within their units, NMs promote a cohesive team dynamic that directly improves patient safety.

Methods: Data from the 2023 NDNQI database were used to examine collaborative registered nurse (RN) relationships as a mediator between NM leadership and patient fall rates.

Results: The mediation analysis demonstrated that collaborative RN relationships significantly mediated the relationship between NM leadership and patient fall rates.

Conclusions: This study underscores the critical role of NM leadership in cultivating a culture of collaborative RN relationships, which were shown to significantly reduce patient fall rates. Organizations should acknowledge the importance of NM leadership in shaping the culture and collaborative RN relationships within their units.

National campaigns have the power to alter the trajectory of nursing. Twenty-five years ago, Johnson & Johnson's Campaign for Nursing's Future reversed declining nursing school enrollments and strengthened public trust. Today's challenges demand another united effort. The new initiative, The National Campaign for Nursing, will change public perception through story-driven media, promote nurse well-being and safe work environments, strengthen professional identity and pride, build governance and financial infrastructure for sustainability, and measure impact and nursing's value. DAISY's global recognition offers authentic stories that, joined with evidence, will strengthen nursing's covenant and affirm compassion at the heart of a thriving profession.

Objective: The purpose of this study was to determine interrater and intra-rater reliability of the Violence Assessment Tool© (VAT©) for identifying patients at risk for aggressive/violent behavior in 4 patient care settings: acute care, emergency department, ambulatory care, and home care.

Background: There is a lack of evidence evaluating the psychometric properties of violence risk assessment tools used outside of the behavioral health setting.

Methods: This psychometric study, using standardized patient vignettes to assess the interrater and intra-rater reliability of the VAT©, was conducted at a large healthcare system in the Midwest and its affiliated simulation center.

Results: Intraclass correlations indicated good interrater reliability (0.75 or higher) for the overall VAT© score in each of the study settings and good intra-rater reliability looking at the VAT© score-based risk category.

Conclusions: Based on this study, the VAT© is a reliable instrument for assessing the risk for violent behavior of patients outside the behavioral health setting.

Objective: This study investigated the well-being of nurse leaders (NLs) and contributing factors that support or detract from their well-being.

Background: Nurse leaders (NL) navigate complex responsibilities that impact patient outcomes, staff retention, and organizational culture. Decreased well-being among NLs can diminish emotional health, which can impact role effectiveness and increase the risk of turnover.

Methods: A cross-sectional, mixed-methods study at a large pediatric academic hospital combined the Mayo Clinic Well-being Index (WBI) (n = 115) and qualitative interviews (n=35).

Results: Nurse leaders had significantly higher at-risk WBI scores than the national mean for "all nurses" (P = 0.003). Qualitative themes included individual resilience factors, leader factors, system factors, and the presence of an intentional alignment of a collective mindset. Barriers or gaps in these factors and mindset can diminish well-being.

Conclusions: Healthcare organizations need to improve resilience factors, incorporate trauma-informed practices, and normalize and enhance an authentic leadership culture to support wellness among NLs.

In this column, Dr Ena Williams, PhD, MBA, RN, CENP, FAAN, FADLN, Senior Vice President and Chief Nursing Executive at Yale New Haven Health and AONL President-Elect shares pivotal moments from her journey in nursing leadership. From a transformative conversation at a train station to her philosophy on innovation and self-care, Dr Williams offers a compelling look into the values and vision that shaped her as a nurse leader.

At the core of every Magnet® and Magnet with Distinction® designated organization is a team of nurses who work tirelessly to achieve and maintain Magnet status. More than a symbol of prestige, Magnet Recognition reflects a profound dedication to healthcare quality, with nurses playing a central role in driving and sustaining excellence.

The discharge suite, a designated area for patients awaiting discharge, helps alleviate hospital overcrowding by improving patient flow and reducing nurse burden. By implementing innovative strategies such as participatory feedback, personalized staff invitations, and discussing discharge plans at admission, a 194% increase in patient utilization was achieved. Beyond efficiency gains, the suite enhanced patient safety by enabling more thorough education and readiness assessments. This approach exemplifies a human-centered, value-driven model for optimizing discharge processes in resource-limited hospital settings.

Objective: This study examines care coordination (CC) in a level IV neonatal intensive care unit (NICU) to enhance social determinants of health (SDoH) screening and resource referral.

Background: SDoH influence health outcomes, especially for high-risk populations such as premature infants.

Methods: This retrospective descriptive study of infants enrolled in CC in 2022 assessed completion of SDoH screenings, resource referrals, and outcomes.

Results: Only 28% of SDoH screenings were completed within 24 hours of admission, but 96% were reassessed by CC. The most frequently offered resources were care advisors, family services, and financial assistance, with 81% to 91% connection to resources.

Conclusions: Longitudinal contact between CC staff and families is critical to understanding and supporting SDoH. This study underscores the importance of mindful and flexible SDoH screening early in the admission process. Reassessing SDoH through dedicated CC can effectively connect families to needed resources, improving engagement and health outcomes. In addition, providing follow-up care coordination support is critical to reducing barriers and fostering trust between families and healthcare systems.