Continuing the Creativity and Connections: The Massachusetts Initiative to Update the Nurse of the Future Nursing Core Competencies.

AIM: This article describes the collaborative effort of nursing education and practice to update the Massachusetts Nurse of the Future Nursing Core Competencies. BACKGROUND: The Nurse of the Future Nursing Core Competencies were published in 2010. With the establishment of the Massachusetts Action Coalition, a primary goal was to continue to promote the integration of these competencies into all education and practice settings throughout Massachusetts and share this process with other states. METHOD: Through an updated literature review and consultation with subject matter experts, the Nurse of the Future Competency Committee developed a process to ensure that significant practice advances were reflected in each of the competencies. RESULTS: The updated Nurse of the Future Nursing Core Competencies were published in March 2016. CONCLUSION: The updated competencies capture the knowledge, attitudes, and skills needed for all nurses to create a culture of health across the continuum of health care.

Creating a Culture of Safety Through Integration of an Early Warning System.

This quality improvement project utilized the Tanner model to identify strategies to enhance the clinical judgment among staff nurses through the development and adoption of an early warning system for patient deterioration outside the ICU. Outcomes included improved communication, decreased variability in the assessment and interpretation of patient status, and a significant decrease in codes.

Defining a Role for Nursing Education in Staff Nurse Participation in Antimicrobial Stewardship.

The role of the staff nurse in antimicrobial stewardship programs (ASPs) is not clearly defined. This study explored the ASP educational needs of staff nurses, using survey, focus group, and Delphi methods of engaging nurse educators. Low awareness of components of ASPs and areas of educational need were identified.

Revitalizing the infection prevention workforce with a fellowship program for underrepresented groups.

Infection preventionist (IP) positions are difficult to fill, and future workforce shortages are anticipated. The IP field has less racial and ethnic diversity than the general nursing workforce or patient population. A targeted fellowship program for underrepresented groups allowed the recruitment and training of IPs while avoiding staffing shortages.

Nursing leadership orientation: a competency and preceptor model to facilitate new leader success.

Many nurse manager orientation programs are loosely structured and fail to provide new managers with the experiences and support that will assure them a smooth transition. The authors describe an orientation program for new nurse managers that combines 3 components-nurse manager competencies, precepting by the nurse manager's supervisor, and written and classroom resources that, together, assure that new managers are ready to face the challenges that await them.

Lightening the burden for preceptors: consider adding a "Faculty Model" week to orientation.

The physical and emotional stress on preceptors creates a conundrum as hospitals expand and/or experience higher rates of nursing staff turnover. When chosen well, preceptors are an excellent way to integrate and teach new nurses. However, being a preceptor can often be an added burden in a busy hospital climate. Creating innovative systems, within new nurse orientation, that respect the preceptor role and provide some relief have much merit in today's bustling hospital environment. The creation of such a system in a large tertiary care hospital in Boston, MA, entitled the Faculty Model Pilot Program, seems to be both supporting the overworked preceptors and providing a comprehensive standardized practice week for newly hired medical/surgical nurses. The pilot program appeared to increase not only their knowledge of the hospital itself but also the standards of patient care throughout the hospital. This added week seemed to provide a good understanding of general nursing practice prior to the acquisition of the unit-based, specific knowledge; thus, lightening the burden for unit preceptors.

Reshaping the practice environment: the importance of coherence.

Today's nurse leader is challenged to create a practice environment that fosters multidisciplinary collaboration, professional development, and a culture of safety. Fostering a sense of coherence among staff nurses about their place within the nursing department and the department's place within the broader organization id essential to the development of such environments. When nurses have a sense of coherence about their work setting, they are more likely to feel confident that their care of patients and families is fully supported by the organization in which they work. The authors describe the concept of coherence, discuss findings from a preliminary study regarding attributes that may contribute to coherence in individual nurses, and describe systems ans programs that have been implemented in a large academic medical center to foster a sense of coherence in individual nurses, the nursing department, and the institution as a whole.