A Post-Pandemic Review of American Association of Critical Care Nurses's Domains of Establishing and Sustaining Healthy Work Environments: Strategies for Nurse Leaders.

This article explores current evidence and practical strategies for nurse leaders to advance a healthy work environment. American Association of Critical Care Nurses's Standards for Establishing and Sustaining Healthy Work Environments should guide efforts to reconnect clinical teams with meaningful and satisfying work. Authors propose adding the domain of Wellbeing to guide leaders in holistically addressing the health of all care team members and the work environment.

"We Take Care of Our Young, No Matter What," Experiences of Engagement in HIV Care Among Black Mothers Parenting Dependent Children in Southwestern Pennsylvania: A Retrospective Descriptive Qualitative Study.

ABSTRACT: This retrospective descriptive study sought to explore the lived experiences of Black mothers with HIV navigating HIV medical care while parenting dependent children. Six themes were generated from the semi-structured interviews conducted with mothers ( N = 9) related to motherhood, interactions with health care systems and providers, coping, social support, HIV self-management, and HIV prevention. Findings suggested that supportive interpersonal relationships with HIV health care providers, HIV nondisclosure to family and friends, and social network support, inclusive of health care providers, were protective factors in achieving optimal treatment adherence and viral suppression. Findings may inform interventions for improving social support and reducing stigma in HIV care for Black mothers with HIV who are parenting dependent children.

A concept analysis of influence for nurse leaders.

BACKGROUND: To shape priorities for health and health care outcomes, it is essential for nurse leaders to be influential. The application and impact of influence are readily recognized, but not its characteristics. PURPOSE: The purpose of this project was to conduct a concept analysis of influence relative to nurse leaders. METHODS: The Walker and Avant method of concept analysis was utilized. FINDINGS: Attributes of influence include advocacy, communications skills, competency, confidence, credibility, and engagement. Antecedents of influence are authority, collaboration, integrity, and mentorship. Consequences of influence are action, change, commitment, compliance, decision-making, motivation, and resistance. DISCUSSION: By drawing upon a systematic understanding of the concept of influence, nurse leaders are urged to develop and leverage the attributes of influence to drive and achieve collective good for the future of health and health care in society.

Measuring nurses' health policy participation: WSPPIR instrument development and psychometric evaluation.

AIM: To measure nurses' health policy participation by developing and psychometrically testing the Waddell Spectrum for Policy Participation Influence and Research (WSPPIR) Instrument. DESIGN: Instrument development; based on a nursing conceptual framework. METHODS: This four-phase study was conducted in 2018 to estimate content validity, construct validity, and internal consistency reliability of the WSPPIR instrument. Phase 1- item generation for the multi-dimensional concept of health policy participation as described in WSPPIR theory. Phase 2- a content validity index was calculated based on ratings by seven experts. Phase 3- cognitive interviews of five nurses. Phase 4- 306 Registered Nurses completed the WSPPIR instrument. Exploratory factor analysis was used to identify and to estimate construct validity, Cronbach's alpha was calculated to estimate internal consistency reliability. RESULTS: The 38-item WSPPIR Instrument consists of five subscales (Professional Nursing Organizations; Health Care Delivery Systems: Organizations that Deliver Health Care Services; Governance Levels: City/Town, State, National, Global; Valuing Health and Policy; Influence Skills) and exhibits adequate estimates of reliability and content and construct validity, as a measure nurses' health policy participation. CONCLUSION: As efforts to enhance nurses' health policy participation continue globally, the WSPPIR instrument should be useful in measuring individual nurses' health policy participation and benchmarking health policy participation for the nursing profession at large. IMPACT: The WSPPIR instrument will be useful to individual nurses, educators, and the profession as we work to systematically and strategically increase nurses' participation in and influence on health policy.

Advancing health policy education in nursing: American Association of Colleges of Nursing Faculty Policy Think Tank.

Based upon an awareness of the need to increase its policy footprint, the American Association of Colleges of Nursing's (AACN) Board of Directors convened a think tank of nurse experts in the field of policy curriculum to advise the Board. The goal of the think tank was to review the current landscape, analyze trends, and create a set of recommendations for AACN's Board to consider. The Faculty Policy Think Tank (FPTT) met between 2016 and 2017 to review and reflect on methods to increase expertise of nursing faculty and students in health policy and make recommendations to the AACN Board to advance the agenda of the organization, member schools, and the profession. This article describes the methods and processes the Think Tank employed to develop a set of recommendations for the AACN Board of Directors.

Nursing Organizations' Health Policy Content on Facebook and Twitter Preceding the 2016 United States Presidential Election.

AIM: The aim of this study was to describe and analyse Facebook and Twitter content associated with three United States national nursing organizations during the month preceding the 2016 United States presidential election. BACKGROUND: Social media is increasingly significant in political and civil society dialogue. Many professional nursing organizations have an explicit commitment to advancing health policy and have established a presence on social media platforms; yet, little is known about what policy topics professional nursing organizations choose to disseminate. DESIGN: Descriptive study of qualitative data from three national nursing organizations' social media posts 1 month prior to the 2016 United States presidential election. METHODS: Content analysis of social media content was guided by the Conceptual Module of Nursing and Health Policy and the Culture of Health Action Framework. RESULTS: A total of 2,137 social media units were collected. National Nurses United shared more policy-related content on Facebook and Twitter than the American Nurses Association and the American Academy of Nursing. Two policy issues relevant in the 2016 national election-expanded use and regulation of marijuana and containing the cost of prescription drugs-received considerable attention on the nursing organizations' social media feeds, while a substantial percentage of analysed content was not related to health policy. CONCLUSION: Professional nursing organizations often represent the voice of nurses in policy discussions. Organization leaders and members should consider how social media content could enhance nurses' policy participation and advance dialogue about health and well-being in the context of high-stakes healthcare debates.

