Canadian journal of nursing administration最新文献

A project was initiated by the Vice-President, Nursing at The Queen Elizabeth Hospital, Toronto, to clarify the role of the Nurse Manager. The strategy undertaken involved the Staff Development department, and an outside consulting firm, Richard Kemerer and Associates Ltd. The facilitated process resulted in alignment of job expectations, management development strategy, and performance accountability. The model used behavioral statements of what should be done based on a vision of the role at least two to three years ahead of the present time. Each nurse manager accountability was elaborated by a small group of nurse managers considered most competent in that area of practice. Ultimately all management team members reviewed the Job Profile for validation. The result of the process has been better performance plus higher morale and a paradigm shift for the nursing division at The Queen Elizabeth Hospital, Toronto, Ontario.

This article proposes a different approach to address a key issue within the performance appraisal process: the preparation of Peer Evaluators. The need to regularly assess and verify the clinical expertise of registered nurses has long been recognized. Health care facilities have responded, acknowledging that competency--based evaluation systems can contribute to RN autonomy, accountability, and the refinement of professional standards. The evolution of peer review has expanded the benefits and efficacy of such systems.

Although the Canadian Human Rights Act was enacted in 1977 and The Charter of Rights and Freedoms was introduced in 1981, a paucity of Canadian literature regarding their implications for nursing managers is apparent. The modern nursing unit manager is faced with a variety of decisions pertaining to employment, performance evaluations, and delegation of responsibilities, which if not sensitively and fairly handled may expose the manager and the organization to non-defensible vulnerabilities. This paper briefly reviews pertinent human rights issues in the nursing setting and the effect of human rights considerations on the management of a nursing unit. Discrimination, harassment, the hiring process, performance appraisal and discipline are discussed along with recommendations regarding mandatory inservices for managers.

The participative management literature, particularly that which focuses on self-managing teams or Superteams has much to offer to the changing scene in health care today. These concepts and their value to health care and nursing are illustrated through describing an emerging Superteam formed by the authors for a specific project. This transformation has the potential to yield many important benefits for both staff and management.

Total Quality Management (TQM) is a management philosophy that has had great success in increasing quality and productivity in the private sector. Health care executives are interested in adapting this approach to a health care environment. This article discusses the implementation of theory based nursing practice as one initiative that lays the groundwork for the successful utilization of TQM in a nursing department. The barriers to quality are usually processes not people. Implementation of Jean Watson's nursing theory emphasizes that nurses are co-participants in the processes of health care which results in better outcomes. Nurses are viewed as knowledge workers. Treating them as such, removes barriers to pride of workmanship and renews their commitment to the pursuit of excellence in their care.

This article describes a conceptual framework for implementation of outcomes driven management. The framework is defined in terms of strategic and financial planning, and quality management. The concept of value for investment is explored and definitions are presented in the introduction. Background information provides an overview of the literature with an emphasis on management challenges and quality management. The methodology is described including implementation and evaluation. Experiential examples of implementation techniques and global outcomes in the three domains of service, service provider and service manager are presented. The article is concluded with advantages, disadvantages and summative remarks.

There has been considerable impetus to use conceptual frameworks to guide nursing practice, yet many nursing theories are not supported by research or understood by nurses. At Foothills Hospital, a Committee developed and implemented a conceptual framework based on self-care. Concepts within the framework are grounded in current nursing practice, consistent with consumer expectations and supported by philosophical statements about patient, society/environment, health and nursing.

Nurses are as susceptible as others to trends and fads which have an unproven impact on the provision of quality health care. One enduring trend has been the adoption of nursing models which, it is claimed, unifies nurses in distinctive approaches to caring. In Newfoundland, the current financial constraints in health care have created an opportunity to investigate the soundness of jumping on the nursing model "bandwagon". The author explores the meaning of nursing knowledge, the importance of developing knowledge for safe, effective practice, and explains how nursing models have become associated with nursing knowledge and imbued with almost mystical qualities. One aspect not seen in the literature-that of the cost of implementing a model for nursing care in hospitals-is presented. The implications, financial and ethical, are discussed and, in conclusion, another approach to encourage philosophizing about nursing work is outlined.

How does a national, non-profit, community health organization introduce and implement quality management (QM) throughout its branches? This article traces VON's move from a traditional quality assurance model to a systematic QM approach, focused on customers and on outcomes. Implementing Quality Management in a three-tiered organization (national, provincial and local levels), with boards and staff, is not an easy challenge but is feasible. Effective and creative strategic planning is a necessity. Educational strategies and ideas for implementation are included.