Renewing the Nursing Culture: Sustaining the Professional Community of Practice Through the Role of the Preceptor.

Culture is the driving frame within which all human action takes form. This article explores the elements and characteristics of culture and applies them to the nursing professional community of practice. As it drills down to the work in the cultural context, it argues for the central role of the preceptor in evidencing the influence of culture. For onboarding nurses and the nursing community, the preceptor becomes the carrier of culture, demonstrating the impact of culture in a way that exhibits its influence and impact on nursing practice and patient care.

A blueprint for nursing innovation centers.

BACKGROUND: The interest in and demand for healthcare innovation has heightened amid the COVID-19 pandemic. Organizations are challenged to balance the goals of daily operations with innovation to stay relevant and compete in the marketplace. Innovation is critical for not only the success and sustainability of organizations, but the well-being of the faculty, staff, and clients they serve. PURPOSE: In this article, we present an overview of several Nursing Innovation Centers in the United States as well as examples of colleges without formal innovation centers but who are addressing innovation in their programs. METHODS: We examined the subjective experience of nursing innovation in seven colleges of nursing using semi-structured intervieweds and thematic analysis. FINDINGS: We discuss four themes for creating an innovation center or innovation focus and six themes important for sustainability and impact. In addition, we provide a working model for these themes and provide lessons learned along with trends and recommendations for the future. DISCUSSION: This information provides guidance and a framework for academic and practice organizations aspiring to create opportunities for innovation to flourish in their institutions. We also encourage leadership to critically evaluate and address biases in faculty hiring, research evaluation, publication practices, educational opportunities and mentoring to overcome the diversity innovation paradox.

Addressing Falls Among Older Oncology Patients Through Complexity Science.

Traditional quality assurance processes provide significant opportunities for positive disruption. Doctor of Nursing Practice (DNP) students are well positioned to apply program learning to large-scale change in complex organizations. This article presents an innovative approach for creating a point-of-care interdisciplinary approach to address high fall risk frequencies in ambulatory oncology clinics using complexity leadership principles. Processes for nurse executives to consider for replication of this approach for other challenging clinical situations are suggested using the emerging competence of DNP educated nurses. Adults with cancer who are older than 65 years are at a higher risk for falls than older adults without cancer. Oncology providers and nurses are not routinely screening, documenting, and preventing falls. A fall injury in an older adult with cancer may not only delay or impact cancer treatment but also result in hospitalization, loss of function, and/or death. Increasing awareness of the impact of falls and implementing change within a large ambulatory health care organization requires an interdisciplinary team approach. Complexity theory supports nonlinear change initiated at the grassroots level to create a dynamic movement to bring forth emergence and adaptation. The use of the Centers for Disease Control and Prevention STEADI (Stopping Elderly Accidents, Deaths, and Injuries) initiative will enable oncology professionals to screen, assess, and intervene by collaborating, communicating, and coordinating with other health care specialists to introduce a fall prevention quality improvement system process. Nurse executives need to know about STEADI.

Quantum Caring Leadership: Integrating Quantum Leadership With Caring Science.

The authors of this article integrate two historically parallel yet disparate fields of nursing, caring science theory and nursing quantum leadership science. Through a nursing, discipline-specific unitary paradigm lens, intersecting principles of caring science and quantum leadership science are uncovered. The result is a model for unitary, discipline-specific, nursing healthcare leadership: Quantum Caring Healthcare Leadership. Ontological congruence is uncovered among the philosophical-ethical-theoretical principles of caring science and the unifying disciplinary structural concepts from quantum leadership. The result is a model for discipline-specific, healthcare leadership. This convergence is potentially theory-generating for both unitary science and healthcare leadership. In this model, both quantum leadership and caring science are transformed and metamorphosed into a new unitary, discipline-specific entity to guide further advancement of knowledge, theory, and discipline-specific healthcare leadership and practice.

Transitional Moments: Reflections on Fulfilling the Professional Role Across a Lifetime.

All leaders require a plan and a template for either transition from a career to another career or retirement. Part of this plan includes receiving transition information from others. Reflections about an individual's career, observations from a career, and insights about strategies to create a rich and robust transition experience are discussed in this article. Also included are suggestions for the "transition receivers," or those benefitting from the experiences and wisdom of others, to optimize their career transitions while recognizing the value of transitioning as a 2-way process and dialogue.

Leading DNP Professionals: Practice Competencies for Organizational Excellence and Advancement.

The doctorate in nursing practice (DNP) role is quickly emerging across the United States in numerous practice settings, especially in hospitals, outpatient services, and academic institutions. There is now a need for guidelines to evaluate the enactment of the standards used to create DNP education and practice, competencies expected in practice, and the outcomes and value created by this role. This article presents a DNP Performance Demonstration and Impact template created on the basis of the AACN (American Association of Colleges of Nursing), NONPF (National Organization of Nurse Practitioner Faculties), and AONE (American Organization of Nurse Executives) standards to assist leaders in evaluating DNP performance from a standards-driven perspective.

Leaving a lasting legacy.

Most nurses have an idea about what they want to do in their profession over the next few years. However, few nurses think about the professional legacy they want to leave behind.

Measurement of Nursing's Complex Health Care Work: Evolution of the Science For Determining the Required Staffing For Safe and Effective Patient Care.

The availability of technology to monitor and manage data increases our ability to better understand the processes and outcomes needed for patient care. It is important to remember this work requires not only the science of data management, but also the art of integrating the multiple variables involved in the dynamic of safe staffing. Fasoli and Haddock (2010) provided an excellent summary of the literature. Nurse leaders must be open to new additions to this work and the possibility that the essential ingredient of the gold standard for patient classification systems (PCS) might still be missing. The goal of a new approach to determine time for nurse work was to advance the science of PCS from the perspective of the characteristics identified by Fasoli and Haddock.

Developing high-level change and innovation agents: competencies and challenges for executive leadership.

The work of health care reform and revolution requires leadership competencies that integrate the digital realities of time, space, and media. Leadership skills and behaviors of command, control, and directing from predigital times are no longer effective, given the impacts of the digital changes. Developing leadership competence in evidence-driven processes, facilitation, collaborative teamwork, and instilling a sense of urgency is the work of today's executive leaders. Ten competencies necessary for contemporary executive leadership are presented in this article.

Changing tides: increasing evidence to embrace a patient classification system.

The effective use of a patient classification system (PCS) in a way that provides value to all health care organizations has yet to be realized given the challenging developmental pathway of these systems. As the science and technology of workforce management emerges along with evidence to support the relationships between nurse work and patient care needs, it is no longer appropriate to rely on systems that provide aggregated and minimal data to address the need for safer patient care and retention of nurses. Specificity about patient care needs in a valid and reliable PCS is essential on our pathway to improved resource utilization, improved decision making, integration of nurse cognitive and knowledge work, and management of variances from planned resource use. Advancements with technology, the ability to create and monitor equitable nurse-patient assignments, conceptual clarity, evidence, regulatory requirements, and professional role development point to a new receptiveness for PCSs.