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Call to action: Blueprint for change in acute and critical care nursing 行动呼吁:急危重症护理变革蓝图
IF 4.1 2区 医学 Q1 NURSING Pub Date : 2024-09-12 DOI: 10.1016/j.outlook.2024.102271
Martha A.Q. Curley PhD, RN, FAAN , Margarete L. Zalon PhD, RN, FAAN , Maureen A. Seckel MSN, RN, FAAN , Anne W. Alexandrov PhD, RN, FAAN , Lauren R. Sorce PhD, RN, FAAN , Laura Beth Kalvas PhD, RN , Vallire D. Hooper PhD, RN, FAAN , Michele C. Balas PhD, RN, FAAN , Kathleen M. Vollman MSN, RN, FAAN , Devin S. Carr DNP, RN, ACNS-BC , Vicki S. Good DNP, RN, CENP , Christine L. Latham DNSc, RN, FAAN , Jane M. Carrington PhD, RN, FAAN , Sonya R. Hardin PhD, RN, FAAN , Jan Odom-Forren PhD, RN, FAAN

Herein, we propose a blueprint for action to completely measure and recognize the care provided by acute and critical care nurses to be incorporated into policy that shapes and supports practice. We address the nature of nurses’ work by identifying nine practice domains, hospital practice environment assumptions, and expected outcomes. Nurses’ work, as a cross-system process, needs to be included in hospital-based core measures to fully reflect nurses’ impact on patient care. We call for a balanced measurement portfolio focused on patient/family-, unit-, and systems-level outcomes. We focus on what nurses do and what patients and their families can expect rather than only on the elimination of select adverse events. We provide a way forward to allow measure development and implementation with incentives for their use. This approach to making nurses’ contributions and impact on outcomes visible will enhance acute and critical care nursing practice and benefit patients and their families.

在此,我们提出了一个行动蓝图,以全面衡量和认可急危重症护理护士提供的护理服务,并将其纳入形成和支持实践的政策中。我们通过确定九个实践领域、医院实践环境假设和预期成果来探讨护士工作的性质。护士的工作作为一个跨系统的过程,需要纳入医院的核心衡量标准,以充分反映护士对患者护理的影响。我们呼吁建立一个平衡的衡量组合,重点关注患者/家庭、科室和系统层面的结果。我们关注护士的工作以及患者及其家属的期望,而不仅仅是消除特定的不良事件。我们为制定和实施衡量标准提供了前进方向,并为使用这些标准提供了激励措施。这种使护士的贡献和对结果的影响显而易见的方法将加强急危重症护理实践,并使患者及其家属受益。
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引用次数: 0
Improving Maternal Health Outcomes Through Nursing Science 通过护理科学改善孕产妇健康成果
IF 4.1 2区 医学 Q1 NURSING Pub Date : 2024-09-01 DOI: 10.1016/j.outlook.2024.102276
Victoria Vaughan Dickson PhD, RN, FAHA, FHFSA, FAAN
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引用次数: 0
The Value of Every Vote 每一票的价值
IF 4.1 2区 医学 Q1 NURSING Pub Date : 2024-09-01 DOI: 10.1016/j.outlook.2024.102277
Linda D. Scott PhD, RN, NEA-BC, FADLN, FNAP, FAAN
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引用次数: 0
Information for Readers 读者信息
IF 4.1 2区 医学 Q1 NURSING Pub Date : 2024-09-01 DOI: 10.1016/S0029-6554(24)00175-1
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引用次数: 0
Chronicling the pursuit for full practice authority in Tennessee: Recommendations for a path forward 田纳西州争取全面执业权的历程:关于前进道路的建议
IF 4.1 2区 医学 Q1 NURSING Pub Date : 2024-09-01 DOI: 10.1016/j.outlook.2024.102240
Carole R. Myers PhD, RN, FAAN , Elizabeth Lund MSN, RN , Mavis N. Schorn PhD, CNM, FAAN , Ruth Kleinpell PhD, APRN-BC, FAAN

Background

The quest for full practice authority (FPA) for Tennessee Advanced Practice Registered Nurses (APRNs) began with promise in the late 1960s. However, progress has stalled in the ensuing time, and prospects for advancing FPA do not look promising.

