Why Pursue a Doctorate? Findings From a Study of Doctorally Prepared RNs in an Integrated Healthcare System.

OBJECTIVE: The aim of this study was to examine the motivations and perceptions of RNs with completed doctorates in an integrated healthcare system. BACKGROUND: Historically, PhD preparation was the primary doctorate available for nurses, preparing them to conduct research and hold leadership positions. The recent growth of Doctor of Nursing Practice (DNP) programs that focus on either advanced clinical practice or executive competencies has significant implications for the future of nursing in practice settings. METHODS: A 30-item survey was sent to all 93 RNs at a healthcare system who have completed doctorates. RESULTS: A response rate of 71% found DNPs outnumber PhDs 3 to 1. PhDs are significantly more likely to perceive concrete benefits associated with their degrees, and DNPs are more likely to report that their degrees have not made a difference in their jobs. CONCLUSIONS: Leaders in practice and education must collaborate to ensure that both DNPs and PhDs are engaged in positions that use their highest level of competence in any setting.

Evaluating the NICHE program in an Academic Medical Center: Uncovering the missing link between training and effective practice change in the care of older adults.

PURPOSE: This paper recounts the history and experiences of one academic medical center that sought to improve the care of elderly patients by adopting and adapting the Geriatric Resource Nurse (GRN) model recommended by the Nurses Improving the Care of Healthsystem Elderly (NICHE) program. A formal evaluation examined the perceptions, opinions and attitudes of non-GRN nursing peers, Nurse Managers (NMs) and members of the Inter-Professional Advisory Board (IAB) regarding GRN practices and the institution's NICHE program. DESIGN: A qualitative research design with purposive sampling was utilized. METHODS: Semi-structured interviews and focus groups conducted in the fall/winter 2017 were analyzed using standard content analysis methods of isolating and grouping contextual themes without a predefined framework. FINDINGS: The institution's GRN training program, a hybrid of the national NICHE program and organization-developed components, has strong support among NMs, members of the IAB and other RNs. However, there exist many misconceptions, erroneous information and misunderstandings about the program and the roles and expectations of GRNs that have hindered the likelihood of producing desired outcomes. CONCLUSIONS: Training GRNs was insufficient in disseminating and implementing evidenced-based geriatric practices in this hospital. Future work in this area would benefit from integrating concepts and methods from dissemination and implementation science when developing, launching, and sustaining NICHE programs. CLINICAL RELEVANCE: Integrating principles and models of dissemination and implementation science can increase consistent use of evidence based practices and the likelihood of improved geriatric patient outcomes in NICHE hospitals.

Participating in a Multisite Study Exploring Operational Failures Encountered by Frontline Nurses: Lessons Learned.

This article describes our experience participating in a multisite collaborative study involving frontline nurses and operational failures (OFs). We encountered a range of challenges conducting the study as proposed by the study's coordinating center (CC), which hindered our ability to meet our goals and objectives. We identified 3 general areas in which our expectations and actual experience diverged: 1) research resources, design, and methods; 2) CC communications and deliverables; and 3) influencing organizational change. Nurse executives considering collaborative research or assessing methods to engage clinical nurses in organizational improvements will benefit from our experience.

Developing and Implementing a Professional Practice Model.

Professional practice models guide nursing practice by giving meaning to the work of nurses. They elevate the practice from tasks to theory, from skills to knowledge, and remind us that the patient and family are at the center of our practice. Professional practice models are one of the foundations of the Magnet Recognition Program. The purpose of this paper is to describe the development and implementation of a professional practice model in a healthcare system, which includes three hospitals and over 80 ambulatory practices in the New York City region.