Mitigating Knowledge Loss: A Strategic Imperative for Nurse Leaders.

With the aging of the nursing workforce and expected retirement of large numbers of experienced nurses in the next decade, mitigating the impact that lost knowledge will have on organizational performance and patient outcomes is critical. The authors raise awareness of the problem, summarize observations procured from hospital nurse executive regarding approaches for knowledge transfer through workforce development, and pose proactive strategies for nurse leaders who can provide direction to offset the issue before it becomes a crisis.

Experienced nurse retention strategies: what can be learned from top-performing organizations.

Pursuit of high-quality care depends, in part, on hospital leaders' ability to retain an experienced RN workforce. Yet, 55% of nurses plan to retire between 2011 and 2020, heightening the need to identify proven retention strategies. Findings from 7 case studies conducted at hospitals and nonhealthcare organizations publicly recognized for success retaining experienced employees are summarized. The authors conclude that although the mix of retention strategies varies, all top-performing organizations share common success factors.

Commentary: experienced RN retention strategies: what can be learned from top-performing organizations.

The authors provide commentary on the article, "Experienced Nurse Retention Strategies: What Can Be Learned From Top-Performing Organizations," also in this issue by authors Hirschkorn, West, Hill, Cleary, and Hewlett.

Race, stability of health insurance coverage, and prescription medication use.

OBJECTIVE: To determine the effects of health insurance and race on prescription medication use and expense. METHODS: An observational, non-experimental design was used. Multivariable regression analyses were conducted to evaluate the independent effects of health insurance status and race on prescription medication use and expense while controlling for sociodemographic, geographic, and health status characteristics. The sample consisted of 19,035 participants in the 1996 through 2003 Medical Expenditure Panel Survey. FINDINGS: European Americans spent about $300 to $400 more and used three to four more prescriptions annually compared to other racial groups. Prescription medication expenses increased as time spent uninsured increased. Participants with part-year coverage filled four fewer prescriptions than those with full-year health insurance coverage. Participants with private coverage spent less on prescription medications compared to those with public and those with dual public and private coverage ($1,194 vs. $1,931 and $2,076, respectively; p < or = 0.001). CONCLUSIONS: Significant racial and health insurance status disparities in prescription medication use and expenses exist after controlling for sociodemographic, geographic, and health status characteristics.

Investing in Nursing's Future.

Nursing leaders continue to struggle with capacity issues in both clinical and academic settings-particularly those related to aging patient and nurse populations and the increasing complexity of health care in general. Programs and resources for formal mentoring have primarily focused on mid- and advanced-career RNs, but there is an imperative to develop methods of expertly mentoring "professionally younger" RNs across all settings and roles. In 2017, the American Nurses Association (ANA) conducted an extensive member needs assessment with more than 15,000 respondents. Three distinct career-stage categories were identified: early-career nurses, up-and-comers, and nursing leaders. The early-career nurses and up-and-comers listed "being mentored" among their top two member benefit requests. In response, the ANA launched a national virtual mentorship program in September 2018. The program aligned with criteria, recommendations, and charges from the American Nurses Credentialing Center's 2019 Magnet Recognition Program; the landmark 2010 report from the Institute of Medicine (IOM), The Future of Nursing: Leading Change, Advancing Health; and a 2019 IOM consensus study, The Future of Nursing 2020-2030. This article provides a general overview of the program, including evaluation and modifications, and discusses implications of using the ANA's career-stage categories in virtual mentoring.

Mitigating knowledge loss: a strategic imperative for nurse leaders.

With the aging of the nursing workforce and expected retirement of large numbers of experienced nurses in the next decade, mitigating the impact that lost knowledge will have on organizational performance and patient outcomes is critical. The authors raise awareness of the problem, summarize observations procured from hospital nurse executive regarding approaches for knowledge transfer through workforce development, and pose proactive strategies for nurse leaders who can provide direction to offset the issue before it becomes a crisis.

Geospatial information technology: an adjunct to service-based outreach and education.

