Is the hospital's magnet status linked to HCAHPS scores?

This study identified a significant link between Magnet hospitals and higher HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores across 110 Illinois hospitals. Compared with registered nurse nursing hours per patient-day and registered nurse turnover rate, Magnet status was a stronger contributor to the HCAHPS scores. A moderate to strong, reverse relationship between hospital's percentage of African American patients and HCAHPS scores suggests a need for strengthening culturally sensitive nurse-patient communications.

Medication management roles in assisted living.

Residents in assisted living (AL) frequently need assistance with medication management. Rooted in a social model, AL serves people facing increasing health management challenges as they "age in place." This study explored roles in AL medication management and satisfaction with unlicensed assistive personnel (UAP) as medication aides, a cost-effective staffing approach that is used frequently. The sample included 112 participants representing all parties involved in medication administration (residents, medication aides, administrators, RNs and licensed practical nurses, pharmacists, and primary care providers) in 15 AL settings in four states. Results include description of medication management roles; empirical validation of existing AL nursing professional standards; and satisfaction with the role of UAP as medication aide from all perspectives. Clinical implications include creating a supportive environment for medication aides (i.e., UAPs); the importance of the RN role as facilitator of AL medication management; and the need for collaboration and interprofessional team development across disparate settings.

The effect of hand massage on preoperative anxiety in ambulatory surgery patients.

Anxiety in patients awaiting surgery and diagnostic procedures in an ambulatory department can affect the patient's physiological and psychological well-being and outcome. We conducted a quasi-experimental study at a midwestern US community hospital to determine the effects of hand massage on patient anxiety in the ambulatory surgery setting. We also investigated whether adding the hand massage procedure affected the timing and flow of procedures. The results indicated that hand massage reduces anxiety for patients awaiting ambulatory surgery and outpatient procedures. Participants who received hand massage experienced lower anxiety levels than those who received customary nursing care. In addition, the performance of hand massage did not affect the flow or timing of procedures. Hand massage is an easy procedure for nurses to learn and administer, and it is within the scope of perioperative nursing practice.

Culture-change training: nursing facility staff perceptions of culture change.

Identifying effective alternative strategies for training staff and implementing culture change can be useful to nursing facilities striving to provide optimal resident-centered care. This study assessed the perceptions of nearly 400 nursing facility staff experiencing organizational culture change. Formal and informal training methods were used. We used a pre- and post-test to evaluate leadership practices and 6 subscales related to culture change (systemwide culture change, resident choice, organization design, empowering supervision, job design, decision making, and permanent assignments). Staff of formally trained facilities perceived improvements in all subscales; 2 were statistically significant (resident choice and organization design). Respondents for informally trained facilities identified improvement in decision making, although this was not statistically significant. Formalized culture-change training produced better outcomes than did the informal strategy. Culture change is a complex process and may continue to evolve over time. A 3-year evaluation period may be insufficient to demonstrate the full extent of these changes.

Promoting physical activity for persons with diabetes.

PURPOSE: The purpose of this study was to evaluate the effectiveness of a self-help physical activity program for persons with type 2 diabetes. Effectiveness was measured by cardiovascular indicators, hemoglobin A1C, anthropometric indicators, and activity levels. METHODS: This intervention study included 53 individuals with type 2 diabetes. Participants were randomly assigned. Participants in the intervention group attended the usual Diabetes Self-Management Education Program (DSMEP) and received a copy of the book, Manpo-kei; a concise handout summarizing the key points of Manpo-kei; and a pedometer. Participants not assigned to the intervention attended the usual DSMEP only. Data collection was completed at the beginning of the study and 3 months later using a lifestyle and diabetes questionnaire, a physical activity questionnaire, and cardiovascular and anthropometric measures. RESULTS: Those who participated in the intervention demonstrated a significant decrease in hemoglobin A1C, weight, and body fat. In addition, they increased their number of daily steps as measured by the pedometer. The control group also demonstrated a significant decrease in hemoglobin A1C and weight. Both groups demonstrated increases in their regular weekly activity. At the end of the study period, the intervention group had a significantly lower diastolic blood pressure than the control group. CONCLUSIONS: Pedometers can be a helpful strategy to motivate persons with diabetes to increase physical activity. However, it appears that attendance at DSMEP alone may be enough to increase physical activity for persons with type 2 diabetes.

Nursing staff attitudes and behaviours regarding family presence in the hospital setting.

