An Effective Academic Medical Center-Based Strategy to Enhance Diversity Among Nurse Researchers.

The Connell-Jones Endowed Chair Diversity Nursing Research Scholars Program was created to promote engagement in nursing research and scholarship among nurses of color. Preliminary evaluation suggests that the program was widely beneficial, resulting in enrollment in doctoral education for some. Establishing opportunities that promote exposure and participation in nursing research and scholarship among nurses of color helps cultivate cohorts of diverse nurses armed to address health disparities through the advancement of nursing knowledge.

Policy education in a research-focused doctoral nursing program: Power as knowing participation in change.

Nurses have moral obligations incurred by membership in the profession to participate knowingly in health policy advocacy. Many barriers have historically hindered nurses from realizing their potential to advance health policy. The contemporary political context sets additional challenges to policy work due to polarization and conflict. Nursing education can help nurses recognize their role in advancing health through political advocacy in a manner that is consistent with disciplinary knowledge and ethical responsibilities. In this paper, the authors describe an exemplar of Elizabeth Barrett's "Power as Knowing Participation in Change" theory as a disciplinary lens within a doctoral nursing health policy course. Barrett (radically) emphasizes "power as freedom" instead of "power as control." This approach is congruent with nursing disciplinary values and enhances awareness of personal freedom and building collaborative relationships in the policy process. The theory was used in concert with other traditional policy content and frameworks from nursing and other disciplines. We discuss the role of nursing ethics viewed as professional responsibility for policy action, an overview of Barrett's theory, and the design of the course. Four student reflections on how the course influenced their thinking about policy advocacy are included. While not specific to policymaking, Barrett's theory provides a disciplinary grounding to increase students' awareness of freedom and choices in political advocacy participation. Our experience suggests that Barrett's work can be fruitful for enhancing nurses' awareness of choices to participate in change across settings.

Initial Psychometric Evaluation of the Staff Perception of the Disruptive Patient Behavior Scale.

OBJECTIVE: The aim of this study is to develop and psychometrically test the Staff Perception of Disruptive Patient Behavior (SPDPB) Scale. BACKGROUND: Disruptive patient behaviors impact work safety for nurses in hospitals. There is no standardized approach to capturing staff perceptions of these behaviors. METHOD: A mixed-methods approach was used to develop and psychometrically evaluate the SPDPB Scale. Items were generated from a survey completed by 770 healthcare providers. A prototype 66-item instrument was developed and content validity was obtained. Evaluation of the psychometric properties of the SPDPB Scale was completed with 558 nurses. Evaluation included internal consistency reliability, principal components analysis, and internal consistency reliability derived subscales to refine the final scale. RESULTS: The SPDPB Scale is a multidimensional measure of perceptions of disruptive patient behaviors. The analysis identified 6 components explaining 54.1% of the variance. The final scale contained 65 items. CONCLUSION: This scale demonstrated psychometric adequacy and can be recommended to measure staff perceptions of disruptive patient behavior.

Profession at the crossroads: A dialog concerning the preparation of nursing scholars and leaders.

The purpose of a practice discipline's terminal degree is to develop wise scholars to guide the profession in anticipating and meeting the health-related needs of those served via philosophical, conceptual/theoretical, and empirical inquiry on behalf of professional practice. Each of these dimensions is important for the discipline's ability to meet its obligations to society. However, contemporary circumstances have created a context within which the maturation of the profession may be threatened by an imbalance among the three dimensions of PhD education. Specifically, we discuss the possibility of a tilt toward the empirical at the expense of the other two. Yet, the philosophical and conceptual/theoretical dimensions are those that have permitted core disciplinary knowledge to be developed. We aim to create a dialog about current challenges and the responsibilities of the discipline's scholars for stewardship of the discipline and offer some strategies to ensure balance among the three equally important dimensions.

Development and psychometric evaluation of the patient care associates' work environment scale.

OBJECTIVE: The purpose of this study is to examine the psychometric properties of the Patient Care Associates' Work Environment Scale (PCA-WES). BACKGROUND: Few studies exist examining patient care associates (PCAs) working in acute care settings, and no instruments are available to examine the impact of the work environment on their practice. METHODS: A psychometric evaluation using a nonprobability purposive sample of 390 PCAs was undertaken. RESULTS: Cronbach's α internal consistency reliability of the total score was .95. Principal components analysis with varimax rotation and Kaiser normalization identified 5 components that accounted for 57.2% of variance and confirmed the original theoretical structure. The resulting 35-item scale had subscale Cronbach's α reliability estimates that ranged from .84 to .93. CONCLUSIONS: The multidimensional PCA-WES is a psychometrically sound measure of 5 components of the PCA practice environment in the acute care setting and is sufficiently reliable and valid for use as independent subscales in healthcare research.

Commonalities of nurse-designed models of health care.

