Using clinical models to frame outcomes evaluation: the Arizona Nurses' Association Nursing Report Card Project.

The American Nurses Association (ANA) inaugurated Nursing's Safety and Quality Initiative in 1994. This multiphased initiative provides a framework for the application of the Nursing Care Report Card for Acute Care that aims to evaluate the nature and strength of the linkages between nursing care and nursing-sensitive quality indicators in the acute care setting. Arizona is one of six states participating in this investigation. This article describes the development of the Arizona Nurses' Association (AzNA) Nursing Report Card Project and associated model.

Transitions in nursing leadership roles.

Today's turbulent, chaotic health care environment necessitates dramatic changes in the roles of nurse executives. These role changes are rapidly being cast upon individuals who are pressured to react, accept, and adapt quickly. Previously successful leadership styles no longer serve nurse executives as they assume nonoperational roles without line authority and power. No prescriptive strategies will be effective to assist nurse leaders in their new roles. One nurse executive's story of her own journey will be shared to illustrate how she is creating a successful transition.

Implementing clinical paths in a managed care environment.

The survival of health care institutions depends upon a delivery system focusing on appropriate use of resources and controlling length of stay while monitoring clinical progress toward identified outcomes. Using a clinical path as a tool for managing resources, research activities, continuous quality improvement, and increased collaborative practice can enhance the professional practice environment and benefit patient care.