Purpose

The purpose of this article is to chronicle the pursuit of FPA in Tennessee, offer reflections on what has transpired to date, and suggest a path forward.

Methods

Various data from various sources were used to chronicle the history of FPA in Tennessee, make the case for its need, and identify better approaches for success.

Discussion

As one of a dwindling number of states without FPA, access to primary care health services and the economic vitality of Tennessee communities are of concern.

Conclusion

The path forward for achieving FPA in Tennessee necessitates changes in approach and players. Specific recommendations are offered.

背景田纳西州高级执业注册护士 (APRN) 对全面执业授权 (FPA) 的追求始于 20 世纪 60 年代末,当时充满希望。本文的目的是记录田纳西州追求 FPA 的历程,对迄今为止所发生的事情进行反思,并提出前进的道路。方法使用各种来源的数据记录田纳西州 FPA 的历史,说明其必要性,并找出取得成功的更好方法。讨论作为没有 FPA 的越来越少的州之一,田纳西州社区获得初级医疗保健服务的机会和经济活力令人担忧。现提出具体建议。
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引用次数: 0
Nurses as Advocates for Science and Role Models for Measured Skepticism 护士是科学的倡导者,也是衡量怀疑论的榜样
IF 4.1 2区 医学 Q1 NURSING Pub Date : 2024-09-01 DOI: 10.1016/j.outlook.2024.102274
Sean Clarke
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引用次数: 0
Evaluation of meaningful recognition programs in three colleges of nursing 评估三所护理学院的有意义认可计划
IF 4.1 2区 医学 Q1 NURSING Pub Date : 2024-08-29 DOI: 10.1016/j.outlook.2024.102268
Timian M. Godfrey DNP, FNP-BC, FAAN , Danika Bowen EdD, MBA, MS , Ann Joyce PhD , Cheryl L. Lacasse PhD, RN, AOCNS , Jessica Rainbow PhD, RN, CNE , Ken Wofford PhD, CRNA, CHSE

Background

The nursing faculty shortage in the United States presents a challenge to maintaining a robust healthcare workforce. Meaningful recognition (MR) is an evidence-based practice that improved nurse burnout (BO) in the clinical setting. There is limited literature on its impact on nurse faculty.

Purpose

Three colleges of nursing implemented The DAISY Diseases Attacking the Immune SYstem Award for Extraordinary Nursing Faculty as an MR program to improve compassion satisfaction (CS) and BO among nursing faculty.

Methods

This project employed a pre- and post-survey design to assess changes in faculty CS, BO, and secondary traumatic stress using the ProQOL Professional Quality of Life version 5.

Discussion

The results suggest that while the implementation of MR programs did not significantly alter these metrics, the faculty maintained stable levels of CS despite the stressful COVID-19 pandemic.

Conclusion

Additional research is needed to explore the potential for MR to mitigate faculty BO.

背景美国护理师资短缺,这对维持一支强大的医疗队伍提出了挑战。有意义的认可(MR)是一种以证据为基础的做法,可以改善护士在临床环境中的职业倦怠(BO)。目的三所护理学院实施了 "DAISY疾病攻击免疫系统杰出护理教师奖",作为一项MR计划,以提高护理教师的同情心满意度(CS)和职业倦怠。方法该项目采用前后调查设计,使用ProQOL专业生活质量5版评估教师CS、职业倦怠和继发性创伤压力的变化。讨论结果表明,虽然 MR 计划的实施并未显著改变这些指标,但在 COVID-19 大流行的压力下,教职员工的 CS 水平仍保持稳定。
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引用次数: 0
PhD nursing programs: Where are we headed? 护理博士课程:我们将何去何从?
IF 4.1 2区 医学 Q1 NURSING Pub Date : 2024-08-29 DOI: 10.1016/j.outlook.2024.102267
James A. Fain PhD, RN, BC-ADM, FADCES, FAAN, Susan Sullivan-Bolyai DNSc, RN, CNS, FAAN, Carol Bova PhD, RN, ANP
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引用次数: 0
Nurse-reported workplace violent events: Results from a repeated statewide survey 护士报告的工作场所暴力事件:全州重复调查的结果
IF 4.1 2区 医学 Q1 NURSING Pub Date : 2024-08-28 DOI: 10.1016/j.outlook.2024.102265
Christopher R. Friese PhD, RN, AOCN , Barbara R. Medvec DNP, RN, NEA-BC , Deanna J. Marriott PhD , Lara Khadr MPH , Marissa Gurka Wade PhD , Melissa Riba MPH , Marita G. Titler PhD, RN, FAAN

Background

Workplace violence significantly affects registered nurses, contributing to burnout and intention to leave.

