Survey of Managers Regarding Nurses' Performance of Nonnursing Duties.

BACKGROUND: The performance of nonnursing duties by nursing staff contributes to an already busy workload while taking time away from patient care. OBJECTIVE: This article reports on a process implemented by a large regional health authority in Canada to measure and address nurses' performance of nonnursing duties through a newly created tool. METHODS: Process improvement methodology was used to conduct this project. A measurement tool, the "Non-Nursing Duties Tracking Tool," was designed for frontline nursing staff and patient care attendants to document the performance of tasks classified as clerical, housekeeping, food services, clinical support, and transportation. This article reports on a survey of managers regarding information collected from frontline nurses and patient care attendants regarding their performance of nonnursing duties and actions taken or planned to address this. RESULTS: Tasks were identified that could be delegated to housekeeping, transport, and clerical staff. Both frontline nurses and managers expressed the need for administrative support to realign nonnursing tasks to more appropriate personnel. Although most managers of nurses expressed concern about the support of managers in other departments to make these changes, little resistance was encountered when adequate resources were in place. CONCLUSIONS: The "Non-Nursing Duties Tracking Tool" is a valid instrument to support the assessment of nonnursing direct care duties.

Triage in times of drug shortage.

This paper addresses the current drug shortage, and examines the ethics framework for dealing with drug shortages developed by our organization. That three-step allocation process and framework was published previously in this journal. Specifically, this paper offers a rationale and justification for the framework's second step, which involves a triage process aimed to ensure that the available drug supply is utilized effectively and ethically.

Nurses: Leading change one day at a time.

There has been enormous progress in nursing, and that progress did not come without change. Nurses have two choices: to be a part of developing and leading the change, or to have change happen to them.

Clinical integration: a burning platform.

The growing burden of healthcare cost demands a change in healthcare delivery. Hospitals must be reserved for those requiring specialized acute services that can only be received in such a setting. Investment must be made in alternative delivery models, beginning with the home and community as the primary environments in which to receive care. Through focusing on clinical integration, the system will be moving towards better care. System integration enables this burning platform.

From framework to the frontline: designing a structure and process for drug supply shortage planning.

Drug shortages are not new; they have been managed through conservation, procurement of alternatives, and redistribution of stock The Sandoz shortage in 2012 has caused a radical reduction of generic injectables. In Newfoundland and Labrador, our response has led to the development of the framework, structure, and process outlined in this paper. The efforts have eased the concerns of clinicians and leaders, as they are aware of the decision-making resource for situations of drug and technology shortage.

The estrogen receptor/progesterone receptor testing errors in Newfoundland and Labrador: a journey of hope, health, and healing.

In Newfoundland and Labrador, the estrogen receptor/progesterone receptor testing errors left an unparalleled effect. Patients, families, members of healthcare teams, and many others were left shaken and wondering how the province could move forward. This article reflects on some of the processes Eastern Health had to go through to learn and grow from the experience, as well as discusses how the organization met the requirements set forth in the Commission of Inquiry report.