The American Academy of Nursing has identified examples of care redesign developed by nurses who address the health needs of diverse populations. These models show important clinical and financial outcomes as summarized in the Select Edge Runner Models of Care table included in this article. A study team appointed by the Academy explored the commonalities across these models. Four commonalities emerged: health holistically defined; individual-, family-, and community-centric approaches to care; relationship-based care that enables partnerships and builds patient engagement and activation; and a shift from episodic individual care to continuous group and public health approaches. The policy implications include examining measures of an expanded definition of health, paying for visionary care, and transparency and rewards for community-level engagement.

Content validation of the nursing diagnosis "Insufficient breast milk production (00216)".

PURPOSE: To review and validate the elements of the nursing diagnosis (ND) "Insufficient breast milk production" (00216) based on the literature and expert consensus, and to construct operational definitions (ODs) for its defining characteristics (DCs). METHODS: It is a methodological study carried out in two phases. In the first phase, a scoping review was conducted, and in the second, a committee of experts reviewed the elements' content. Items with a Content Validity Index ≥0.8 were validated for relevance, clarity, and precision. Discussions were conducted until a consensus was reached on all items and criteria evaluated. The Ethics Committee approved the study. FINDINGS: The final scoping review sample consisted of 61 articles, and 19 experts evaluated the content of the ND. All DCs were revised. Three at-risk populations, three associated conditions, and one related factor were added. Three elements had their category changed, and an element was deleted. Experts also validated ODs developed for all DCs. CONCLUSION: "Insufficient breast milk production (00216)" was validated by experts. This study improved the ND through literature and expert consensus. New elements were added, and existing ones were revised. IMPLICATIONS FOR NURSING PRACTICE: This study improves this ND based on scientific evidence and clinical expertise and potentially improves nurses' diagnostic accuracy through ODs.

OBJETIVO: Revisar e validar os elementos do Diagnóstico de Enfermagem "Produção insuficiente de leite materno (00216)", com base na literatura e no consenso de especialistas, e construir definições operacionais para suas características definidoras. MÉTODO: Estudo metodológico realizado em duas fases. Na primeira fase foi realizada uma revisão da literatura e na segunda um comitê de especialistas revisou o conteúdo dos elementos. Os itens com Índice de Validade de Conteúdo ≥ 0,8 foram validados quanto à relevância, clareza e precisão. As discussões foram conduzidas até que se chegasse a um consenso sobre todos os itens e critérios avaliados. O estudo foi aprovado por Comitê de Ética em Pesquisa. RESULTADOS: A amostra final da revisão foi composta por 61 artigos e 19 especialistas avaliaram o conteúdo do diagnóstico de enfermagem. Todas as características definidoras foram revisadas. Foram acrescentadas três populações de risco, três condições associadas e um fator relacionado. Três elementos tiveram sua categoria alterada e um elemento foi excluído. Os especialistas também validaram as definições operacionais desenvolvidas para todas as características definidoras. CONCLUSÃO: "Produção insuficiente de leite materno (00216)" foi validado por especialistas. Este estudo melhorou o diagnóstico de enfermagem por meio da literatura e do consenso de especialistas. Novos elementos foram adicionados e os existentes foram revisados. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: Este estudo melhora o diagnóstico de enfermagem estudado com base em evidências científicas e experiência clínica, assim como tem potencial para melhorar a precisão diagnóstica dos enfermeiros por meio do desenvolvimento de definições operacionais.

Identification of the psychometric properties of the leadership influence over professional practice environments scale.

This study uses the qualitatively developed Adams influence model (AIM) and concepts from the psychometrically validated revised professional practice environment scale to guide the development of the leadership influence over professional practice environments scale. Nurse executives and others can use this scale individually or in conjunction with instruments targeting staff or patient perceptions of their influence as part of health services research, leadership development, and professional practice environment enhancement strategy.

The American Academy of Nursing 50th Anniversary of the Nursing Theory Guided Practice Expert Panel (NTGPEP): Exploring the Past-Re-envisioning the Future.

The Nursing Theory-Guided Practice Expert Panel (NTGP-EP), one of the 14 Expert Panels, is officially designated to advance the mission and strategic goals of the American Academy of Nursing. The NTGP-EP has created a forum for dialogue among nurse scholars interested in advancing nursing theory to promote health and wellbecoming. The purpose of this paper is to share the important work of the NTGP-EP and its history, contributions, and accomplishments, and to propose a member-driven agenda to re-envision our preferred future and the impact of the use of nursing theory to guide nursing education, research, practice, and policy.

Evaluation of basic arrhythmia knowledge retention and clinical application by registered nurses.

The purpose of this descriptive study was to evaluate knowledge retention over time and clinical application of basic arrhythmia knowledge following exposure to an orientation program. Data showed significant differences in knowledge retention at 4 weeks and clinical application in rhythm identification using simulation at 3 months.

