Nurse Managers' Professional Quality of Life During the COVID-19 Pandemic.

BACKGROUND: Health systems cannot effectively support nurse managers without understanding psychosocial effects of the COVID-19 pandemic. OBJECTIVE: The objective of this study was to describe the professional quality of life of frontline nursing management during the COVID-19 pandemic. METHODS: A cross-sectional online survey of 54 nurses in management positions at a large Midwest academic medical center during 2022 was conducted. Participants completed an electronic survey including demographics, Professional Quality of Life Measure Version 5, and items assessing past consideration of and future intent to leave their position, organization, or profession. RESULTS: Most participants had previously considered changing roles (80%) or leaving the organization during the pandemic (76%). Fewer respondents reported that changing role (24%) or organization (20%) was likely during the upcoming 6-12 months. Most participants scored in moderate ranges of Compassion Satisfaction, Burnout, and Secondary Traumatic Stress scales (85%, 89%, and 74%, respectively). Higher Compassion Satisfaction was associated with extreme unlikelihood of leaving for an internal non-management role. Higher Burnout scores were associated with more time working and past consideration or future likelihood of leaving for an external non-nursing position. Secondary Traumatic Stress scores were higher for nurse managers and house operation managers than assistant nurse managers and associated with past consideration of moving to an internal non-management role or external non-nursing position and future likelihood of moving to an external non-nursing position. CONCLUSIONS: Nurse management occupies a demanding position between frontline staff needs and administrative requirements, profoundly impacted by COVID-19. Health care researchers, administration, and policymakers must learn how to support, retain, and sustain nursing management in a post-pandemic world.

Testing the Decision Support Tool for Responsible Pain Management for Headache and Facial Pain Diagnosis with Opioid-Risk-Stratified Treatment.

In primary and urgent care, headache and facial pain are common and challenging to diagnose and manage, especially with using opioids appropriately. We therefore developed the Decision Support Tool for Responsible Pain Management (DS-RPM) to assist healthcare providers in diagnosis (including multiple simultaneous diagnoses), workup (including triage), and opioid-risk-informed treatment. A primary goal was to supply sufficient explanations of DS-RPM's functions allowing critique. We describe the process of iteratively designing DS-RPM adding clinical content and testing/defect discovery. We tested DS-RPM remotely with 21 clinician-participants using three vignettes-cluster headache, migraine, and temporal arteritis-after first training to use DS-RPM with a trigeminal-neuralgia vignette. Their evaluation was both quantitative (usability/acceptability) and qualitative using semi-structured interviews. The quantitative evaluation used 12 Likert-type questions on a 1-5 scale, where 5 represented the highest rating. The mean ratings ranged from 4.48 to 4.95 (SDs ranging 0.22-1.03). Participants initially found structured data entry intimidating but adapted and appreciated its comprehensiveness and speed of data capture. They perceived DS-RPM as useful for teaching and clinical practice, making several enhancement suggestions. The DS-RPM was designed, created, and tested to facilitate best practice in management of patients with headaches and facial pain. Testing the DS-RPM with vignettes showed strong functionality and high usability/acceptability ratings from healthcare providers. Risk stratifying for opioid use disorder to develop a treatment plan for headache and facial pain is possible using vignettes. During testing, we considered the need to adapt usability/acceptability evaluation tools for clinical decision support, and future directions.

Innovative Management of Nursing Student COVID-19 Cases and High-Risk Exposures.

BACKGROUND: The novel coronavirus disease 2019 (COVID-19) pandemic created significant disruption in higher education, especially in health science colleges where in-person and hands-on patient-facing learning environments are essential. Student monitoring and follow-up was an essential aspect of in-person learning for the fall 2020 semester. METHOD: Senior leaders and faculty in a college of nursing developed and implemented an innovative college-based COVID-19 management system to ensure real-time response to prolonged pandemic-related student absences. RESULTS: Decisions made from this management system allowed leaders within the college to implement programmatic changes to ensure student and faculty well-being. Furthermore, the COVID-19 management system allowed for close student follow-up through phone calls with a faculty member to ensure student well-being. CONCLUSION: Monitoring helped ensure appropriate physical and mental health services were accessible to students undergoing quarantine or self-isolation while also fostering positive student satisfaction throughout their prolonged absences. [J Nurs Educ. 2022;61(4):217-220.].

Toolkit to Increase Provider Knowledge, Comfort, and Adoption of POLST: Portable Medical Orders in a Primary Care Setting.

BACKGROUND: POLST-Portable Medical Orders-abbreviated as POLST, is a nationwide initiative to help providers document and meet a patient's end-of-life wishes. PROBLEM: Provider completion of POLST documents in primary care can promote continuity and implementation of patient preferences at the end of life in community-dwelling adults. Educating and providing a clinical process to support POLST use may improve implementation. APPROACH: A POLST toolkit was developed for primary care providers with measurement of knowledge, comfort, and likelihood of use with pre- and postsurvey data collection. The POLST toolkit was used to engage primary care providers in an educational session to enhance understanding and increased utilization. OUTCOMES: Providers reported increased knowledge, self-reported comfort, and likelihood of using POLST documents. CONCLUSIONS: Utilization of a POLST toolkit, with an educational component, improved provider interest in POLST implementation.

Nurses' Safety Motivation: Examining Predictors of Nurses' Willingness to Report Medication Errors.

Medication errors are common in health care settings. Safety motivation, such as willingness to report error, is needed to contain medication errors. Limited evidence exists about measures to enforce nurses' safety motivation. The purpose of this study was to test a proposed model explaining the mechanism by which organizational and social factors influence nurses' safety motivation. Survey for this cross-sectional study was mailed to a random sample of 500 acute care nurses. Data collection started in January 2014 and lasted 6 months. Path analysis results showed a good fitting final model with 15% of explained variance on nurses' safety motivation. Safety climate dimensions of error feedback (ß = .38, p ⩽ .00) and nonpunitive response to errors (ß = .22, p = .01) significantly predicted the outcome. There is a need for both organizational and social factors to motivate nurses to report errors. Leadership practices emphasizing safety as a priority is needed to enhance nurses' safety motivation.

Voluntary Medication Error Reporting by ED Nurses: Examining the Association With Work Environment and Social Capital.

INTRODUCTION: Medication errors are one of the most frequently occurring errors in health care settings. The complexity of the ED work environment places patients at risk for medication errors. Most hospitals rely on nurses' voluntary medication error reporting, but these errors are under-reported. The purpose of this study was to examine the relationship among work environment (nurse manager leadership style and safety climate), social capital (warmth and belonging relationships and organizational trust), and nurses' willingness to report medication errors. METHODS: A cross-sectional descriptive design using a questionnaire with a convenience sample of emergency nurses was used. Data were analyzed using descriptive, correlation, Mann-Whitney U, and Kruskal-Wallis statistics. RESULTS: A total of 71 emergency nurses were included in the study. Emergency nurses' willingness to report errors decreased as the nurses' years of experience increased (r = -0.25, P = .03). Their willingness to report errors increased when they received more feedback about errors (r = 0.25, P = .03) and when their managers used a transactional leadership style (r = 0.28, P = .01). DISCUSSION: ED nurse managers can modify their leadership style to encourage error reporting. Timely feedback after an error report is particularly important. Engaging experienced nurses to understand error root causes could increase voluntary error reporting.