This exemplar highlights how geospatial information technology was effective in supporting academic practice, faculty outreach, and education initiatives at the University of Mississippi School of Nursing. Using this cutting-edge technology created a community-based prototype for fully integrating point-of-service research, practice, and academics into a cohesive strategy to influence change within the health care delivery system. This exemplar discusses ways this knowledge benefits practice and curriculum development; informs critical decision making affecting the people we serve; underscores the vital role nurses play in linking this technology to practice; and develops community residents as partners in their own health and that of the community.

Beyond tradition: synergizing intellectual and material capital to forge the new academic-service partnership.

Academic-service partnerships are being touted as a solution to workforce problems. "Traditional" approaches to these partnerships have been directed primarily at academic and hospital institutions for mutual benefit. An expanded model of partnership possibilities is presented through three detailed exemplars that include population health (with descriptors from an Institute of Medicine study addressing the public's health in the 21st century), public-private ventures (public institution with faith-based and community agencies), and nursing-corporate opportunities (academia and a proprietary information technology corporate supplier). The benefits of these expanded partnerships and the criteria for selecting a partnership sensitive to the scholarship of practice and the mission/purpose/goals of each partnering organization is highlighted.

Analysis of the nursing workforce crisis: a call to action.

In our integrative review of reports on the health care workforce shortage, we examined 15 reports that focused primarily on nursing and were conducted by various stakeholders. We studied these reports objectively, identifying problems and solutions as described by the authors, which we then categorized by theme. We found problems at both the national and institutional levels and noted that the reports contained similar problem and solution "themes." Yet we also found gaps between these-some problems had no solutions and some solutions didn't address any of the suggested problems. Gaps occurred among problems and solutions listed in the following theme categories: demand, health care economics, workforce planning, research and data support, and technology. Despite the urgent need, we still lack a national strategy designed to avert the nursing shortage. This review may provide a foundation for such a plan.We present the results of our analysis and our recommendations to the federal government and national organizations, to institutions, and to nurses. These recommendations don't provide a comprehensive strategy for averting the nursing shortage, but they do offer a basis upon which one may be created.

Dissipating the perfect storm - responses from nursing and the health care industry to protect the public's health.

This article summarizes the major national workforce reports and references the need for a tiered and comprehensive approach to avert the imminent nursing shortage crisis. Since 2002, commendable efforts have been made to increase supply, respond to current demand, and enhance the working environment to benefit recruitment and retention. Four areas are highlighted as exemplars of effort: supply and demand; work environment; new partnerships and public/private ventures; and patient-centered and essential patient-safe care.

Grassroots coalition building: lessons from the field.

In an era of major health care reform, nursing professionals will best impact both the politics surrounding reform as well as related health policy through well-established and effective collaborative groups. Whether the work is taking place at the local, state, or national levels, successful and powerful coalitions are the result of skill and finesse-not luck-and therefore must be built upon connecting with the right people, communicating effectively, understanding political challenges, and navigating them skillfully. The authors offer 10 success strategies for building successful coalitions based on lessons learned over a decade of involvement in grassroots nursing workforce initiatives.

Changing times: the role of academe in health reform.

What is the role of nursing educators in the politics surrounding health reform? This critical question is posed, and exemplars of how nurse faculty can and should become more involved in the political arena are shared. The authors issue a call to action for every nurse educator in the country to become actively engaged in health reform discussions to bring this all-important perspective to the table. Recognizing and overcoming traditional roles and barriers for nurse faculty on university campuses are essential parts of the political activism that must be assumed. Opening the doors for increased patient access will result in higher utilization of health care providers, and if the nursing shortage is not abated, then bottlenecking of qualified students in programs with critical faculty shortages will create immense pressure in an overloaded care delivery system. The full impact of legislated health reform changes on academe may not be fully realized until after the fact-and as often experienced in the past, this may come too late for policy makers to adequately address questions that should have been raised by the faculty corps beforehand. The time to get involved is now.