Examining the Effect of Entrepreneurial Leadership on Nursing Team Creativity in New Hospitals: A Structural Equation Model.

METHODS: This cross-sectional study sampled 833 nurses from 2 new hospitals in Guizhou Province, China. They completed a questionnaire on entrepreneurial leadership, nursing team creativity, innovation climate, creative self-efficacy, team psychological safety, and knowledge sharing. Data were analyzed using structural equation modeling. RESULTS: Entrepreneurial leadership positively influenced nursing team creativity. Innovation climate, creative self-efficacy, team psychological safety, and knowledge sharing mediated the relationship between entrepreneurial leadership and nursing team creativity in new hospitals. CONCLUSIONS: This study confirmed the significant role of innovation climate, creative self-efficacy, team psychological safety, and knowledge sharing in mediating the relationship between entrepreneurial leadership and nursing team creativity through empirical analysis.

Does nursing leaders' humility leadership associate with nursing team members' psychological safety? A cross-sectional online survey.

AIMS: The leader's ability to act with self-awareness, lead with generosity, and consider others' opinions is what defines humility leadership. In recent healthcare literature, there has been extensive exploration of humility leadership and psychological safety, but these studies were non-nursing. It is crucial to understand how humble leaders can empower their staff's psychological safety, as inclusivity is a key aspect of humility leadership and is closely linked to psychological safety. Therefore, this study examined the association between nursing leaders' humility leadership and team members' psychological safety. DESIGN: A quantitative cross-sectional design was used in the current study. METHODS: To assess the studied variables, 245 nursing academics, nurses, and nursing leaders were recruited from different universities and hospitals using the convenience snowball sampling technique, yielding a response rate of 70%. After a pilot study, an online survey using Google Forms was hosted in 2022. FINDINGS: The psychological safety of nursing team members was not found to be associated with the humility leadership of nursing leaders. Despite the participants' reports of their nursing leaders exhibiting humility leadership (mean = 3.57/5, SE = 0.055), the participants also reported that psychological safety was borderline (mean = 3.09/5, SE = 0.041). CONCLUSION: The borderline nursing team members' psychological safety implies that different types of leadership may have an impact on the psychological safety of nursing team members. The lack of association between nursing leaders' humility leadership and the psychological safety of nursing team members highlights the need for further understanding and effort from nursing leaders to establish psychologically safe work environments. IMPACT: This research offers valuable insights into how the humility of nursing leaders impacts the psychological safety of nursing team members. The psychological safety of the nursing team members highlights the specific responsibilities that nursing leaders should assume to establish psychologically safe work environments. PATIENT OR PUBLIC CONTRIBUTION: There was no Patient or Public Contribution, as the sample included nursing academics, nurses, and nursing leaders recruited from different universities and hospitals. IMPLICATIONS FOR PRACTICE/POLICY: A simple intervention that humble leaders can initiate is inclusivity, where subordinates' positive worth, strengths, and contributions are acknowledged. Inclusivity is a characteristic of humility leadership. Improving teams'' psychological safety calls to promote a culture of civility in the workplace. A random and larger sample is needed, including other types of universities and hospitals, using other research designs across other cultures.

Supporting the Health of Our Nurses Using the 4A Model.

Despite the well-documented need for nurse-focused efforts on health and wellness, too few healthcare organizations have made a meaningful impact on this issue. Nurse health should be integrated into the strategic and operational workings of the organization. Environments of health and wellness require attention, accountability, action, and accessibility. Although individual choice is the starting point, true success will be achieved when nurse health is a nonnegotiable outcome consistent with quality, safety, finance, and patient experience.

Team working part 3: leading a team.

John Fowler, Educational Consultant, explores the qualities that enhance leadership in clinical practice.

Pivoting During a Pandemic.

When the coronavirus hit the United States earlier this year, hospitals across the country were forced to quickly convert to crisis mode. Overnight, health systems transformed clinical and administrative operations to care for rising numbers of COVID-19 patients. Now, as the country slowly reopens and we move back to "normal," hospitals again face a major reboot to regroup and recover. Those that meet this challenge successfully will survive. Many others will not. This month's Magnet Perspectives column examines how Magnet hospitals are uniquely positioned to ride the waves and manage the chaos. What are the components that helped them adapt and adjust when COVID-19 struck, and how are those elements facilitating response and recovery? The column also looks at how the Magnet Recognition Program itself responded to challenges posed by the coronavirus and altered some of its long-standing processes to meet customer needs.

Fundamental care for people with cognitive impairment in the hospital setting: A study combining positive organisational scholarship and video-reflexive ethnography.

