A crosswalk between the Omaha System and guiding undergraduate public health nursing education documents.

The Omaha System is the hallmark evidence-based clinical information management system used in nursing education, research, and practice. Multiple education documents guide public health workforce preparation. This qualitative study identified similarities and gaps between the Omaha System and seven guiding documents commonly used by nurse educators. A crosswalk design was employed. The setting was virtually based using online technology. Recommendations are for public health nurse educators to update their teaching practices using evidence-based approaches.

Theory Development Strategies for Middle-Range Theories.

The purpose of this article is to present an analysis on the theory development strategies that have been used to develop middle-range theories through an integrated literature review and to provide directions for future theoretical development in nursing. First, theory development strategies that have been suggested and used in nursing are briefly discussed. Second, the methods used for the analysis are described. Then, 4 themes reflecting the theory development strategies that have been used to develop middle-range theories are discussed. Finally, suggestions for future theoretical development in nursing are made on the basis of the findings.

Framework for Evaluating the Impact of Advanced Practice Nursing Roles.

PURPOSE: To address the gap in evidence-based information required to support the development of advanced practice nursing (APN) roles in Switzerland, stakeholders identified the need for guidance to generate strategic evaluation data. This article describes an evaluation framework developed to inform decisions about the effective utilization of APN roles across the country. APPROACH: A participatory approach was used by an international group of stakeholders. Published literature and an evidenced-based framework for introducing APN roles were analyzed and applied to define the purpose, target audiences, and essential elements of the evaluation framework. Through subsequent meetings and review by an expert panel, the framework was developed and refined. FINDINGS: A framework to evaluate different types of APN roles as they evolve to meet dynamic population health, practice setting, and health system needs was created. It includes a matrix of key concepts to guide evaluations across three stages of APN role development: introduction, implementation, and long-term sustainability. For each stage, evaluation objectives and questions examining APN role structures, processes, and outcomes from different perspectives (e.g., patients, providers, managers, policy-makers) were identified. CONCLUSIONS: A practical, robust framework based on well-established evaluation concepts and current understanding of APN roles can be used to conduct systematic evaluations. CLINICAL RELEVANCE: The evaluation framework is sufficiently generic to allow application in developed countries globally, both for evaluation as well as research purposes.

Development, implementation and evaluation of a peer review of teaching (PRoT) initiative in nursing education.

For many years, an area of research in higher education has been emerging around the development and implementation of fair and effective peer evaluation programs. Recently, a new body of knowledge has developed regarding the development and implementation of fair and effective peer evaluation programs resulting in formative and summative evaluations. The purpose of this article is to describe the development, implementation, and evaluation of a peer review of teaching (PRoT) program for nursing faculty, initiated at one small comprehensive university in the northeastern United States. Pairs of nursing faculty evaluated each other's teaching, syllabi, and course materials after collaborating in a pre-evaluation conference to discuss goals of the classroom visit. Qualitative data gathered in post project focus groups revealed that faculty found their modified PRoT process to be a mutually beneficial experience that was more useful, flexible and collegial, and less stressful than their previous evaluation process.

An overview and evaluation of combining an addiction liaison nurse outpatient service with hepatitis C outpatient clinics in Glasgow, Scotland.

A new purpose-built facility for the care of patients with Hepatitis C was opened at Gartnavel General Hospital in Glasgow, Scotland, in 2009, bringing together infectious diseases and gastroenterology disciplines. An addiction liaison nurse outpatient service was established alongside existing Hepatitis C outpatient clinics in October 2010. This service supports staff and patients with Hepatitis C and addiction issues. The purpose of this study was to evaluate the usefulness of combining the Addiction Liaison Nurse outpatient service with the Hepatitis C outpatient clinic. Two methods were used in data collection. A brief questionnaire asking staff their view on the addiction liaison service and addiction issues with regard to Hepatitis C was distributed and completed by personnel assigned to the clinics. Staff were also queried about their view on the number and quality of referrals generated by the addiction liaison clinic. The results from the questionnaire indicate that staff agreed that patients should be abstinent from alcohol and illicit drugs before and during treatment of Hepatitis C. Further research is called for with regard to abstinence from alcohol and drugs before and during Hepatitis C treatment.

"The midwifery two-step": a study on evidence-based midwifery practice.

