Richard Hader Visionary Leader Award 2023 Visionary Leader Linda Casey.

The following manuscript is the winning 2023 Richard Hader Visionary Leader Award entry submitted to Nursing Management in recognition of Linda Casey, MHA, BSN, RN, OCN, NE-BC, director of nursing and operations and former director of nursing patient care for infusion at the John Theurer Cancer Center (JTCC) at Hackensack University Medical Center (HUMC) in Hackensack, N.J.

Compassion Fatigue Resiliency Program Effects on Oncology-Hematology Nurses' Professional Quality of Life, Stress Levels, and Patients' Care Satisfaction: Nurse, Nurse Manager, and Patient Perspectives, a Mixed-Methods Study.

OBJECTIVES: This study aimed to evaluate the effects of the Compassion Fatigue Resiliency Program applied to oncology-hematology nurses on the professional quality of life and stress levels of nurses, on the satisfaction of cancer patients, and on the perspectives of nurse managers. DATA SOURCES: An experimental embedded mixed-methods design was conducted between December 20, 2022, and February 20, 2023. The study included 15 oncology-hematology nurses, 19 cancer patients, and 6 nurse managers. Qualitative interviews were conducted with patients and pre-tests were applied to patients and nurses. The Compassion Fatigue Resiliency Program was implemented for the nurses. Then qualitative interviews were repeated with the same patients; focus group interviews were conducted with the nurse managers; post-tests were applied to patients and nurses who participated in the training; and narrative feedback was collected. Quantitative data analysis was carried out using the Wilcoxon signed-rank test. Qualitative data were processed using an inductive approach to thematic analysis. CONCLUSION: Compassion satisfaction decreased after the Compassion Fatigue Resiliency Program. Qualitative results showed that the training program improved nurses' effective communication skills and ability to cope with stress. The program improved nurses' approach to patients and communication, and patients' care satisfaction levels increased. IMPLICATIONS FOR NURSING PRACTICE: The Compassion Fatigue Resiliency Program should be included in hospital in-service training programs and implemented and sustained. With this, compassion fatigue of nurses can be reduced or prevented, which will help to avoid the nurse shortages that already existing and increasing.

Exploring the telehealth readiness and its related factors among palliative care specialist nurses: a cross-sectional study in China.

BACKGROUNDS: The majority of Chinese people who are nearing the end of their lives prefer to receive home-based palliative care. Telehealth, as a new service model, has the potential to meet the increasing demand for this service, especially in remote areas with limited resources. However, nurse-led telehealth-based palliative care services are still in the pilot implementation phase. Assessing the telehealth readiness among palliative care specialist nurses and identifying associated factors is crucial to facilitate the successful implementation of telehealth services. Therefore, this study aimed to examine TH readiness and its related factors among Chinese palliative care specialist nurses. METHODS: Four hundred nine Chinese palliative care specialist nurses from 28 provinces or municipalities participated in this study between July and August 2022. The Chinese version of Telehealth Readiness Assessment Tools (TRAT-C), and Innovative Self-Efficacy Scale (ISES-C) were used to assess the degree of TH readiness and the levels of innovative self-efficacy. RESULTS: The total score of the TRAT-C was 65.31 ± 9.09, and the total score of ISES was 29.27 ± 5.78. The statistically significant factors that influenced telehealth readiness were the experience of using telehealth platforms or services, the willingness to provide telehealth to patients, and the level of nurses' innovative self-efficacy. The innovative self-efficacy is positively correlated to telehealth readiness (r = 0.482, P < 0.01). These related factors could explain 27.3% of the difference in telehealth readiness. CONCLUSION: The telehealth readiness of Chinese palliative care specialist nurses are at a moderate level. Measures such as providing incentives to promote nurses' innovation self-efficacy by nurse managers, and establishing a comprehensive telehealth training system for palliative care specialist nurses should be taken to facilitate the implementation of telehealth services in the field of palliative care.

Experiences of early-career nurses working in specialist adolescent/young adult cancer units: A narrative inquiry.

