Applying the Patient Empowerment, Engagement, and Activation Survey to Improve Patient Outcomes.

This article focuses on applying the patient empowerment, engagement, and activation (PEEA) model as an implementation strategy to achieve patient- or person-centered care. There is substantial evidence linking PEEA to improved patient care outcomes and reduced healthcare costs. Interrelationships among the 3 concepts are discussed and how the PEEA survey can be used to evaluate patients' activation for self-care postdischarge and their perceptions of nurses' empowering and engaging them during the care encounter.

Development and Psychometric Testing of a Leadership Competency Assessment.

OBJECTIVE: This article discusses the development and psychometric testing of the Nursing Leadership Competency Assessment (LCA). BACKGROUND: Several leadership assessments are available for purchase, which are aligned with professional organizations. A competency-based leadership assessment is needed to identify the developmental needs of nurse leaders. Competent and confident nurse managers are critical to ensure positive relationships between nurse managers and clinical nurses. METHODS: A multimethod approach was used to develop and test psychometric properties of the LCA. Items were drawn from 8 sources identifying nurse leader competencies. RESULTS: The 76-item assessment had a Cronbach's α of 0.99. Confirmatory factor analysis supported 6 hypothesized factors (domains): leading self, people, organizations, change, innovation, and globally. Subscale reliabilities ranged from α = 0.87 to α = 0.98. CONCLUSIONS: The LCA has demonstrated utility in assessing nurse leader competencies and guiding the development of educational opportunities in targeted content areas for specific leadership roles.

Adapting and Creating Healing Environments: Lessons Nurses Have Learned From the COVID-19 Pandemic.

The purpose of this article is to discuss how nurse leaders influenced facility design decisions, quickly evaluated the outcomes, and rapidly adapted the environment based on their own observations, assessments, changing regulatory requirements, and the needs of patients, nurses, and the caring workforce. Nurses must validate their clinical voice in the future design of healthcare environments based on the adaptations discovered and instituted during COVID-19. Many lessons were learned and physical adaptations made during the pandemic. While the pandemic spotlighted the emotional and physical stress and strain on nurses, it is important to consider all adaptations made in the physical environment to improve care delivery.

Psychometric Testing of a Nurse Residency Program Stakeholder Evaluation Survey.

This article describes the development and psychometric testing of a 43-item nurse residency program stakeholder evaluation. The valid and reliable survey provides nursing professional development practitioners with insight into opportunities to improve nurse residency program design and educational content. Survey results may also substantiate human and capital resources required for effective programs.

A 1-Year Accredited Nurse Residency Program's Effect on Intent to Leave.

OBJECTIVE: This article describes the evaluation of a system-wide program to enhance new graduate nurse resident (NGNR) experience, enculturation, and commitment to the organization. BACKGROUND: Structured nurse residency programs support NGNR transition to the work environment and increase retention and organizational commitment. METHODS: The study used a descriptive, comparative design measuring NGNR perceptions of affective commitment, job satisfaction, job stress, and other variables over 3 times from baseline to 24 months. RESULTS: Findings demonstrated a reduction in affective commitment and an increase in nursing stress from baseline to 12 and 24 months of employment. The highest mean in intent to leave occurred at 12 months, highlighting the vulnerability of the NGNR at that time. CONCLUSIONS: Nurse leaders must consider resources supporting NGNRs beyond the traditional 12 months to ensure retention and organizational commitment, thereby decreasing intent to leave.

Psychometric Testing of a Patient Empowerment, Engagement, and Activation Survey.

BACKGROUND: Patient or person-centered care has become a widely used philosophical framework and yet has varying definitions and characteristics. Person-centered care has recently been conceptualized as patient empowerment, engagement, and activation with studies citing positive outcomes. PURPOSE: This study reports the psychometric properties of the Patient Empowerment, Engagement, and Activation Survey. METHODS: An instrument development and testing approach was used. RESULTS: A 21-item survey was developed demonstrating respectable Cronbach α coefficients for the total scale (α = 0.88) and for each subscale: Empowerment (α = 0.71), Engagement (α = 0.81), and Activation (α = 0.76). A regression analysis with 1 item, "I am ready to be discharged" as the dependent variable and all other items as independent variables explained 65% of the variance in readiness for discharge (P < .001). DISCUSSION: The Patient Empowerment, Engagement, and Activation Survey can be used to evaluate patients' perspectives of care quality (empowerment and engagement) and readiness for discharge (activation).

