Canadian journal of nursing administration最新文献

Autonomous professional practice continues to be elusive for registered nurses. Autonomous professional practice implies that nurses would be free to determine the procedures for carrying out their nursing work. In other works, they would be able to make independent decisions about their own nursing practice. This article reports research that describes the nature of nursing leadership that supports autonomous professional practice of registered nurses.

This article is the first of a series of three focusing on key management processes in home care--quality management, financial and information management, and, service and human resource management. The articles examine the current state of practice in Ontario and suggest a desirable future state. In this first article, home care is defined and a brief description is provided from a national and provincial perspective. Quality is also defined and the drivers for quality in home care outlined. Using a framework of key principles, the current home care program is assessed and conclusions drawn about where it sits on the quality continuum. Activities to move home care closer to true quality management are then suggested for the province, community, and service provider levels.

The need to incorporate research findings into public health nursing has never been greater. This paper describes briefly, the initiatives to promote research in a public health nursing division and the results of the evaluation questionnaire. Results indicated that public health nurses valued research and felt comfortable with the concepts and phases of the research utilization model. They would engage in research activities if conducted at team meetings and when time was allotted. They identified administrative support and the supportive environment as being positive facilitators to research utilization. Despite these findings, the majority (67.5%) were not changing their practice as a result of the initiatives. They identified having difficulty formulating a research question and needing assistance with article critique. Time was cited as the greatest deterrent. They felt they did not have time to read research or engage in the steps of the research utilization model. Recommendations from the evaluation include the need to designate time for research utilization at team meetings. Once the nurses comfort level and value placed on research utilization increases, they may be motivated to initiate research activities on their own.

A computer-based system which automatically generates nursing workload figures for the Emergency Department is described. This system uses measures derived from the GRASPR system, linked to the discharge diagnosis, to generate total workload figures, obviating the need for data collection or input beyond the initial implementation.

The Queen Elizabeth II Health Sciences Centre developed as a result of the merger of the five adult hospitals in Halifax, Nova Scotia. The merge involved 7000 staff members, 2700 of whom were nursing staff. Although mergers are becoming relatively common amongst health care organizations, there is a paucity of information in the literature to describe such an enormous human resource effort. This two-part article describes the hiring process for the selection and placement of 52 nurse managers over a concentrated time period of six weeks. Issues identified and resolved included: unionized and non unionized head nurses, the role of nurse managers, varying educational preparations, the time frame and organization of the process itself, options for unsuccessful incumbents, and multi unit and multi site management. The second part of the article reports on the results of a survey which was carried out to obtain feedback from the applicants and the interview panel members. The survey was conducted within eight weeks of the conclusion of the hiring process. Overall the process was deemed successful, albeit stressful. Some of the problems encountered are discussed.

The determination of nursing staff mix is a challenge for many health care agencies. Staff mix decisions have historically been based on workload measurement information, the type of patient care unit and on a subjective or intuitive basis. Weighted task lists (workload measurement systems) do not comprehensively consider the skill and knowledge level required to meet patient care needs. This project describes the development of an instrument that considers patient's nursing care needs as a determinant of nursing staff mix. Recommendations for the use of the tool are identified.

In a qualitative, retrospective case study to identify, describe, and develop a theoretical analysis of perceived group process among female nursing educators/administrators, the term "conflict," as traditionally defined in discussions of "conflict management strategies," was rejected. The term did not readily fit with the management styles of the 27 female nurse educators and administrators. Participants rejected "conflict" as a term. The word was deliberately avoided. In fact, conflict rejection was a specific administrative process identified as part of the successful working of the group over the three-year period studied. This finding indicates a break with traditional male-oriented literature and therefore may have implications for future research into conflict management strategies, especially into successful management strategies used by women and health care professionals.