Part 1: Evidence-based facility design using Transforming Care at the Bedside principles.

An academic hospital used Transforming Care at the Bedside (TCAB) principles as the framework for generating evidence-based recommendations for the design of an expansion of the current hospital. The interdisciplinary team used the table of evidence-based data to advocate for a patient- and family-centered, safe, and positive work environment. A nurse project manager acted as liaison between the TCAB design team, architects, and facilities and design consultants. Part 2 of this series describes project evaluation outcomes.

Nurse manager perceptions of role satisfaction and retention at an academic medical center.

OBJECTIVE: The aim of this study was to explore the perceptions of inpatient acute care nurse managers (NM) employed at an academic Magnet® hospital about factors that influence NM retention, including current work environment, satisfaction, work-life balance, sucssful NM traits, and personal development and educational needs. BACKGROUND: Nurse managers are challenged with increased workloads impacting their ability to implement all role components. METHODS: A qualitative descriptive study design used focus group methodology to explore perceptions of the NM role. RESULTS: Nurse managers identified staff recognition, support, peer relationships, collaboration, and ability to make positive change as factors influencing their decision to remain in the role. Burnout factors included workload issues, work-life imbalance, and difficulty sustaining positive relationships. Traits supporting success were communication, resiliency, integrity, and a visionary outlook. Suggestions for NM development and education were identified. CONCLUSIONS: Findings can be used to improve NM satisfaction, work-life balance, recruitment, retention, and succession planning.

Factors affecting nurse retention at an academic Magnet® hospital.

OBJECTIVE: : The aim of this study was to examine the factors affecting the retention of registered nurses (RNs) and validate the revised Casey-Fink Nurse Retention Survey (2009). BACKGROUND: : Creating an organizational culture of retention may reduce nurse turnover. Focusing on why nurses leave and identifying factors why nurses stay are essential. METHODS: : A descriptive survey design gathered data from RNs with 1 or more years of experience providing direct patient care and employed in inpatient/ambulatory settings in an acute care, academic, Magnet hospital. CONCLUSIONS: : There were no statistically significant relationships between nurse respondents' perceptions of work environment/support/encouragement and age or years of experience. However, there were significant differences between inpatient and ambulatory nurse responses in several key areas including job satisfaction, mentorship, and educational support. Overall, nurses reported feeling a lack of support and recognition from managers. Results provide evidence to support improved strategies to foster nurse retention.

The impact of dry versus moist heat on peripheral IV catheter insertion in a hematology-oncology outpatient population.

PURPOSE/OBJECTIVES: To determine whether dry versus moist heat application to the upper extremity improves IV insertion rates. DESIGN: Two-group, randomized, controlled clinical design. SETTING: An academic cancer infusion center in the western United States. SAMPLE: 136 hematologic outpatients with cancer or other malignancies. METHODS: Participants were randomly assigned to dry or moist heat with warmed towels wrapped around each patient's arm for seven minutes prior to IV insertion. Skin and room temperatures were monitored pre- and postwarming. Two experienced chemotherapy infusion nurses performed the venipunctures according to protocol. Outcomes were examined using variance analysis, with 34 patients for each combination of nurse and heat type. MAIN RESEARCH VARIABLES: Number of IV insertion attempts, time to achieve IV insertion postheating, patient anxiety levels pre- and postheating, and patient comfort. FINDINGS: Dry heat was 2.7 times more likely than moist heat to result in successful IV insertion on the first attempt, had significantly lower insertion times, and was more comfortable. Heat type had no effect on patient anxiety. CONCLUSIONS: Dry heat application decreases the likelihood of multiple IV insertion attempts and procedure time and is comfortable, safe, and economical to use in an outpatient oncology setting.