AIM: To explore the experiences of early-career registered nurses working in specialist adolescent/young adult cancer units. DESIGN: Narrative Inquiry. METHODS: A purposive sample of nine early-career registered nurses from six specialist adolescent/young adult cancer units in the United Kingdom participated in online in-depth narrative conversations between October 2020 and January 2021. Data were analysed thematically using Clandinin and Connelly's (2000) metaphorical three-dimensional narrative inquiry approach focussed on commonplaces of temporality, sociality and place. RESULTS: The intensity and complexity of the nursing work associated with young patients and their families, over protracted periods, impacted the nurses personally and professionally. The similarity of age between patients and nurses was shown as having benefits as well as posing risks. The complexity of four types of nursing labour was highlighted: emotional, cognitive, physical and organizational providing justification for the provision of specialist training and support. CONCLUSION: This study presents unique insights into the complex work of early-career nurses in specialist units that reveal challenges in caring for the distinct needs of this cancer patient population. IMPACT STATEMENT: Better understanding of the experience of adolescent/young adult nursing work is revealed. Nurse managers could use these findings to consider the level of expertise on cancer units and ensure a spread of ages and experience. Managers and funders should also consider the clinical supervision and well-being needs of nurses so that they can thrive in these unique environments. Educators could use findings to develop curricula and reinforce messages of self-care, reflection and boundary management. The findings of this study may be transferable to other areas where early-career nurses care for younger age groups. PUBLIC AND PATIENT ENGAGEMENT AND INVOLVEMENT IN RESEARCH STATEMENT: No patient or public contribution was requested or required as this research wanted to examine nurses' experiences and not those of patients or the public.

Recalibrate Your Leadership Lens for Nurse Retention: An Interview With Christopher R. Friese.

In this column, Dr Christopher Friese, PhD, RN, AOCN, Elizabeth Tone Hosmer Professor of Nursing, Health Management & Policy; Director: Center for Improving Patient and Population Health; and Associate Director for Cancer Control and Population Sciences at the University of Michigan, discusses undergraduate experiences that shaped his nursing career trajectory, how maintaining a deep footprint in practice influences his research, nurse retention, and appreciation for nurse leaders.

Effectiveness of a case management model for people with multimorbidity: Mixed methods study.

AIMS: The aim was to determine the impact of a case management model on indicators of health service utilization, polypharmacy, quality of life and dependency of patients with multimorbidity, and family caregiver overload in a group of patients insured with two insurance companies in the city of Bogotá (Colombia). DESIGN: This was a mixed methods study, which integrated a quantitative and qualitative component. METHODS: The study was conducted between July 2019 and March 2020. A quantitative component is based on a pre-experimental study with a single group and pre- and post-test measurements. Patients with multimorbidity with a medium or high level of complexity were included in the study. A sample of 317 patients and their caregivers was estimated. Following the completion of the intervention, a descriptive study that explored the perspective of nurses, patients and caregivers was developed to better understand the process and results from their own words and experience. A total of 17 dyads of patients and caregivers were interviewed, as well as six nurse managers. The integration strategy was developed based on a comparison made from the perspective of multiple stakeholders. RESULTS: The model's impact on quality of life, particularly in terms of social functioning and mental health, has been documented. Caregiver overload was reduced and an improvement in the adoption of the role was observed, aspects that converge with the experience of the dyads and the caregivers in the support and backing provided by the model. CONCLUSION: The intervention was structured in five modules: case detection, complexity screening, comprehensive assessment with various instruments, individualized care and follow-up plan, and plan assessment. The nurse manager role is confirmed as that of a professional with the leadership capacity to articulate disciplines and actors, whilst also dealing with the day-to-day needs of people with complex health conditions. IMPACT: A comprehensive and integrated approach to patients with multiple diseases in a health insurance context marked by access barriers and fragmentation of health services. The study provides quantitative and qualitative evidence of the benefits of the case management model in Colombia for patients with multiple diseases and their family caregivers, particularly in terms of the psychosocial dimensions of health-related quality of life and dependence assessment. A significant impact on the caregiver role, as well as an improvement in perception and trust in the health system, was observed as a result of the overcoming of administrative barriers achieved by the nurse case manager. The findings are considered to be extremely useful for decision-makers and insurers in developing a case management model focused on comprehensive and individualized care plans, as well as for individuals with multiple diseases and their caregivers.

