Journal of Nursing Administration最新文献

In this article, Dr K. David Bailey, PhD, MBA, RN, CCRN, NEA-BC, FACHE, FAONL, FAAN, chief nursing officer, UCLA Health Santa Monica Medical Center, shares 5 foundational elements of effective nurse leadership. Drawing from personal experience and professional insights, he highlights strategies for fostering innovation, advancing professional development, and preparing for the evolving challenges of healthcare.

Objective: The aim of this study was to implement a bystander training program for nurses to mitigate lateral violence.

Background: Lateral violence is bullying and harassment between coworkers with equivalent status and positively associated with turnover, distress, suicide, and reduced satisfaction.

Methods: Evidence-based practice change feasibility pilot study was conducted. Program outcomes were evaluated by postcourse RN knowledge, confidence to intervene, course satisfaction, and intention to leave.

Results: Confidence to intervene significantly improved (mean: pre = 4.09, post = 4.69; P < 0.001). Most nurses (90.8%) reported very to extremely satisfied. Future likelihood to attend (83.7%) and recommend (87.8%) were high. Most nurses (69.4%) (n = 68) reported that using the skills learned would strengthen intent to stay. Most nurses (80.6%) (n = 79) indicated that departmental skill application would strengthen intention to stay. Knowledge scores post intervention reflected a 99% pass rate.

Conclusions: Bystander training benefits nurses indicating the feasibility of broader program implementation to prevent and mitigate nurse lateral violence.

In the evolving landscape of healthcare, nurse managers are expected to lead across systems, influence patient outcomes, and drive strategic priorities, far beyond the traditional scope of direct supervision. Yet, the term "span of control" remains a default metric for evaluating their workload and effectiveness. Rooted in industrial-era management theory, this language no longer reflects the complexity of contemporary nursing leadership. These authors propose a shift to "span of accountability," a more accurate, empowering, and future-ready framework. This commentary explores the theoretical rationale, practical implications, and strategic benefits of updating this lexicon to align with modern healthcare realities.

Peer feedback, also known as peer review or evaluation, is a structure and process in which nurses assess one another's competencies, ethical conduct, and adherence to professional standards. Embedded in Magnet® standards, peer feedback supports professional development and accountability. As healthcare delivery evolves, organizations may face challenges implementing standardized peer feedback, especially when nurses practice in environments where they are the only RN or advanced practice RN. Magnet's inclusive approach ensures meaningful feedback across all roles and levels of practice.

Objective: The aim of this study was to understand the unique role of professional governance (PG) in shaping nurse leaders focusing on the role of mentors and early leadership exposure.

Background: Since 1984, Rush University Medical Center has had a PG model with a clinical nurse president in a dyad relationship with the CNO.

Methods: This study used 1:1 qualitative interviews and a self-administered quantitative survey.

Results: Eighty-three percent (25/30) of presidents participated. Average time as a clinical nurse to presidency was 13.06 years. Mentors, past presidents, or leaders encouraged 84% (21/25) of the candidacies. Presidents identified leadership mentors, highlighting the CNO (96%, 24/25) and past presidents (68%, 17/25). Post presidency, 52% (13/25) matriculated to leadership or specialty roles. Graduate level education increased to 72% (18/25).

Conclusions: Family influences, early leadership opportunities, and critical life events impacted these presidents. A past presidents committee and transition plans are recommended to support future PG leaders.

Objective: The aim of this study was to describe a team-based care model that co-located patients with discharge delays to a central hospital unit.

Background: Nationally, discharge delays are increasing amidst a marked shortage of nurses and increasing patient acuities, prompting hospitals to explore innovative and cost-effective care models.

Methods: The authors convened a multidisciplinary team to develop a new care model for inpatients with discharge delays. The model, which leveraged the role of the LPN, was overseen by a lead RN.

Results: In the unit's 1st year, 358 patients were discharged. Patients expressed satisfaction with their care, quality care was being provided, and nurses reported less burnout and more meaning in their work.

Conclusion: An innovative care model capitalized on the LPN role, reducing the nursing staff required, without compromising quality of patient care or nursing satisfaction.

Objective/background: The purpose of this study was to explore medical ICU (MICU) nurses' lived experiences coping with potentially morally injurious events (PMIEs). Medical ICU nurses directly care for critically ill patients, which increases the likelihood of experiencing PMIEs.

Methods: Researchers conducted interviews with MICU nurses (N = 25) using a semistructured interview guide designed to identify nurses' ethical and moral values, explore how these values informed the care of patients, and discuss PMIEs in their workplace settings.

Results: Three major themes were identified for MICU nurses: 1) values; 2) lived experiences; and 3) sustaining oneself. Participants indicated that a lack of resources and insufficient support from institutional leadership both hinder the ability to provide value-aligned care.

Conclusions: Delivering value-discordant care cultivates stress and frustration. Tools are needed for healthcare organizations to identify and discuss PMIEs and inform resources to mitigate the harm caused by PMIEs.

Nurse leaders are poised to respond to current challenges while simultaneously looking to the future to identify new opportunities. This year's Journal of Nursing Administration Magnet® Supplement will provide articles highlighting predicted nursing and healthcare trends over the next few years.