AIMS AND OBJECTIVES: To clarify how high-quality fundamentals of care for people with dementia and/or delirium were practised in a specialist geriatric evaluation and management unit. BACKGROUND: Older people with cognitive impairment represent a significant number of people who are admitted to hospital. They are at increased risk of dying, readmission and long hospital stays, relative to those without cognitive impairment. There is an urgent need to elucidate the conditions that underpin safe and high-quality fundamental care for these patients and their families. METHODS: Using the innovative methodologies of positive organisational scholarship in healthcare and video-reflexive ethnography, this 18-month study was conducted within an inpatient geriatric evaluation and management unit for people with dementia and/or delirium in South Australia. Patients, family members and staff members (managerial, clinical and nonclinical) participated by allowing researchers to document ethnographic fieldwork notes and film their practices and/or accounts thereof; and/or interpreting digital recordings with researchers in order to make sense of data in a process of co-analysis. This study is reported using Standards for Reporting Qualitative Research reporting guidelines. RESULTS: High-quality fundamental care for people with dementia and/or delirium in hospital and their families was associated with the special space of the hospital unit; an aptitude for people with dementia; a capacity to translate person-centred fundamentals of care from rhetoric to reality; and an appreciation for teamwork. CONCLUSION: This study clarified how teams working in hospital can practise high-quality fundamentals of care for older people with dementia and/or delirium. Delivery of high-quality fundamental care in this setting was dependent, not only on nurses, but the entire ward team working cohesively in a "weave of commitment." RELEVANCE TO CLINICAL PRACTICE: Efforts to improve fundamental care for people with cognitive impairment need to encompass values and philosophy of person-centred care, including the contributions by all staff to care delivery.

An Intervention for Person-Centered Support in Irritable Bowel Syndrome: Development and Pilot Study.

Irritable bowel syndrome is a common and often chronic functional bowel disorder that can cause severe disruption of daily functioning in those affected, with subsequent high healthcare utilization and work absenteeism. Nurses represent an underutilized group in the current management of irritable bowel syndrome. The aim of this study was to systematically develop a person-centered support intervention in irritable bowel syndrome and evaluate this in a pilot study. The development followed the revised framework for complex interventions from the Medical Research Council and involved literature reviews and multiprofessional expert groups. The intervention was then tested in a pilot study including 17 patients and evaluated through validated questionnaires measuring irritable bowel syndrome symptom severity, gastrointestinal-specific anxiety, and self-efficacy as well as through interviews. There was a significant improvement in irritable bowel syndrome symptom severity between baseline and follow-up, but not for self-efficacy or gastrointestinal-specific anxiety. The patients' perceptions of participating in the intervention were positive and induced a learning process; they were able to form a supportive relationship with the nurse and their ability to self-manage improved. The promising results from this small pilot study in terms of feasibility, potential efficacy, and the patients' positive feedback make this intervention a suitable candidate for a larger controlled trial.

[Nursing Team Applied Learning Organization to Patient Group Care].

This article reports on an effort to use the learning organization to change the existing mental model of a nursing team in order to transform from a nursing-oriented group to a patient-oriented group and to build shared vision, self-affirmation, and self-transcendence in order to change perspectives using team-learning spirit. The nursing group built partnerships with the patient group. The nursing group learning process fostered positive thinking logic and, under the inheritance of knowledge and technology, the patient-oriented group was successfully established. This model will be expanded to more patient-oriented groups. Through the experience sharing and joint supervision, this model may change lifestyles by implementing the concept of "My health, I care" and, ultimately, help patients achieve self-healthcare.

Implementing an adapted Buurtzorg model in an inner city NHS trust.

District nursing in inner city areas faces many challenges, particularly with regard to sustaining the nursing workforce, and ensuring nurses gain satisfaction and enjoyment from their work. The Dutch Buurtzorg model of self-managing teams offers a potential solution to address these problems. In this article, the authors, as nurse leaders, reflect on their experience of implementing a 'test and learn' pilot of such a model in the NHS in London, and then on a further scaling up of the model. This paper offers insights related to such issues as governance and assurance as well pragmatism in supporting a process of change. It is hoped that these reflections will guide other nurse leaders in setting up and sustaining this excellent model of team management and care.

A Nursing Leadership Immersion Program: Succession Planning Using Social Capital.

This article describes the inception and evolution of a 3-month immersion experience between hospital and nurse leaders where sociological principles were applied to support nurse leader succession. Unique to this program, the bedside nurse joins the nursing executive team full time to participate in all organizational leadership activities as part of the experience.