Nurse-Led Telehealth Interventions During COVID-19: A Scoping Review.

Since the outbreak of COVID-19, telehealth expanded rapidly and was adopted as a substitute for in-person patient and nurse visits. However, no studies have mapped nurse-led telehealth interventions during the pandemic. This study aimed to identify and summarize the strengths and weaknesses of nurse-led telehealth interventions for community-dwelling outpatients during the COVID-19 pandemic. This study used a scoping review methodology and was guided by the Preferred Reporting Items for Systematic Reviews and Meta-analyses Scoping Review Extension. Five electronic databases were searched to find studies published in English peer-reviewed publications between January 2020 and February 2022. A total of 490 articles were retrieved, of which 23 empirical studies were selected based on the inclusion/exclusion criteria. Primary studies from nine countries with a variety of research designs were included. Four strengths and three weaknesses of nurse-led telehealth interventions for patients during COVID-19 were identified. For telehealth services to provide effective, efficient, and quality patient care, future research and nursing practice need to overcome the identified weaknesses of current nurse-led telehealth interventions. More rigorous evidence-based research and updated and standardized guidelines for nurses' telehealth services will help improve the quality of patient care. Nurse managers, leaders, and policymakers can use the findings of this scoping review to refine the current telehealth services system.

Quality indicators of colonoscopy care: a qualitative study from the perspectives of colonoscopy participants and nurses.

BACKGROUND: Quality of care in colonoscopy is closely related to colonoscopy participants and the nursing workforce in endoscopy-related settings. However, limited data are available on the evaluations and recommendations regarding quality indicators for nursing care by these two groups. Therefore, the aim of this study was to explore the standards and requirements of quality of care in colonoscopy from the perspectives of patients and nurses. METHOD: With a descriptive qualitative study, semi-structured interviews were conducted between November 2021 and January 2022 with colonoscopy participants (P = 11) and nursing workforce (N = 7) in the endoscopy unit in a tertiary hospital. The interviews were analyzed using a thematic analysis. RESULTS: Nine major themes emerged according to the structure, process, and outcome care quality model: workforce structure, quality requirements, unit facilities, nursing tools, nursing quality control systems, dynamic assessment and intervention, pre-examination care, strengthening education, and colonoscopy outcomes. CONCLUSION: The indicator of quality of colonoscopy care should be used to assess and improve current practices to ensure a more direct and sustained impact of colonoscopy care. This study highlights the importance of nurse managers valuing the opinions and reflections of people involved in colonoscopy to improve the quality of colonoscopy care.

Data-driven clinical improvement: Oncology nurse leaders' perceptions and experiences of organisational data reports.

AIM: To elicit oncology nurse leaders' perceptions and experiences of accessing, using and interpreting report data at the unit level, and their suggestions for future reports. BACKGROUND: Nurse leaders are expected to use data reports for decisions about unit-level operations, yet data may be inaccessible, unavailable and lack relevance for improving patient care and unit-level outcomes. METHODS: A purposeful sampling was used to recruit 12 unit-level nurse leaders. Qualitative data were collected through semi-structured interviews and analysed using thematic content analysis. RESULTS: Consistent themes included the lack of accurate, useful and meaningful data specifically related to patient care. Accessibility Challenges, Limits to Applicability and Suggestions for Improvement were the main themes. CONCLUSION: Nurse leaders require real-time data to effectively implement clinical interventions and practice changes for improving unit-level patient care. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse leaders emphasized that their insight into the development of customizable reports is crucial for obtaining meaningful data relevant to the varied unit-level health care setting. Reports targeting unit-level outcomes would provide meaningful data to facilitate clinical improvement where patient care is provided. Improved reports increase the likelihood of their use and the potential for enhancing the quality and safe care outcomes.