A Staged Approach to Educating Nurses in Health Policy.

Nurse leaders and health-care experts agree that nurses have a responsibility to address the health problems facing the nation by participating in health policy development. However, nurses have not fully realized their potential when it comes to engaging in health policy advocacy and leadership. Nurse leaders, professional nursing organizations, accrediting bodies, and the Institute of Medicine have all identified the need to educate nurses in heath policy. Valuable recommendations for content and learning activities in health policy have been made. We argue that nursing education in health policy and the many recommendations offered have been broad and overly ambitious. This article presents a proposal for a staged approach to educating nurses. This approach would tailor content to the role of the nurse at each level of nursing education. The focus of health policy content would progress from the organizational level to local, state, and finally national level health policies. The goal of this approach is to better prepare all levels of nursing students to participate in shaping effective health policies.

Exploring Nurse Leaders' Policy Participation Within the Context of a Nursing Conceptual Framework.

This study was designed to describe and quantify the experiences of nurse leaders working to influence policy and to build consensus for priority skills and knowledge useful in policy efforts within the context of a nursing conceptual framework. The conceptual model for nursing and health policy and the Adams influence model were combined into a conceptual framework used to guide this two-round modified Delphi study. Twenty-two nurse leaders who were members of a state action coalition participated in the Round 1 focus group; 15 of these leaders completed the Round 2 electronic survey. Round 1 themes indicated the value of a passion for policy, the importance of clear communication, and an understanding the who and when of policy work. Round 2 data reinforced the importance of clear communication regarding policy engagement; knowing the who and when of policy closely followed, and having a passion for policy work was identified as least important. These themes inform learning objectives for nursing education and preparation for interactions with public officials because influencing policy requires knowledge, skills, and persistence. Study findings begin to describe how nurse leaders influence policy within the context of a nursing conceptual framework and generate implications for research, education, and professional practice.

Thoughts About Health Policy Content in Baccalaureate Nursing Programs.

We describe a framework used to analyze health policy content in baccalaureate nursing program courses that combines the conceptual model for nursing and health policy and the Adams influence model to account for knowledge and skills needed for health policy work. Our analysis of health policy content in courses in one baccalaureate nursing program focused on what policies were emphasized and how educational content supported the development of personal influence. The analysis revealed course content focused on public sources of health policies and lack of overt course content about policies from organizational and professional sources. Additionally, we identified little course content about the development of personal influence skills except for communication and message articulation components. As the nursing profession continues to build influence in the policy arena, educators must continue to prepare future nurses for such work.

A Hospital-Based Interdisciplinary Model for Increasing Nurses' Engagement in Legislative Advocacy.

The Legislative Action Interest Group (LAIG) is a hospital-based health policy forum that engages nurses in exploring clinical implications of existing and pending health policies and regulations, while also creating a feedback loop to inform policy makers about the realities nursing practice and patient care. The LAIG is a collaborative effort between the hospital's Department of Nursing and Patient Care Services and the Office of Government Relations at an academic children's hospital. Nurses participating in the LAIG forums build a working knowledge of health policy and can articulate the practice realities for policy decision makers. Participants explore the political context of nursing and pediatric policies while learning about the state legislative process. Beyond the monthly meetings, members build policy advocacy skills and have testified at public hearings, met with state and federal legislators, and led tours for policy makers through the hospital. The LAIG model also benefits the government relations staff by providing time for them to discuss clinical implications of pending policies with nurses from practice settings in the hospital. Forum discussions enhance the ability of the hospital's lobbyists to articulate practice implications of health policy to lawmakers. This case study, describing the origin, structure, operations, and outcomes of the LAIG model, and has implications for nurses in hospitals and academic settings who are interested in engaging in policy work. Opportunities to research the sustainability, replicability, and patient-centered outcomes of LAIG forums represent future work needed to advance nursing's participation in policy.

A model of new nurse transition.

The progression from nursing student into the RN role remains difficult, despite over 30 years of effort to ease the transition for new graduates. We review the research on programs designed to help new graduates move into practice and propose a model for new nurse transition that starts during nursing education and continues 2 years into practice. The model illustrates the frequent detachment between efforts taken by nursing schools and employers to facilitate this transition. We offer recommendations for the design of future research to capture all transition efforts, from student to functioning RN, and better identify the critical elements of new nurse transition programs. Evidence such as this is needed to allow schools and employers to use their limited resources most effectively to support graduate nurses.

Cultivating quality: implementing surgical smoke evacuation in the operating room.

OVERVIEW: Inspired by a presentation at an educational conference, two operating room (OR) nurses at Children's Hospital Boston raised concerns at the hospital's perioperative evidence-based practice committee meeting about the potential hazards associated with exposure to surgical smoke and aerosols. The nurses initiated a safety project involving the use of smoke evacuation devices in ORs. The subsequent policy development took two years and involved a literature review, a survey of other institutions, and the support of numerous stakeholders. A utilization review and supportive educational initiatives are ongoing.

Cultivating quality: shared governance supports evidence-based practice.

Blending a shared governance model with the concept of evidence-based practice (EBP) creates a dynamic situation for both nurses and hospitals: staff nurses are directly involved in improving the care they provide while growing in their practice and becoming more invested in their institution. Shared governance enables staff nurses to assume leadership roles in identifying areas for change and driving the change through an EBP process, while nursing leaders provide the tools and maintain an environment that will allow such a process to take place.