AIM: This paper is a report of a study conducted to assess the attitudes and values of nursing staff towards family presence during routine nursing care. BACKGROUND: Nursing staff attitudes are an important factor in the adoption of family-centred care for children, and for all ages in the emergency room, special care units, and anaesthesia induction and recovery. Little is documented about nurse attitudes and behaviours related to family presence during day-to-day routine nursing care. METHOD: In 2006, primary data were collected with a convenience sample of 89 nursing staff using an 18-item questionnaire developed by the authors and based on several family-centred care instruments in the literature. Items assessed attitude and nurse behaviours related to family presence during routine nursing care. FINDINGS: Nurses' attitudes and behaviours towards family presence during routine nursing care were generally favourable. There was low agreement about family members being allowed to visit whenever the patient wished. Nursing staff attitudes were consistent with their self-reported behaviours supporting family presence. CONCLUSION: Nursing staff who believe family presence is important are more likely to include families in daily care. The organization plays a key role in encouraging family-centred care by providing appropriate education and support to nursing staff.

Ensuring a knowledgeable and committed gerontological nursing workforce.

There is a growing societal need for professional nurses who are knowledgeable and committed to working with older adults. In order to address this need, a small study that included self-evaluation and curriculum review was conducted by faculty at one Midwestern nursing program in the United States. A moderately positive attitude, moderately high knowledge, and moderate pursuit of knowledge of older adults were identified with the faculty in the presence of limited curricular content of gerontology. Implications for nursing education included continuing education for nursing faculty and program support in nursing curricula.

Measuring resident and family member determinants of satisfaction with assisted living.

PURPOSE: This study developed measures of satisfaction with assisted living from residents' and family members' perspectives. DESIGN AND METHODS: We collected survey data from 204 residents and 232 family members associated with 11 assisted living facilities. We used confirmatory factor analysis to evaluate the goodness of fit of a priori measurement models. RESULTS: Iterative analysis to improve measurement models resulted in a multifaceted unidimensional model of resident satisfaction and a 5-factor model of family member satisfaction. The scales are both comprehensive and parsimonious and display strong scalar properties. IMPLICATIONS: These scales provide tools for estimating the impact of assisted living on various relevant domains for residents and their family members. These measures should prove useful to administrators attempting to meet the needs of their clients and to potential clients of assisted living attempting to judge the appropriateness of specific assisted living facilities.

Collaboration to promote best practices in care of older adults.

A successful grassroots collaboration of faculty members from one Midwestern school of nursing to promote best practices in gerontological nursing is described. Recommendations are made for developing similar collaborations in other settings.

Magnet Recognition Program 2005: an update.

The Magnet Recognition Program has been revised to simplify instructions, eliminate redundancy, and reduce the documentation burden for applicants. One of the major changes is that required documentation is now categorized by the 14 Forces of Magnetism to match the Scope and Standards for Nurse Administrators (American Nurses Association [ANA], 2004) through the use of a crosswalk matrix. However, in general, the original concepts that characterized Magnet recognition remain intact.

Provider dilemmas with relocation in assisted living: philosophy vs. practice.

Support for increasing tenant frailty in assisted living (AL) is a complex and challenging issue. Philosophically, older persons, families, providers, and policymakers want to avoid unnecessary relocation. However, there is considerable opportunity for inconsistency in practice. We examined provider perspectives related to implementing aging-in-place, using information obtained from an evaluation of a three-year AL demonstration project in Illinois. We found differences in approaches to explicit move-out criteria, the actual application of move-out criteria, and provider willingness to develop flexible service plans. These findings raise questions for consideration in all states confronted with implementing the philosophy and intent of AL.

Magnet designation: A communiqué to the profession and the public about nursing excellence.

Achieving Magnet designation by health care institutions is gaining momentum, both nationally and internationally. The impetus behind the Magnet movement is its sole focus on nursing care services. Hence, imbedded in the Magnet designation is the concept of the recognition of nursing services reaching a high level of excellence. Research conducted during the last 2 decades provides evidence that Magnet recognition has been a successful organizational reform that holds promise to shape patient care quality in all types of health care institutions.

Achieving Magnet recognition: the process.

Awareness of the Magnet Recognition Program is increasing as health care organizations struggle with the challenges of recruiting and retaining professional nurses and benchmarking nursing-sensitive patient outcomes. Steps in the Magnet process include application, written documentation and evaluation, site visit, decision, and award. These steps are outlined in this article to inform and assist staff nurses in health care organizations that may consider seeking this designation. The more staff nurses know about the elements and process of the Magnet program, the more they can contribute to achieving this prestigious award for quality nursing care.

Assisted living issues for nursing practice.

Assisted living has become a popular setting for older people and their families. Although health care services in these settings are limited, many residents require some level of medication management. In some states, unlicensed assistive personnel can perform medication management, suggesting delegation of nursing activities. However, confusion may arise between the licensing requirement for settings and the nurse practice act on this issue. This report discusses assisted living, nurse delegation with regard to medication management, and recommendations for nursing practice for both delegator and delegate.