Medical emergency kits in ambulatory care clinics.

Implementation and staff perceptions of usability and feasibility.

Continuing the Creativity and Connections: The Massachusetts Initiative to Update the Nurse of the Future Nursing Core Competencies.

AIM: This article describes the collaborative effort of nursing education and practice to update the Massachusetts Nurse of the Future Nursing Core Competencies. BACKGROUND: The Nurse of the Future Nursing Core Competencies were published in 2010. With the establishment of the Massachusetts Action Coalition, a primary goal was to continue to promote the integration of these competencies into all education and practice settings throughout Massachusetts and share this process with other states. METHOD: Through an updated literature review and consultation with subject matter experts, the Nurse of the Future Competency Committee developed a process to ensure that significant practice advances were reflected in each of the competencies. RESULTS: The updated Nurse of the Future Nursing Core Competencies were published in March 2016. CONCLUSION: The updated competencies capture the knowledge, attitudes, and skills needed for all nurses to create a culture of health across the continuum of health care.

Enhancing safety reporting in adult ambulatory oncology with a clinician champion: a practice innovation.

This article examines whether a patient safety "champion" on an ambulatory chemotherapy infusion unit can increase reporting of adverse events and close calls. Reporting rates increased substantially on both intervention and control units. It was accompanied by more reports of medical errors and conditions that worried staff and fewer reports of service quality incidents. The facilitated reporting method described here is a novel approach to incident reporting, complements the spontaneous reporting systems used in hospitals and some ambulatory care settings, and may help to build a safety culture. By identifying errors and worrisome conditions, it may help managers identify problems before they lead to harm.

Reshaping the practice environment: the importance of coherence.

Today's nurse leader is challenged to create a practice environment that fosters multidisciplinary collaboration, professional development, and a culture of safety. Fostering a sense of coherence among staff nurses about their place within the nursing department and the department's place within the broader organization id essential to the development of such environments. When nurses have a sense of coherence about their work setting, they are more likely to feel confident that their care of patients and families is fully supported by the organization in which they work. The authors describe the concept of coherence, discuss findings from a preliminary study regarding attributes that may contribute to coherence in individual nurses, and describe systems ans programs that have been implemented in a large academic medical center to foster a sense of coherence in individual nurses, the nursing department, and the institution as a whole.

Collaboration among nurse executives in complex environments: fostering administrative best practice.

In the past decade, many healthcare institutions have formed new partnerships, alliances, and networks. Collaboration among chief nursing officers and other leaders from affiliating institutions is essential to the success of these new organizational structures. The authors explore the nature of the collaboration among chief nursing officers and senior nurse leaders at 5 Harvard-affiliated teaching hospitals that provide cancer care. In particular, this article examines how collaborative relationships have been fostered and highlights the challenges, benefits, and outcomes of successful cross-institutional collaboration.

Making patient-centered care come alive: achieving full integration of the patient's perspective.

A patient-centered model of care has profound implications for the way that care is planned, delivered, and evaluated. Although most leaders in healthcare organizations today embrace the basic tenets of a patient-centered philosophy, they often find that moving toward a patient-centered model requires an unanticipated level of commitment and significant adjustments in organizational structures. In this article, the authors describe how patients and families have been integrated into the care delivery model by involving them in planning, decision-making, and improvement processes at all levels of the organization.