INTRODUCTION: To date, there has been little documentation of how practice-based midwifery networks in the United States might influence the transfer and development of knowledge in childbearing and women's health care. The first phase of this participatory action research project was to conduct a qualitative study with a community of midwifery practices to understand their perspectives on evidence-based practice and how an organized network could facilitate their work. METHODS: Midwives within the community of interest were invited by letter or e-mail to participate in individual or small group interviews about knowledge transfer, primary concerns of evidence-based practice, and potential for a midwifery practice-based research network. Participatory action research strategies and organizational ethnographic approaches to data collection were used to guide qualitative interviews. RESULTS: Eight midwifery practices enrolled in the study with 23 midwives participating in interviews. They attended births at 2 hospitals in the community. Two broad areas of discourse about evidence-based practice were identified: 1) challenges from influential persons, finances and resources, and the cultural perception of midwifery, and 2) strategies to foster best practice in the face of those challenges. The midwives believed a research network could be useful in learning collectively about their practices and in the support of their work. DISCUSSION: Evidence-based practice is a goal but also has many challenges in everyday implementation. Practice-based research networks hold promise to support clinicians to examine the evidence and form strong coalitions to foster best clinical practice. The second phase of this study will work with this community of midwives to explore collective strategies to examine and improve practice.

An innovation in design of a school of nursing evaluation protocol.

Program evaluations in schools of nursing (SONs) serve the purpose of clearly demonstrating how the SON meets the quality standards established by governance, regulatory, and accreditation bodies. The authors describe the step-by-step process taken by a SON to develop a new model of an evaluation protocol that includes linkages to external criteria for evaluation of the plan itself. This analysis and feedback step is often neglected but is essential to the quality improvement process.

Alberta: evaluation of nursing retention and recruitment programs.

Retention and recruitment strategies are essential to address nursing workforce supply and ensure the viability of healthcare delivery in Canada. Knowledge transfer between experienced nurses and those new to the profession is also a focus for concern. The Multi-Employer/United Nurses of Alberta Joint Committee attempted to address these issues by introducing a number of retention and recruitment (R&R) initiatives for nurses in Alberta: in total, seven different programs that were introduced to some 24,000 nurses and employers across the province of Alberta in 2001 (the Transitional Graduate Nurse Recruitment Program) and 2007 (the remaining six R&R programs). Approximately 1,600 nurses participated in the seven programs between 2001 and 2009. Of the seven strategies, one supported entry into the workplace, two were pre-retirement strategies and four involved flexible work options. This project entailed a retrospective evaluation of the seven programs and differed from the other Research to Action (RTA) projects because it was solely concerned with evaluation of pre-existing initiatives. All seven programs were launched without a formal evaluation component, and the tracking of local uptake varied throughout the province. The union and various employers faced challenges in implementing these strategies in a timely fashion, as most were designed at the bargaining table during negotiations. As a result, systems, policy and procedural changes had to be developed to support their implementation after they became available.Participants in the programs indicated improvements over time in several areas, including higher levels of satisfaction with work­life balance, hours worked and their current practice and profession. The evaluation found that participation led to perceived improvements in nurses' confidence, greater control over their work environment, decreased stress levels, increased energy and morale and perceived improved ability to provide high-quality care. However, no formal implementation plan had been developed or made available to assist employers with implementation of the programs. The findings highlight the need for more discipline in communicating, implementing and evaluating initiatives such as those evaluated retrospectively in this project. In particular, key performance indicators, baseline data, monitoring mechanisms and an evaluation plan need to be developed prior to implementation.

Emergency code color standardization: implementation without traumatization.

An emergency code call for a life-threatening cardiovascular emergency may be identified differently between facilities. Nurses and physicians who work secondary jobs or for temporary agencies may find themselves in the position of misunderstanding emergency code calls. The miscommunication of an emergency could easily result in a life-threatening situation for patients and staff. Therefore, the need for standardization is crucial. This article describes an entertaining education plan to assist with implementing standardization facility wide.

Developing and testing a new measure of staff nurse clinical leadership: the clinical leadership survey.