A concept analysis of health literacy.

AIM: To propose a conceptual definition of health literacy incorporating system demands, burdens, and complexities that are a critical part of patients' level of health literacy. BACKGROUND: Health literacy is used frequently in health care and often is confused with patients' reading and comprehension levels. DESIGN: Walker and Avant's concept analysis method was used. DATA SOURCE: Cochrane Library, Cumulative Index of Nursing and Health Literature, OVID, PubMed, EBSCO Host databases, and Google Scholar. REVIEW METHOD: The primary Search terms and MeSH terms used were health literacy, patient education, patient engagement, patient activation, health communication, health promotion, and nursing. Empirical and nonempirical articles published in English were reviewed. Ten systematic literature reviews were included. RESULTS: A new definition of health literacy is provided based on four components that include: system demands, burdens, and complexities; measurable components, processes and outcomes; the dynamic nature of health literacy; and demonstration of the direct relationship of informed decisions to informed actions. Defining attributes, antecedents, and consequences are identified. Implications for nursing practice, education, and research are given. CONCLUSIONS: Because health literacy is a dynamic and quickly changing concept, further exploration and evolution of the concept is warranted as empirical research and theoretical literature emerge.

Effectiveness of a Psychiatric-Mental Health Nurse Residency Program on Retention.

BACKGROUND: Nurse residency programs (NRPs) provide new graduate nurses (NGNs) with social support and experiential activities as a formal transition to clinical practice. AIMS: The study was conducted to answer the question: What is the effectiveness of an NRP in retaining NGNs in a psychiatric-mental health setting? METHOD: This study used a quantitative time-sequenced comparative study of multiple cohorts of NGNs hired into an NRP at a freestanding hospital in California. RESULTS: The study yielded a turnover rate of 11.7% in Year 1 (88.3% retention) and 2.9% in Year 2 (97.1% retention rate), which are lower than reported turnover rates (17.5% and 33.5%, respectively). Significant correlations are described in the workplace domains of knowledge and skills, social support, organizational citizenship behavior, civility, coping self-efficacy, organizational and occupational commitment, person-organizational fit, and burnout. CONCLUSIONS: NRPs are effective in attracting and retaining competent, confident NGNs in psychiatric-mental health nursing.

An Exploratory, Descriptive Study of Nurse Leaders' Personal and Work Experiences During Union Negotiations and Strike Events.

OBJECTIVE: This study explored the experiences, perceptions and emotional state of nurse leaders during union activities to understand the impact on their personal and professional lives. BACKGROUND: Other than anecdotal stories shared during union negotiations and strike preparations, very little evidence exists in nursing and healthcare literature about nursing unions and their impact on nurse leaders and their organizational priorities. METHODS: This study used an exploratory, descriptive design with a convenience and snowball sample of Association of California Nurse Leaders members. RESULTS: The findings indicate nurse leaders experience a range of emotional states in response to union activities with perceptions of increased workload, job stress, and constrained and deliberate communications with their staff. CONCLUSION: This study adds to the body of knowledge about nurse leader experiences and feelings during union activities.

Health Literacy: Essential for a Culture of Health.

BACKGROUND: A culture of health requires a commitment from all-individuals, families, communities, organizations, and municipalities-to value health and make decisions reflective of a healthy society. At the individual level, health literacy is a necessary precursor to assist individuals in achieving a higher level of health. METHOD: One method for ensuring that staff members are routinely assessing and promoting health literacy is using competencies and practices previously identified for all health professions. RESULTS: Cross-walking these competencies with the Health Literacy Tapestry model can be extremely helpful in framing assessment, action steps, and outcomes for nurses. CONCLUSION: Professional development nurse leaders have the challenge of ensuring that nurses are addressing patient health literacy as a fundamental nursing activity in every nursing-patient-family interaction. Assuming health literacy deficits as a "universal approach" to care is one method of ensuring health literacy needs are routinely addressed by staff. J Contin Educ Nurs. 2018;49(2):73-78.