Methods

The Michigan Nurses Study conducted surveys in 2022 and 2023, examining the prevalence of verbal, physical, and sexual violence, and coworker bullying. Personal and workplace factors associated with reporting any violent event were examined using multivariable logistic regression.

Results

There was a decline in overall workplace violence from 50.2% to 43.4%, despite a rise in sexual harassment from 9.9% to 11.8%. Over half of the events were patient-sourced. Underreporting remained a problem. Factors associated with increased likelihood of reporting any violent event included younger age, employment in acute care and long-term care settings, unfavorable practice environments, less confidence in management, inadequate support for workplace stress, and understaffing on the past shift.

Conclusion

Despite a decrease in reported violent events, incidents remain common. Improvements in working conditions, management of understaffing, and support systems are crucial to mitigate workplace violence against nurses.

方法密歇根护士研究于 2022 年和 2023 年进行了调查,研究了语言暴力、肢体暴力和性暴力以及同事欺凌的发生率。结果尽管性骚扰的发生率从 9.9% 上升到了 11.8%,但总体工作场所暴力发生率却从 50.2% 下降到了 43.4%。超过一半的事件来自患者。报告不足仍然是一个问题。与报告任何暴力事件的可能性增加有关的因素包括:年龄较小、在急症护理和长期护理机构工作、不利的工作环境、对管理层的信心不足、对工作场所压力的支持不足以及上一班的人手不足。改善工作条件、管理人手不足和支持系统对于减少针对护士的工作场所暴力至关重要。
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引用次数: 0
Commentary on “Racial and ethnic diversity in academic nursing leadership: A cross-sectional analysis” by Travers and colleagues (2024) 关于 "护理学术领导中的种族和民族多样性:Travers 及其同事撰写的 "横断面分析"(2024 年)
IF 4.1 2区 医学 Q1 NURSING Pub Date : 2024-08-27 DOI: 10.1016/j.outlook.2024.102270
Rosa M. Gonzalez-Guarda PhD, MPH, RN, FAAN

The purpose of this commentary is to highlight key points made by Travers and colleagues (2024) in their study entitled, “Racial and ethnic diversity in academic nursing leadership: A cross-sectional analysis” and provide additional recommendations for future research and policy related to diversity in academic nursing leadership. While there is a significant underrepresentation of racial and ethnic minoritized populations in academic leadership in nursing, the level of underrepresentation and contributors to underrepresentation are not the same across racial and ethnic minoritized populations. As we design strategies to promote diversity in academic nursing it is important to benchmark efforts to ensure representation from groups who experience the most significant health inequities, create tailored strategies that consider the unique historical and contemporary barriers to leadership in academic nursing across and within minoritized groups, and build upon evidence-based strategies, especially the important role that minority serving institutions have played.

本评论旨在强调 Travers 及其同事(2024 年)在题为 "学术护理领导中的种族和民族多样性 "的研究中提出的要点:横断面分析 "中提出的要点,并为未来与护理学术领导力多样性相关的研究和政策提供更多建议。虽然在护理学术领导层中,少数种族和族裔人口的代表性严重不足,但不同种族和族裔人口的代表性不足程度和导致代表性不足的因素并不相同。当我们设计促进护理学术多元化的战略时,重要的是要制定工作基准,以确保经历最严重健康不平等的群体的代表性,制定量身定制的战略,考虑到不同少数群体和少数群体内部在学术护理领导力方面独特的历史和当代障碍,并以循证战略为基础,特别是少数群体服务机构所发挥的重要作用。
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Nursing Outlook
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