AIM: To test the psychometric properties of a newly developed measure of staff nurse clinical leadership derived from Kouzes and Posner's model of transformational leadership. BACKGROUND: While nurses have been recognized for their essential role in keeping patients safe, there has been little empirical research that has examined clinical leadership at the staff nurse level. METHODS: A non-experimental survey design was used to test the psychometric properties of the clinical leadership survey (CLS). Four hundred and eighty registered nurses (RNs) providing direct patient care in Ontario acute care hospitals returned useable questionnaires. RESULTS: Confirmatory factor analysis provided preliminary evidence for the construct validity for the new measure of staff nurse clinical leadership. Structural empowerment fully mediated the relationship between nursing leadership and staff nurse clinical leadership. CONCLUSION: The results provide encouraging evidence for the construct validity of the CLS. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing administrators must create empowering work environments to ensure staff nurses have access to work structures which enable them to enact clinical leadership behaviours while providing direct patient care.

Working within the guidelines: case studies.

Both accredited and approved continuing nursing education providers can be challenged by requirements related to using faculty who have relationships with commercial entities, or when managing commercial support or sponsorship. This column presents case studies that can be used to further an understanding of the guidelines for disclosure and for commercial support that comply with the provision of continuing nursing education activities.

School nursing in a contemporary society: what are the roles and responsibilities?

The foundation studies cited in this manuscript was funded by the American Federation of Teachers (AFT) Healthcare. This study was funded by Kean University's Release Time for Research (RTR) Award and the manuscript developed through Kean University's Center for Nursing Research, The principal investigator wishes to thank the school nurses who participated in this research as well research assistants Kimika Samms (second author) and Michelle Proudfoot (graduate assistant).

Eleven years of experience with low-bandwidth telemedicine in a nurse-led rural clinic in Scotland.

A pilot trial of telemedicine in primary care began in the village of Letham in 1998. The service provided conventional consultations with the district nurse, plus teleconsultations with a general practitioner (GP) at the health centre in Forfar, a few km away. In the first year, the videoconferencing link was used by 14 patients, all aged over 65 years. The telemedicine service was judged to be successful and subsequently expanded to patients of any age. It was used for a wide range of health matters, including postnatal care, mental health problems, physical ailments, receiving test results and discussions with the doctor. During the 11-year study period, a total of 646 teleconsultations were conducted, a median rate of 65 per year. A qualitative evaluation of the service was conducted in 1999. Although the GPs involved expressed some reservations about the limited video quality, all three user groups were positive about the service. Nonetheless, the telemedicine service was not adopted as a routine method of health-care delivery by the NHS. To enable any telemedicine application to move from the pilot trial stage to routine service requires several things to happen at an organisational and contractual level. Ultimately an organizational decision about adoption is required, followed by appropriate mechanisms to enable diffusion.

Evaluation of patient self-management outcomes in health care: a systematic review.

BACKGROUND: The importance of self-management and its intervention for improving the ability and skill of self-management has been discussed in literatures. It is, however, unclear how to choose the fitted, objective and accurate evaluation system when assessing the outcome. AIM: The aim of this article was to establish a general evaluation system for skill and ability of self-management in chronic diseases through systematic review on different evaluation indicators and scales. METHOD: A systematic search of six electronic databases was conducted. Two authors independently reviewed each qualified study for relevance and significance. Subsequently, main evaluation indicators and scales were identified and categorized into themes and sub-themes. RESULTS: Nineteen articles were identified in this review. Among them, six main evaluation indicators of self-management, including frequently used scales, were extracted and tabulated. Self-efficacy, health behaviour/attitude, health status, health service utilization, quality of life and psychological indicators were the main indicators in evaluating self-management outcome, and they could be used alone or in combination flexibly according to the different goals of programmes. CONCLUSION: Accurate evaluation of skill and ability of self-management is crucial not only in baseline data collection but also in proving the effectiveness of intervention. The outcomes of this study provide future researchers or caregivers with a better understanding and a series of good choices in self-management outcome evaluation.

Development of community nursing in Zhejiang Province, China: a report of the driving measures.

BACKGROUND: Community nursing is playing an important role in health care worldwide. METHODS: We reviewed recent developments in community nursing in the Zhejiang province of China and reported that the locally tailored practical guidelines, education programmes and management models are the driving measures for promoting local community nursing. RESULTS: In 2008, Zhejiang had 1200 community primary health-care service centres, an increase of 56% and 6789 service stations, a twofold increase, compared with 2004. At present, 27 000 community nurses, together with the same number of family doctors, are working in community health-care service centres and stations. Community nursing in Zhejiang has grown not only by numbers but also by the greatly improved infrastructures and functions of its community primary health care. CONCLUSION: It is the multi-pronged approach that has led to the change being successful in a local health-care system.