Participatory redesign of work organisation in hospital nursing: A study of the implementation process.

AIMS: The main goal of the study was to apply and analyse a moderated participatory small-group procedure with registered nurses, which aims at the development and implementation of measures to improve work organisation in hospital wards and nursing units. BACKGROUND: Participation in job redesign is an essential prerequisite of the successful implementation of improvement measures in nursing. METHODS: The study was carried out in a public hospital of maximum care in Germany. We selected 25 wards with the most critical reported exhaustion and general health and applied a series of moderated small-group sessions in which the registered nurses jointly identified deficits in their work organisation, developed improvement measures, and then implemented and assessed them. RESULTS: Registered nurses of 22 wards actively took part in the small-group procedure. All nursing units jointly identified organisational deficits, developed possible improvement measures, and implemented them. The nursing teams then evaluated the implemented measures which were already assessable at the end of our research period; nearly all (99.0%) showed improvements, while 69.4% actually attained the desired goals. CONCLUSION: Participatory small-group activities may be successfully applied in hospital nursing in order to improve work organisation. IMPLICATIONS FOR NURSING MANAGEMENT: Participatory assessment and redesign of nurses' work organisation should be integrated into regular team meetings. The nursing management should actively support the implementation process.

Alcohol-related harm: developing a drug and alcohol liaison team.

The City of Wolverhampton has much higher rates of accident and emergency (emergency department) attendance and hospital admission for alcohol-related harm than in neighbouring health authorities and double the national death rate from alcohol-related liver disease. Recovery Near You, the local addiction service, in partnership with The Royal Wolverhampton NHS Trust, initiated a nurse-led drug and alcohol liaison team to address these health issues. This resulted in a tenfold increase in screening and engagement with patients in the acute hospital, the creation of guidelines, protocols and training available for staff in the Trust and an accessible service that has impacted positively on patient experience. This article describes the development of the team, outlining the challenges, successes and outcomes.

Focused development of advanced practice nurse roles for specific patient groups in a Swiss university hospital / Gezielte Entwicklung von Advanced Practice Nurse-Rollen für spezifische Patient(inn)engruppen in einem Schweizer Universitätsspital.

Background: To cover future health care needs of the population, new care models are necessary. The development of advanced nursing practice (ANP) offers the opportunity to meet these challenges with novel services. At the Inselspital, Bern University Hospital, ANP services and corresponding advanced practice nurse (APN) roles have been developed since 2011. Purpose: The aim is to develop innovative and evidence based ANP services to supplement health care for specific patient groups and their family members with the goal to improve safety and achieve better outcomes. Methods: Project-based ANP services are developed in close collaboration of clinical departments and the Nursing Development Unit (NDU) of the Directorate of Nursing. Structure, process and outcome data are collected for evaluation. Findings: Currently, five ANP services are established and running, eight more are in the developmental phase. Most services address the long term care of patients with chronic illnesses and their family members. Ten APNs work between 10 % and 80 %, three are leading an ANP-team. APNs work over 50 % in direct clinical practice, primarily in counselling. An ANP network connects APNs and NDU, promoting synergy and exchange. Conclusions: The available resources often constitute a challenge for the development of ANP services. Vital for the long-term success are an adequate extent of the position, the support by department directorate, the conceptual framework that is implemented across the whole hospital, and the development within project structures.

Nursing Care Systematization in a basic health unit: perception of the nursing team.

OBJECTIVE: To conduct a situational diagnosis of the Nursing Care Systematization (NCS) in a Basic Health Unit from the perception of the nursing team. METHOD: This was a quantitative, descriptive-exploratory study, conducted in a Basic Health Unit in the interior of São Paulo state, Brazil. A structured questionnaire containing Likert scale was used for data collection, previously validated by specialists. RESULTS: The questionnaire was applied to 21 nursing professionals. It was verified that implementation of NCS and the nursing process is still incipient in the Basic Health Units. Regarding its use in all nursing actions: 19% of respondents believe that it is never used, 38% thought that it is rarely implemented, and 29% responded sometimes. The main difficulties identified were related to the lack of institutional structure, highlighting a lack of capacity by the institution (81%). The team has a reasonable understanding about the subject, but pointed out that professional education does not prepare them for performing NCS in primary care. CONCLUSION: Institutional interest in NCS is necessary to enable implementation. The study can contribute to the effective implementation in this unit and point out guidelines for its implementation in other similar contexts.

Introducing community integrated nursing teams: How one Clinical Commissioning Group applied an evidence-based approach.