Compassionate Practices for Nurse Managers in Colombia / Prácticas de la compasión para enfermeras administrativas en Colombia / Prática da compaixão para enfermeiras administradoras na Colômbia

Objective: To recognize compassionate practices and the obstacles to their use by nurse managers in Colombia. Method: This is a mixed cross-sectional, descriptive, exploratory, international study with an online survey administered in 17 countries. Data were extracted from Colombia with a sample of 69 nurse managers. Quantitative data were analyzed with descriptive statistics, and qualitative data were processed using the Nvivo software and thematic analysis. Results: 90 % women, mainly from a hospital setting (40 %). Compassionate practices in administrative nursing involve four categories: Listening; supporting and recognizing staff individuality; defining compassion practices, needs, and benefits; receiving compassion and complementary views of compassion and administration where the influence of cultural and organizational patterns become obstacles to compassion. Conclusion: For nursing, compassion demonstrates the intentional ability to recognize the singularity of someone else's suffering, understand their needs, offer support, and find solutions based on an understanding of what being human means. These aspects require significant changes at the organizational and health legislation levels to mitigate the obstacles to compassion.

Objetivo: reconocer las prácticas de compasión y sus obstáculos por parte de enfermeras administrativas en Colombia. Método: estudio mixto de tipo transversal, descriptivo, exploratorio e internacional con una encuesta en línea aplicada en 17 países. Fueron extraídos los datos de Colombia con una muestra de 69 enfermeras administrativas. Se analizaron los datos cuantitativos con estadística descriptiva y los datos cualitativos se procesaron con el programa Nvivo y con un análisis temático. Resultados: 90 % mujeres, principalmente del ámbito hospitalario (40 %). La práctica de la compasión en enfermeras administrativas involucra cuatro categorías: escuchar; defender y reconocer la individualidad del personal; definir la práctica de la compasión, las necesidades y las ventajas; recibir compasión y opiniones complementarias de compasión y administración en las cuales la influencia de patrones culturales y organizacionales se presentan como obstáculos a la compasión. Conclusión: la compasión para enfermería demuestra la capacidad intencional de reconocer la singularidad del sufrimiento del otro, comprender sus necesidades, ofrecer soporte y encontrar soluciones desde la comprensión del sentido de lo humano. Estos aspectos requieren cambios significativos a nivel organizacional y de legislación en salud para mitigar los obstáculos con el fin de ofrecer compasión.

Objetivo: reconhecer as práticas de compaixão e seus obstáculos por parte de enfermeiras administradoras na Colômbia. Método: estudo misto de tipo transversal, descritivo, exploratório e internacional, com um questionário on-line aplicado em 17 países. Foram extraídos os dados da Colômbia com uma amostra de 69 enfermeiras administradoras. Foram analisados os dados quantitativos com estatística descritiva e os dados qualitativos foram processados com o programa Nvivo e com uma análise temática. Resultados: 90 % mulheres, principalmente do ambiente hospitalar (40 %). A prática da compaixão em enfermeiras administradoras envolve quatro categorias: escutar, defender e reconhecer a individualidade do pessoal; definir a prática da compaixão, as necessidades e as vantagens; receber compaixão e opiniões complementares de compaixão e administração em que a influência de padrões culturais e organizacionais são apresentados como obstáculos para a compaixão. Conclusões: a compaixão para a enfermagem demonstra a capacidade intencional de reconhecer a singularidade do sofrimento do outro, compreender suas necessidades, oferecer suporte e encontrar soluções a partir da compreensão do sentido do humano. Esses aspectos requerem mudanças significativas no âmbito organizacional e legislativo em saúde para amenizar os obstáculos a fim de oferecer compaixão.

The Inpatient Nursing Leadership Perspective of Using Mobile Technology at the Bedside.

Introducing technology to support patient care in today's complex healthcare organizations can be innovative yet challenging. Managers are often not included in technology decisions that affect their nursing units, and less often is manager insight into the project taken into consideration. Studies that describe the executive-level role and information technology are helpful but not specific to managers' perspectives. The purpose of this project was to identify the factors related to managers' perceptions about the use of mobile technology at the bedside. Mobile technology includes using smartphones for communication and documentation of patient care. Inpatient nurse managers participated in focus groups; semi-structured interview questions were administered. Nurse managers overwhelmingly indicated they should be involved in technology-related projects that affect their units. Nurse managers have a central role in supporting changes that occur with implementing technology and should be involved at the inception of the innovation. Understanding these associated complex factors is necessary to address issues and promote strategies for the successful implementation of mobile technology. Manager inclusion has far-reaching potential as they can serve as sounding boards and conduits to nursing staff, subsequently promoting engagement and adoption of the technology.

