A Tool to Identify Key Behaviors and Attributes of High-Performing Nurses.

OBJECTIVE: The purpose of this project was to identify key behaviors and attributes that distinguish high-performing nurses to develop a tool for employment screening, staff development, and performance management. BACKGROUND: Selecting nurses who will complement an organization's mission and philosophy is a key step toward achieving quality and safety goals, ensuring patient and family satisfaction, and improving retention rates and overall costs. METHODS: Focus group methodology was used to determine perceptions of high-performing nurses' behaviors and attributes. Content analysis of the meeting transcripts was performed to aggregate data into categories and items. RESULTS: Following several phases of testing with various groups, a 16-item scale has been developed. CONCLUSIONS: This tool has received positive ratings from nurse managers currently using it to interview nurse applicants who best "fit" into the organization's nursing culture. Results will be monitored over time including hiring decisions, preceptor ratings, and retention rates.

Essential qualities of an effective clinical leader.

Strong and effective clinical leadership is needed by practicing nurses as our healthcare systems continue to decentralize and shift decision making closer to the bedside. Innovation and new ways of leading and following are required. New forms of clinical leadership can energize and transform today's work environments.

Improving influenza immunization rates among healthcare workers caring for high-risk pediatric patients.

OBJECTIVE: To assess influenza vaccination rates of healthcare workers (HCWs) in neonatal intensive care units (NICUs), pediatric intensive care units (PICUs), and oncology units in Pediatric Prevention Network (PPN) hospitals. PARTICIPANTS: Infection control practitioners and HCWs in NICUs, PICUs, and oncology units. METHODS: In November 2000, posters, electronic copies of a slide presentation, and an influenza fact sheet were distributed to 32 of 76 PPN hospitals. In January 2001, a survey was distributed to PPN hospital participants to obtain information about the immunization campaigns. On February 7, 2001, a survey of influenza immunization was conducted among HCWs in NICU, PICU, and oncology units at participating hospitals. RESULTS: Infection control practitioners from 19 (25%) of the 76 PPN hospitals completed the surveys. The median influenza immunization rate was 43% (range, 12% to 63%), with 7 hospitals exceeding 50%. HCWs (n = 1123) at 15 PPN hospitals completed a survey; 53% of HCWs reported receiving influenza immunization. Immunization rates varied by work site: 52% in NICUs and PICUs compared with 60% in oncology units. Mobile carts and PPN educational fact cards were associated with higher rates among these subpopulations (P < .001) (361 [63%] of 575 vs 236 [44%] of 541 for mobile carts; 378 [60%] of 633 vs 219 [45%] of 483 for fact cards). CONCLUSION: Despite delayed distribution of influenza vaccine during the 2000-2001 season, immunization rates at 7 hospitals and among HCWs in high-risk units exceeded the National Association of Children's Hospitals and Related Institutions goal of 50%.

The effects of concrete objective information and relaxation on maintaining usual activity during radiation therapy.

PURPOSE/OBJECTIVES: To examine the effects of concrete objective information (COI) and relaxation instruction (RI) on patients undergoing radiation therapy, as well as the contribution of symptom uncertainty and body awareness to the intervention effects. DESIGN: Three-group randomized trial. Assignment was stratified by cancer site. Data collectors were blinded to group assignments. SETTING: University medical center radiation therapy department serving both urban and rural communities in the southeastern United States. SAMPLE: 76 adults having radiation with curative intent for gynecologic, head and neck, or lung cancer. Most were Caucasian and had in situ to stage II disease. Mean age was 55 years. METHODS: COI and RI were delivered by tape recordings. Outcome measures were indicators of usual activities and emotions at treatment week 3 and two and four weeks post-treatment. MAIN RESEARCH VARIABLES: Intervention group; social, household, and recreational activities; anxiety, depression, and anger; body awareness; and symptom uncertainty. FINDINGS: Participants receiving either intervention reported more social activity during treatment. Those given RI who were high in body awareness reported more household activity during treatment. No effects were found regarding emotion. Symptom uncertainty partially explained COI effects. CONCLUSIONS: The findings provide additional support for the effectiveness of COI in helping patients to maintain more of their usual activities during radiation therapy. Instruction in progressive muscle relaxation also may help in maintaining activities. IMPLICATIONS FOR NURSING: COI helps patients to cope with treatment by reducing their uncertainty about symptoms. RI effects may vary by activity type and awareness of usual body sensations.