The present day collection of financial and demographic challenges confronted by health and social care mean that integrated services are undoubtedly essential to sustain adequate care. However, the impact of integrated care upon healthcare staff and patients as well as new ways of working will need to be demonstrated, with collaboration and engagement throughout any transition. This paper provides an overview of the evidence relating to the delivery of effective, integrated out-of-hospital care, with a discussion of the literature. It also considers how one Clinical Commissioning Group has begun the process of integration with the focus on community nursing services for the provision of better care for patients with an evidence-based approach.

Avoiding hospital admission in COPD: impact of a specialist nursing team.

Chronic obstructive pulmonary disease (COPD) is a common, preventable and incurable disease. The costs of caring for patients with COPD is estimated to be more than £800 million a year for acute hospital admissions alone ( Department of Health, 2012 ). The hospital-at-home model is increasingly being adopted for COPD patients following British Thoracic Society (BTS) guidelines for the delivery of hospital admission-avoidance schemes ( BTS, 2007 ). The aim of this case-note review was to evaluate the safety and effectiveness of a specialist nurse-led acute respiratory assessment service working with COPD patients in the community. The review recorded patient flow through the service and documented assessments and treatments. It was able to document potential benefits and cost savings.

Factors contributing to nursing team work in an acute care tertiary hospital.

Background: Effective nursing teamwork is an essential component of quality health care and patient safety. Understanding which factors foster team work ensures teamwork qualities are cultivated and sustained. Objective: This study aims to investigate which factors are associated with team work in an Australian acute care tertiary hospital across all inpatient and outpatient settings. Methods: All nurses and midwives rostered to inpatient and outpatient wards in an acute care 600 bed hospital in Sydney Australia were invited to participate in a cross sectional survey between September to October 2013. Data were collected, collated, checked and analysed using Statistical Package for the Social Sciences (SPSS) Version 21. Factors reporting a significant correlation with where p < 0.05 were analysed in a multiple regression model. Results: A total of 501 surveys were returned. Nursing teamwork scores ranged between 3.32 and 4.08. Teamwork subscale Shared Mental Model consistently rated the highest. Mean scores for overall communication between nurses and team leadership were 3.6 (S.D. 0.57) and 3.8 (SD 0.6) respectively. Leadership and communication between nurses were significant predictors of team work p < 0.001. Conclusion: Our findings describe factors predictive of teamwork in an acute care tertiary based hospital setting across inpatient and outpatient specialty units. Our findings are of particular relevance in identifying areas of nurse education and workforce planning to improve nursing team work.

Strengthening ethical decision-making: the experience of Iranian nurses.

AIMS: Ethical decision-making is a complex process that nurses perform daily. The aim of this study is to explain how ethical leaders in Iran strengthen ethical decision-making in their nursing teams. METHOD: Data were collected using deep and semi-structured interviews with 20 Iranian nurses in 2015. Analysis was based on constant comparative analysis. RESULTS: Ethical leaders strengthen ethical decision-making by promoting ethical commitment, developing an ethical atmosphere and guiding ethical decision-making. CONCLUSION: The development of ethical decision-making in nursing can improve ethics-based nursing care.

Interprofessional Collaboration Between Mental Health Counselors and Nurses.

The continuous and rapid evolution of medical technology and the complexity of delivering person-centered care in the 21st century calls for collaboration among health care professionals. Global health now "involves many disciplines within and beyond the health sciences and promotes interdisciplinary collaboration; and is a synthesis of population-based prevention with individual-clinical care" (Koplan et al., 2009, p. 1995). The need for mental health practitioners to work in interprofessional contexts requires graduate and postgraduate programs to incorporate interprofessional education into their student training. This article focuses on an approach to interprofessional education for students in mental health nursing and counseling.

Caring for Trauma Patients With Coexisting Heart Failure.

The coexisting conditions of traumatic injury coupled with a comorbid condition such as heart failure create a complex scenario for the trauma nurse to manage. Initial care of the trauma patient includes following the Advanced Trauma Life Support guidelines and managing the airway, breathing, and circulation (ABC) of the patient. Once the airway is secure and breathing is managed, the team addresses circulation. At this point in the patient's care, the team typically does not know which, if any, comorbid conditions exist. Managing circulation for a hypotensive or hypoperfused patient will most likely include 1-2 L of crystalloid solution being given intravenously. Although most patients can tolerate this fluid volume challenge, excess volume can be difficult for a patient with heart failure. This article describes the monitoring and management techniques that are recommended for patients presenting with trauma and the comorbid condition of heart failure.