How to Support the Nursing Informatics Leadership Pipeline: Recommendations for Nurse Leaders and Professional Organizations.

There is a need for nursing informatics leaders. However, there are not enough people educated and trained in informatics and leadership to fill that need. Therefore, the purpose of this study was to understand how professional organizations and nurse leaders support nursing informatics leadership development. This cross-sectional, descriptive study collected data via a scan of Web sites for eight nursing, informatics, and/or leadership professional organizations; interviews and surveys with nursing informatics leaders within the eight organizations; and a review of Web site, interview, and survey findings by nursing informatics leaders involved in leadership development. We found that nursing informatics leaders and professional organizations can support the nursing informatics leadership pipeline several ways. Examples included mentoring, education/training, and providing opportunities for networking and engagement in leadership roles. To help meet the need for nursing informatics leaders, professional organizations and current leaders can engage in various activities that provide training, education, and experiences for emerging leaders.

Levels of education and technical skills in registered nurses working in post-anaesthesia care units in Sweden.

BACKGROUND: Specialized nursing care should be provided by nurses working in post-anaesthesia care units to ensure safe and successful recovery after surgery and anaesthesia. However, there is no consensus regarding the competence and education needed by nurses working in post-anaesthesia care units. AIM: The aim of this study is to describe and compare levels of education and technical skills in registered nurses working in post-anaesthesia care units in Sweden, as well as the education that post-anaesthesia care unit nurse managers' desire for registered nurses working in post-anaesthesia care units. METHODS: This descriptive cross-sectional study was conducted in Sweden between September and December of 2019. A web-based survey was developed that included questions about the levels of education and technical skills possessed by registered nurses working in Swedish post-anaesthesia care units and desired by nurse managers for these nurses. The survey was evaluated for content validity by four experts. The survey was distributed to the nurse manager of each studied post-anaesthesia care unit. All nurse managers received written information and were informed that submitting the survey was considered as consenting to participate in the study. RESULTS: Most surveyed nurses held a postgraduate diploma in specialist nursing. Registered nurses performed many tasks autonomously; however, there was a significant difference between specialist nurses and registered nurses, with specialist nurses being more autonomous than registered nurses. Most of the nurse managers (n = 31/45) wanted the registered nurses in their units to have education in postoperative care. The relatively low overall response rate of 58% is a study limitation. CONCLUSIONS: Registered nurses working in post-anaesthesia care units in Sweden must have various technical skills. Some of these skills are only performed by specialist nurses, indicating that postoperative care is an advanced level of nursing care.

American Academy of Nursing Expert Panel consensus statement on nursing's roles in ensuring universal palliative care access.

The purpose of this consensus paper was to convene leaders and scholars from eight Expert Panels of the American Academy of Nursing and provide recommendations to advance nursing's roles and responsibility to ensure universal access to palliative care. Part I of this consensus paper herein provides the rationale and background to support the policy, education, research, and clinical practice recommendations put forward in Part II. On behalf of the Academy, the evidence-based recommendations will guide nurses, policy makers, government representatives, professional associations, and interdisciplinary and community partners to integrate palliative nursing services across health and social care settings. The consensus paper's 43 authors represent eight countries (Australia, Canada, England, Kenya, Lebanon, Liberia, South Africa, United States of America) and extensive international health experience, thus providing a global context for the subject matter. The authors recommend greater investments in palliative nursing education and nurse-led research, nurse engagement in policy making, enhanced intersectoral partnerships with nursing, and an increased profile and visibility of palliative nurses worldwide. By enacting these recommendations, nurses working in all settings can assume leading roles in delivering high-quality palliative care globally, particularly for minoritized, marginalized, and other at-risk populations.

Nursing Informatics in Israel From a Historical Perspective.

