Nursing innovation: The joint effects of championship behaviors, project types, and initiation levels.

BACKGROUND: Frontline nurse champions are key innovation-implementation agents. Despite the growing interest in nurse champions' innovation, whether project novelty is a product of championship behavior (e.g., expressing confidence in the innovation's success and network building), the project's contextual characteristics (project type and initiation level), or their joint effects, remains unsolved. PURPOSE: To develop and test an interactionist model of project novelty in nursing. METHODS: A cross-sectional design with a multisource approach to data collection. FINDINGS: Results demonstrated a direct effect of project type, a two-way interaction effect of level of initiation and project type, a two-way interaction effect of championship and project type, and a three-way interaction effect of project type, initiation level, and championship on project's novelty. DISCUSSION: Bottom-up service and administrative projects require champions' championship behaviors to foster novelty, whereas for bottom-up quality-improvement projects, such behaviors can harm project novelty. For human-resource projects and for top-down projects, championship behaviors do not matter.

Characteristics and behaviours of formal versus informal nurse champions and their relationship to innovation success.

AIMS: To identify the sociodemographic attributes, project characteristics and champion strategies that differentiate formal from informal nursing champions, and to test their success in terms of project spread and novelty. BACKGROUND: Champions spread innovation in healthcare organizations. Empirical research has not explored the differences between formal and informal champions in terms of their antecedents and success. DESIGN: A quantitative cross-sectional design. METHOD: Data were collected on 93 nursing champions in three hospitals from 2015 - 2016. Champions were identified according to a validated approach; data on their sociodemographic attributes, project characteristics and strategies were assembled through interviews and validated questionnaires. Their success in terms of novelty and spread was assessed via expert ratings and validated questionnaire. FINDINGS: Informal champions had longer tenure and were involved mainly in bottom-up projects aimed mostly at improving human resources and services; formal champions were mostly involved in top-down projects aimed at quality control. Informal champions expressed more enthusiasm and confidence about the innovation; formal champions tended to use more online resources and peer-monitoring strategies. Projects of informal champions were more novel than those of formal champions. Project spread did not differ between the two groups. CONCLUSION: Formal and informal champions differ in their characteristics and implementation strategies. To encourage project's innovation, the organizational climate should encourage the emergence of informal champions; formal and informal champions should be chosen wisely, assuring that they possess enough organizational resources; and coaching programmes for junior champions should be planned to equip them with championing behaviours.

[Glioblastoma, innovations in surgery]. / Glioblastome, des innovations en chirurgie.

One of the innovative principles in glioblastoma surgery consists in making the tumour fluorescent in order for it to be more easily visualised during the procedure. 5-aminolevulinic acid (5-ALA) undergoes an enzyme transformation, turning into another molecule, protoporphyrine IX (PPIX) whose property is fluorescence. It emits red light when it is stimulated by blue light.

[The nurses involved in therapeutic innovation]. / Infirmière de recherche clinique en onco-dermatologie.

Clinical research nurses (CRNs) play an important role within the teams involved in the fight against cancer and in therapeutic innovation. In the dermatology department of the Gustave-Roussy Institute, patients treated for melanoma and taking part in clinical trials are supported along their care pathway by a CRN who, in addition to her clinical expertise, acts as a link between the different players concerned.

Role of partnership in a 24/7 stroke research project.

The Royal Stoke has become the first hospital in the country to provide round-the-clock research cover for hyperacute stroke and trauma trials involving patients presenting for emergency care services. The biggest challenge has been the small window of opportunity to recruit patients to a stroke trial before results are lost to the speed and impact of the condition. Good working relationships between research nurses and emergency care teams have proved pivotal in creating the fully funded 24/7 cover.

Compassionate use in research.

Critical care nurses may be involved in clinical trials involving medications, devices, or treatments. Occasionally, there may be a patient who does not meet the inclusion criteria for the clinical trial and has a condition that is not responding to approval therapies. In these cases, compassionate use may be necessary. This article discusses the definition of compassionate use, when it is appropriate, how to gain approval, and the nurse's role in caring for these patients.

An innovative approach to the care of patients on phase I and phase II clinical trials: the role of the experimental therapeutics nurse.

The tremendous strides in survival rates for childhood malignancies in large part can be attributed to the clinical trial mechanism. New and innovative therapies are being developed in the laboratory in an attempt to find a cure for those children who have relapsed or have refractory disease. Phase I and phase II clinical trials move this science from the laboratory to the patient's bedside. With increasing frequency, the oncology staff nurse may be managing the care of a patient receiving a phase I or phase II study drug. Administration of these agents goes beyond what is familiar, requires specialized knowledge, and demands a skill set beyond what is required for standard oncology care. At The Children's Hospital of Philadelphia, the role of the experimental therapeutics nurse was created in an effort to improve the process for identification, treatment, and follow-up of patients receiving these therapies. The broader role of nursing in clinical trials, the multidisciplinary challenges of experimental therapies, and the development of an innovative approach to caring for patients on phase I/II studies are discussed.