An integrative review of comprehensive nursing assessment tools developed based on Gordon's Eleven Functional Health Patterns.

PURPOSE: To evaluate the content and psychometric properties of comprehensive nursing assessment tools developed based on The Eleven Functional Health Patterns Assessment Framework. METHODS: An integrative literature review following Whittemore and Knafl's method and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Searches on PubMed, Cinahl, and Virtual Health Library were conducted between September and December 2018. FINDINGS: Six out of 146 records were included for review. Four articles were methodological studies and two were descriptive reports of the development of the tools. Tools were heterogenous in terms of their purpose, development, characteristics, and testing. Only one study provided data about construct validity. However, there were commonalities regarding the data that should be assessed in each tool. CONCLUSIONS: Few comprehensive nursing assessment tools using The Eleven Functional Health Patterns Assessment Framework are available. Purpose, process of development, characteristics, and testing varied among the tools, and most lack robust psychometric testing. IMPLICATIONS FOR NURSING PRACTICE: This review provided a synthesis of the literature regarding the use of a discipline-specific framework to guide comprehensive nursing assessment. The differences across the tools and the lack of psychometric testing compromise the visibility of nursing and make it difficult to emphasize the contribution of nursing knowledge to patient care.

OBJETIVO: Avaliar o conteúdo e as propriedades psicométricas de instrumentos compreensivos de coleta de dados de enfermagem desenvolvidos com base no modelo dos Onze Padrões Funcionais de Saúde. MÉTODO: Revisão integrativa da literatura que seguiu o método de Whittemore e Knafl e os Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Realizou-se buscas no PubMed, Cinahl e Biblioteca Virtual em Saúde entre Setembro e Dezembro de 2018. RESULTADOS: Seis das 146 citações recuperadas foram incluídas na revisão. Quatro artigos eram estudos metodológicos e dois eram relatos descritivos do desenvolvimento dos instrumentos. Os instrumentos eram heterogêneos em termos de finalidades, desenvolvimento, características e teste. Apenas um estudo forneceu dados sobre a validade de constructo. Entretanto, os instrumentos partilham de aspectos em comum em relação aos dados que devem ser coletados. CONCLUSÕES: Poucos instrumentos de coleta de dados de enfermagem que utilizam o modelo dos Onze Padrões Funcionais de Saúde estão disponíveis. Finalidades, processo de desenvolvimento, características e testagem dos instrumentos variaram entre os instrumentos. Para a maioria deles não há evidências psicométricas robustas de validade. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: Esta revisão forneceu uma síntese da literatura em relação ao uso de um modelo específico da disciplina para nortear a coleta compreensiva de dados de enfermagem. As diferenças entre os instrumentos e a falta de evidências psicométricas de validade comprometem a visibilidade da enfermagem e tornam difícil destacar a contribuição específica da enfermagem no cuidado do paciente.

An evidence-based structure for transformative nurse executive practice: the model of the interrelationship of leadership, environments, and outcomes for nurse executives (MILE ONE).

Identifying and measuring success within the chief nurse executive (CNE) population have proven complex and challenging for nurse executive educators, policy makers, practitioners, researchers, theory developers, and their constituents. The model of the interrelationship of leadership, environments, and outcomes for nurse executives (MILE ONE) was developed using the concept of consilience (jumping together of ideas) toward limiting the ambiguity surrounding CNE success. The MILE ONE is unique in that it links existing evidence and identifies the continuous and dependent interrelationship among 3 content areas: (1) CNE; (2) nurses' professional practice and work environments; and (3) patient and organizational outcomes. The MILE ONE was developed to operationalize nurse executive influence, define measurement of CNE success, and provide a framework to articulate for patient, workforce, and organizational outcome improvement efforts. This article describes the MILE ONE and highlights the evidence base structure used in its development.

Interdisciplinary Institute for Patient Care: advancing clinical excellence.

Healthcare leaders are searching for ways to create new synergies and efficiencies in today's complex health environments to enhance patient care, education, and research and nurture collaborative and rewarding professional practice environments. The authors discuss how the creation of a multidisciplinary Institute for Patient Care is an important innovation that is helping us achieve these aims.

Thoughts About Nursing Curricula: Dark Clouds and Bright Lights.

In this essay, several nurse scholars who are particularly concerned about the contemporary state of nursing science present their concerns about the inclusion of nursing conceptual models and theories in the curricula of nursing programs (dark clouds) and ways in which the concerns have been addressed (bright lights). This essay is the second of two essays that were catalyzed by Barrett's paper, "Again, What Is Nursing Science?" The first essay was published in the previous issue of Nursing Science Quarterly.

Expanding consciousness in nursing education and practice. Interview by Pamela Clarke.

This column focuses on the importance of Newman's work for the future of nursing and healthcare. Dorothy Jones takes a strong position that nursing science should be a driving force in the healthcare arena in today's world. Implications for education are addressed.