The field of nursing informatics is expanding in Israel, which is known as a start-up nation. This study is a systematic literature review aimed to obtain a historical perspective of the Israel's nursing informatics development. To study how nursing informatics has evolved in Israel over the past 20 years, we analyzed two major issues: (1) the development of the nursing informatics field over these years; and (2) nursing informatics studies that were carried out by nurses. The main criteria for choosing these studies were: (1) nursing informatics research conducted in Israel; (2) investigated by nurses; and (3) published in academic international journals, including PhD dissertations. Thirty studies were located, and two main issues were identified: nurse managers who were engaged in health information technology were not recognized as nursing informatics practitioners, and a minority of nurses performed nursing informatics researches. Although many health information technology projects were and are performed in Israel, the nursing informatics field is not fully recognized by Israeli nurses. Therefore, it is essential for Israeli nurses to understand the importance of advancing the nursing informatics body of knowledge, which will give nurses the authorization to become influential as health information technology professionals in areas such as health education, practice, and research-for the benefit of patients.

Nurse coordinator roles in the management of patients with hepatocellular carcinoma: A French national survey.

Hepatocellular carcinoma (HCC) mostly occurs in patients with chronic liver disease (CLD). HCC treatment may have a direct impact on CLD prognosis. HCC management can therefore become complex, involving multiple health care providers, such as oncologists, hepatologists, radiologists, and surgeons. In France, dedicated nurses have been involved in patient care pathways. Their impact is poorly documented. PURPOSE: To determine the country-wide distribution of HCC nurse coordinators in French health care settings and to describe their roles and responsibilities. PATIENTS AND METHODS: A survey using a multi-item questionnaire (including center characteristics, nurse coordinator characteristics, and quality indicators such as patient care pathway initiation timeline, scheduled length of hospital stay, diagnostic disclosure process) was conducted. All French liver cancer centers planning to participate in a prospective national cohort study for patients with HCC (CHIEF Cohort) were invited to take part in the survey. Bivariate analysis compared centers with a nurse coordinator to those without. RESULTS: Among the 42 of 72 centers that replied, 14 treated fewer than 75 HCC patients. Treatment mostly took place in hepatology units (34/42). Sixteen nurse coordinators were part of the health care team in 13 of the 42 centers. Among these 13 centers, 11 were university hospitals and 11 followed more than 75 patients per year. The median number of patients followed in these centers was 300 (min-max 44-600) in 2017. All nurse coordinators were involved in providing patient information and counseling. Other roles included treatment monitoring (13/16), care coordination (12/16), psychological support (12/16) and treatment planning (11/16). Thirteen nurse coordinators conducted diagnostic disclosure nurse consultations; seven conducted initial patient contact consultations; and six held outpatient nurse consultations, with wide heterogeneity between centers. The presence of a nurse coordinator was associated with completion of the full diagnostic disclosure process (p = 0.045). CONCLUSION: In France, nurse coordinators for HCC patient pathway management are present mainly in university hepatology units with a caseload of more than 75 patients per year. All provide patient information and counseling but their roles in care coordination, patient support and holistic assessment are heterogeneous and not standardized.

Challenges for palliative care day services: a focus group study.

BACKGROUND: Palliative care day services provide a safe environment for people with palliative care needs, enabling them to access a range of services while acting as a respite services for family caregivers. Viewed as marginal services, they are often under resourced and under researched. The aim of this study was to understand how palliative day care services contribute to client care from the perspective of management and hospice multidisciplinary teams. METHODS: A descriptive qualitative study, using six focus groups conducted with staff at three United Kingdom hospices in England, Scotland and Northern Ireland. Thirty-five participants were recruited, including management and staff. Discussions were transcribed and analysed thematically. RESULTS: Four key themes emerged: (1) variations of care, beyond heterogeneity of patients; (2) unclear referrals and inconsistent patient population; (3) recognising strengths and challenges and (4) an uncertain future. A major focus of group discussions was the model of care and the benefits of the service, however the importance of demonstrating services' effectiveness and value for money was highlighted. CONCLUSIONS: Management and hospice staff believed day-services to be a helpful introduction to palliative care, providing both social and medical support. Economic pressures and patient demand were influencing them to move from a social model to a hybrid model. Further research is needed to understand the effectiveness of the service.