Strengthening frontline nurse investment in organizational goals.

Frontline nurses are foundational to any organizational goal concerning patient care. In addition, healthcare delivery reform has supported the formalization of specific goals that hospitals must advance to stay financially viable and to deliver high-quality care. As a result, goals for frontline staff are continuously evolving. Frontline nurses must demonstrate a commitment not only to delivering excellent patient care but also to advancing larger institutional performance. The authors discuss a framework for nurse executives to help organizations achieve enhanced nurse investment in organizational goals.

Utah youth suicide study, phase I: government agency contact before death.

OBJECTIVE: To delineate the probability of contact between government agencies and youths who complete suicide, to investigate the nature of those contacts, and to identify new risk factors for suicide. METHOD: A descriptive epidemiological analysis of data from multiple Utah government agencies on consecutive youth suicides (n = 151) between August 1, 1996, and June 6, 1999, aged 13-21 years. Data were collected from four government agencies: Office of the Medical Examiner, Juvenile Justice, Department of Human Services, and the Department of Education. RESULTS: Utah descriptive data were similar to national statistics, with the majority of completers being male (89%) and firearms the most common method of suicide (58%). The data demonstrated an association between youth suicide and contact with Juvenile Justice. Sixty-three percent of youths who completed suicide in Utah had contact with Juvenile Justice, and there was a direct correlation between number of referrals and increased suicide risk. Suicide completers had multiple minor offenses over many years. A significant minority of school-age subjects could not be located within the school system. Few suicide completers had evidence of active psychiatric treatment. CONCLUSIONS: Juvenile Justice is identified as a novel site for the screening and identification of youths at risk for suicide.