An Integrative Review of Team Nursing and Delegation: Implications for Nurse Staffing during COVID-19.

BACKGROUND: During the COVID-19 pandemic, providing care for critically ill patients has been challenging due to the limited number of skilled nurses, rapid transmission of the virus, and increased patient acuity in relation to the virus. These factors have led to the implementation of team nursing as a model of nursing care out of necessity for resource allocation. Nurses can use prior evidence to inform the model of nursing care and reimagine patient care responsibilities during a crisis. PURPOSE: To review the evidence for team nursing as a model of patient care and delegation and determine how it affects patient, nurse, and organizational outcomes. METHODS: We conducted an integrative review of team nursing and delegation using Whittemore and Knafl's (2005) methodology. RESULTS: We identified 22 team nursing articles, 21 delegation articles, and two papers about U.S. nursing laws and scopes of practice for delegation. Overall, team nursing had varied effects on patient, nursing, and organizational outcomes compared with other nursing care models. Education regarding delegation is critical for team nursing, and evidence indicates that it improves nurses' delegation knowledge, decision-making, and competency. LINKING EVIDENCE TO ACTION: Team nursing had both positive and negative outcomes for patients, nurses, and the organization. Delegation education improved team nursing care.

EBP 2.0: Implementing and Sustaining Change: The Malnutrition Readmission Prevention Protocol.

This is the fifth article in a new series about evidence-based practice (EBP) that builds on AJN's award-winning previous series-Evidence-Based Practice, Step by Step-published between 2009 and 2011 (to access the series, go to http://links.lww.com/AJN/A133). This follow-up series features exemplars illustrating the various strategies that can be used to implement EBP changes-one of the most challenging steps in the EBP process.

Fetal alcohol spectrum disorders: a Native American journey to prevention.

Fetal alcohol spectrum disorders, the most common preventable cause for mental retardation, is the result of prenatal alcohol exposure. There is no safe amount of alcohol during pregnancy. Native Americans have a higher risk of alcohol abuse than the general U.S. population. The fetal alcohol spectrum disorders prevalence rates for Native Americans range from 1.0 to 8.97 per 1000 births. Nurses and health care providers working in collaboration with tribal fetal alcohol spectrum disorders prevention specialists can greatly, and positively, impact the physical and mental health and well-being of children in Native American communities.

Collaborative communication: integrating SBAR to improve quality/patient safety outcomes.

Creating work environments that sustain open and supportive communication positively influence teamwork, staff satisfaction, and improved patient quality and safety. The Situation, Background, Assessment, and Recommendation (SBAR)-collaborative communication evidence-based practice (EBP) study described in this article introduced collaborative communication integrating SBAR communication process in a pediatrics/perinatal services department of a 271-bed community hospital in northern Arizona. EBP processes framed the study. Evaluation methods for intervention effectiveness and study outcomes integrated both quantitative and qualitative strategies. Staff transferred evidence, knowledge, and skills into practice to achieve enhanced communication, collaboration, satisfaction, and patient safety outcomes meeting the study goal.