Applying Principles of a Fair and Just Culture to a Student Scenario.

BACKGROUND: This article reviews national efforts toward promoting fair and just cultures in schools of nursing. A real-life vignette in which a nursing student made a medication error is presented, and the nursing program contacted the nursing regulatory body for advice on how to handle the situation. METHOD: A framework was used to analyze the causes of the error. Commentary is offered regarding how applying the principles of a fair and just culture could improve student performance and advance the school's culture to reflect one that was fair and just. RESULTS: A fair and just culture requires a commitment of all leaders and faculty within a school of nursing. Administrators and faculty must recognize that errors are part of the learning process, that errors can be minimized but not eliminated, and that learning can occur from each incident to prevent similar occurrences in the future. CONCLUSION: Academic leaders must engage faculty, staff, and students in a dialogue about the principles of a fair and just culture to develop a tailored plan of action. [J Nurs Educ. 2023;62(3):139-145.].

Using Activism to Get Nurses on Boards.

Over the past 15 years, there has been a growing call for nurses to be placed on boards of hospitals and health systems. Rationale for this action includes the changing nature of health care; a greater emphasis on person and family-centered care; nurses' background and experience in health care delivery; and that boards with a more diverse composition are associated with better organizational performance. Several national organizations have come forward to support this, among them the Robert Wood Johnson Foundation, American Hospital Association, the Institute of Medicine, and several industry leaders in health care. While progress has been made, however, nurses still occupy only 4% of board seats. This article reviews some of the myths and barriers that have prevented nurses from serving on boards, as well as offering 3 major recommendations for action that reflect not only long-term efforts but also short-term activism.

QSEN in an Amazon World.

ABSTRACT: Quality and Safety Education for Nurses (QSEN) was launched in 2005 as a national nursing initiative aimed at preparing nurses with the competencies needed to continuously improve the quality and safety of the health care they provide. The six QSEN competencies-and the knowledge, skills, and attitudes that each entails-have served as a basis for significant curricular revision, more enlightened professional practice, relevant research, and health care system improvements. Since the launch of QSEN, new technologies have emerged, the range of care sites has broadened, new practice roles have emerged, and patients and families have become more active health care consumers. This article highlights these changes, considers Amazon as a powerful contemporary social force, examines the company's core values, and considers their relevancy to the six QSEN competencies. Essential new literacies and cognitive capacities are also identified. Lastly, the authors outline steps nurses can take to incorporate the QSEN competencies, along with the literacies and capacities, into their practice and organizations. Doing so is vital to delivering safe, high-quality care in this rapidly changing health care climate, and will enable nurses to claim their leadership and thrive professionally in an Amazon world.

Nursing leadership in policy formation.

This article provides broad definitions of the concepts of policy, politics, and power, which will be developed further in subsequent articles. The article describes the critical role of nurses in health policy formation at local, organizational, and national levels and outlines the unique strengths and sources of influence that nurses possess and must employ if health care in the United States is to become safer, more accessible, holistic, and more affordable. Many of these same talents can be used at international levels to affect health care worldwide. The basic premise of this article-and actually of the entire issue-is this: When informed nurses are actively involved in shaping healthcare policy at any level, desired outcomes will be substantially improved.

Nursing Disruption for Achieving Sustainable Development Goals by 2030.

Sixteen million nurses, the largest global health care workforce, contribute to achievement of 17 United Nations Sustainable Development Goals through strategic and disruptive research, education, practice, and policy. Responsible for advancing the well-being of individuals, families, communities, and society, nurses are positioned to influence and impact health across the life span. They do this from promoting prenatal health and early childhood success to encouraging healthy aging and end-of-life transitions. They utilize both predictive analytics that prevent rehospitalization and evidence-based practices, such as rocking and kangaroo care, that encourage survival and thriving of preterm newborns. Nurses have a scope of practice that necessitates their presence essentially everywhere. Direct nursing care is delivered in homes, schools, correctional settings, districts, hospitals, helicopters, combat zones, refugee camps, and postnatural disaster or homeless shelters. Nurses advancing system-level health are positioned in health care administration, higher education, international nongovernmental organizations, and governmental offices. Nurse educators and researchers shape tomorrow's practitioners and practice. In general, nurses innovate and generate solutions to improve global health. Shared in this article are strategies for nurses to employ to disrupt the status quo and aggressively contribute to achieving the 2030 Sustainable Development Goals.

Retired Nurse Volunteers.

: Given the looming shortage of RNs, a viable option for hospitals to consider in optimizing available resources is the retired nurse volunteer. This article describes the benefits of using retired nurses to complement existing hospital staff and offers recommendations for setting up a program to effectively use these volunteers in the hospital setting.

Role of the Chief Nurse Officer in Ensuring Person- and Family-Centered Care.

