Mobilizing nurses to address the opioid misuse epidemic.

BACKGROUND: The opioid epidemic is a major health challenge in the United States. PURPOSE: Members from the American Academy of Nursing joined to write a consensus paper about nurses' role in the opioid epidemic. METHODS: The panel reviewed the history of the opioid epidemic and policies to care for patients with opioid use disorder (OUD) and how registered nurses (RNs) and advanced practice nurses (APRNs) could increase care for people with OUD. DISCUSSION: Recommendations are presented to advance policies that empower RNs and APRNs to abate the opioid epidemic. CONCLUSION: Recommendations include (a) advance legislation that supports RNs and APRNs full scope of practice and expands professional role in pain management and addiction prevention; (b) evaluate effective policies that promote RN and APRN care; support federal elimination of X-waiver with state law alignment; (c) sustain the use of nurses in telemedicine; (d) support nursing research on nurse involvement in all aspects of OUD.

Perceptions of Teamwork in Schools of Nursing.

BACKGROUND: Characteristics of high-performing teams include shared purpose, clear vision, strong leadership, and the ability to use conflict management when needed. While many individuals who teach in schools of nursing come from the clinical setting where teamwork is normative, that same expectation of teamwork may not be present for the faculty as a whole. PURPOSE: This study assessed perceptions of teamwork among faculty members in schools of nursing in 4 states in the Midwestern region of the United States. METHODS: Perception of teamwork, related to communication, leadership, team structure, situation monitoring, and mutual support, was examined using a modified TeamSTEPPS Teamwork Perceptions Questionnaire. RESULTS: Perceptions of teamwork were highest for team structure and leadership, whereas communication, situation monitoring, and mutual support were lower. In addition, teamwork dimension scores were higher for those who previously participated in teamwork training. CONCLUSIONS: There are opportunities to improve teamwork in all domains. Teamwork skills are transferrable to different roles and across various situations; therefore once learned and fostered, these can impact the individual as well as improve the organizational climate.

Improving Teamwork and Communication in Schools of Nursing: A Quality Improvement Approach Using TeamSTEPPS.

BACKGROUND: Teamwork training has been identified as an intervention to promote collaboration, improve communication, and reduce conflict. While teamwork training has been implemented in the clinical setting, most schools of nursing are lacking in standardized teamwork training programs. LOCAL PROBLEM: A lack of teamwork, poor communication, and deficient conflict resolution skills among faculty and staff was impacting the ability to form supportive relationships in the interest of working collaboratively. METHODS: This quality improvement (QI) project examined perceptions of teamwork at 3 points over 18 months. INTERVENTION: Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) was adapted for the academic setting and used for the intervention. RESULTS: Results indicated significant improvement in Team Structure, Leadership, and Communication. Situation Monitoring and Mutual Support were identified for continued development. CONCLUSION: Results suggest that a QI intervention using TeamSTEPPS improved teamwork, communication, collaboration, and conflict resolution in one academic setting.

The Effective Use of Psychiatric Mental Health Nurses in Integrated Care: Policy Implications for Increasing Quality and Access to Care.

In the last ten years primary care providers have been encouraged to implement integrated models of care where individuals' medical and mental health needs are addressed holistically. Many integrated models use Psychiatric Mental Health (PMH) nurses as case managers and select exemplars use PMH Advanced Practice Nurses (APNs) as providers. However, the potential value of PMH nurses in integrated health care remains unrealized by health care planners and payers, limiting access to services for the populations most in need of comprehensive care approaches. This current situation is partially fueled by insufficient knowledge of the roles and skill sets of PMH nurses. In this paper, the PMH RN and APN skill sets are detailed, demonstrating how effective use of these nurses can further the aims of integrated care models. Finally, outlined are barriers and enabling factors to effective use of PMH RNs and APNs and attendant policy implications.

Communicating nursing's excellence and value: on the way to Magnet.

Effective communication is essential as nurses convey their critical impact in care delivery. As part of Magnet readiness, the Main Line Health System engaged a nationally recognized expert to develop a communications strategy for staff nurses and front-line managers. This initiative was driven by the chief nursing officer and the nursing leadership team. The goal was to refine communication skills of the nursing staff to tell their story of the Magnet work achieved as well as to better prepare staff to clearly articulate the essential elements of their work in all settings. The result was clinical nurses who were able to articulate their unique value in a changing health care world clearly.

The nursing quality partnership: building a health system approach to improving care in community hospitals using principles of the magnet program of excellence.

Review of the Magnet Recognition Program journey related to the partnership between nursing and quality in building a comprehensive, results-driven quality and safety program in a 5 hospital community system in suburban Philadelphia over a 5-year period (2006-2011).

The CNO/CFO partnership: navigating the changing landscape.

With increasing pressure to cut costs, both real and immediate, and those forecasted and anticipated, the partnership and collaboration between nursing and finance will continue to take on new challenges. This partnership has historically been strained and does not always come easy due to differences in focus, different priorities, and inadequate communication, listening, and hearing. That needs to change and a strong CNO-CFO partnership is needed. Nursing leaders need to understand and appreciate the financial constraints and balance them with expected outcomes, and financial leaders need to understand and appreciate the core clinical business and what gaps in care mean to the financial viability of the organization and to patient outcomes. One health system developed a platform for change and is dedicated to the hard work involved in continuously working on those partnerships so when it comes to patient quality, safety, and financial performance, nursing and finance leaders are well positioned for future health care challenges.

Achieving effective staffing through a shared decision-making approach to open-shift management.

Managing costs while retaining qualified nurses and finding workforce solutions that ensure the delivery of high-quality patient care is of primary importance to nurse leaders and executive management. Leading healthcare organizations are using open-shift management technology as a strategy to improve staffing effectiveness and the work environment. In many hospitals, open-shift management technology has become an essential workforce management tool, nursing benefit, and recruitment and retention incentive. In this article, the authors discuss how a successful nursing initiative to apply automation to open-shift scheduling and fulfillment across a 3-hospital system had a broad enterprise-wide impact resulting in dramatic improvements in nurse satisfaction, retention, recruitment, and the bottom line.