Person- and family-centered care (PFCC) is a philosophy that has been espoused for decades and yet is rarely embedded in health care organizations. Difficulties dispelling the numerous myths about what PFCC is, as well as daunting challenges to designing and implementing it, have hindered progress. The chief nurse officer is well-positioned to assume organizational leadership in successfully navigating this effort. This article provides 9 specific steps a chief nurse officer should take to create a culture, with supportive systems and an environment, to ensure authentic PFCC.

Preferment: A New Meaning in Retirement.

This article reviews key trends affecting societal views on aging, examines data on RN retirement, and explores the many opportunities that are open to nurses who are approaching retirement. It describes a new way to think about this phase-preferment- along with strategies for preparing for preferment.

Creating a Fair and Just Culture in Schools of Nursing.

: In recent years, health care organizations have been moving away from a culture that responds to errors and near misses with "shame and blame" and toward a fair and just culture. Such a culture encourages and rewards people for speaking up about safety-related concerns, thus allowing the information to be used for system improvement. In part 1 of this series, we reported on findings from a study that examined how nursing schools handled student errors and near misses. We found that few nursing schools had a policy or a reporting tool concerning these events; and that when policies did exist, the majority did not reflect the principles of a fair and just culture. This article, part 2 of the series, describes several strategies that nursing schools can use for creating such a culture.

CE: Original Research: Exploring How Nursing Schools Handle Student Errors and Near Misses.

: Background: Little attention has been paid to how nursing students learn about quality and safety, and to the tools and policies that guide nursing schools in helping students respond to errors and near misses. PURPOSE: This study sought to determine whether prelicensure nursing programs have a policy for reporting and following up on student clinical errors and near misses, a tool for such reporting, a tool or process (or both) for identifying trends, strategies for follow-up with students after errors and near misses, and strategies for follow-up with clinical agencies and individual faculty members. METHODS: A national electronic survey of 1,667 schools of nursing with a prelicensure registered nursing program was conducted. Data from 494 responding schools (30%) were analyzed. RESULTS: Of the responding schools, 245 (50%) reported having no policy for managing students following a clinical error or near miss, and 272 (55%) reported having no tool for reporting student errors or near misses. CONCLUSIONS: Significant work is needed if the principles of a fair and just culture are to shape the response to nursing student errors and near misses. For nursing schools, some essential first steps are to understand the tools and policies a school has in place; the school's philosophy regarding errors and near misses; the resources needed to establish a fair and just culture; and how faculty can work together to create learning environments that eliminate or minimize the negative consequences of errors and near misses for patients, students, and faculty.

Sense Making and Knowledge Transfer: Capturing the Knowledge and Wisdom of Nursing Leaders.

Experienced nurse leaders possess leadership wisdom that must be passed on in thoughtful, systematic ways to younger leaders. Sense making is an intentional process that has been useful in bringing forward a leader's implicit knowledge and wisdom gained over the years. This article examines leadership wisdom, complexity, and knowledge in the context of today's dynamic environment-and offers a concrete example of how the sense-making methodology can work.

Mandate for care.

MUCH HAS been written on the need to move to a more patient- and family-centred system of healthcare delivery. Recognised steps that nursing staff can take to design patient-centred care delivery models include, for example, unrestricted visiting for family members, hourly rounding and having open medical record policies.

Differential effects of professional leaders on health care teams in chronic disease management groups.

BACKGROUND: Leadership by health care professionals is likely to vary because of differences in the social contexts within which they are situated, socialization processes and societal expectations, education and training, and the way their professions define and operationalize key concepts such as teamwork, collaboration, and partnership. This research examines the effect of the nurse and physician leaders on interdependence and encounter preparedness in chronic disease management practice groups. PURPOSE: The aim of this study was to examine the effect of complementary leadership by nurses and physicians involved in jointly producing a health care service on care team functioning. METHODOLOGY: The design is a retrospective observational study based on survey data. The unit of analysis is heart failure care groups in U.S. Veterans Health Administration medical centers. Survey and administrative data were collected in 2009 from 68 Veterans Health Administration medical centers. Key variables include nurse and physician leadership, interdependence, psychological safety, coordination, and encounter preparedness. Reliability and validity of survey measures were assessed with exploratory factor analysis and Cronbach alphas. Multivariate analyses tested hypotheses. FINDINGS: Professional leadership by nurses and physicians is related to encounter preparedness by different paths. Nurse leadership is associated with greater team interdependence, and interdependence is positively associated with respect. Physician leadership is positively associated with greater psychological safety, respect, and shared goals but is not associated with interdependence. Respect is associated with involvement in learning activities, and shared goals are associated with coordination. Coordination and involvement in learning activities are positively associated with encounter preparedness. PRACTICE IMPLICATIONS: By focusing on increasing interdependence and a constructive climate, nurse and physician leaders have the opportunity to increase care coordination and involvement in learning activities.