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1.
J Nurs Adm ; 50(2): 63-65, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31977943

RESUMO

The 2019 Association for Leadership Science in Nursing International Conference, Disruptive Innovation, was held in Los Angeles, California, with attendees from 30 US states, Canada, Brazil, and China. Presenters discussed the need for nurse leaders to advocate for health equity, lead evidence-based innovation, how robots and other technology are generating disruptive innovations in healthcare, and building strong academic-practice partnerships to address nursing workforce challenges. This article will report on these important insights.


Assuntos
Enfermagem Baseada em Evidências/organização & administração , Equidade em Saúde/organização & administração , Invenções , Enfermeiras Administradoras/organização & administração , Recursos Humanos de Enfermagem/organização & administração , Inovação Organizacional , Brasil , Canadá , China , Humanos , Liderança , Estados Unidos
2.
Res Theory Nurs Pract ; 33(3): 257-274, 2019 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-31615945

RESUMO

BACKGROUND: Compelling evidence indicates that gaps in quality, safety, and experiences occur when patients encounter transitions across the care continuum. Differences in the organization of healthcare services as well as disparities in health across the globe, may have a unique impact on processes associated with transitions of care for client populations. PURPOSE: Increased attention to the concept of transitions of care has resulted in disparate meanings and lack of clarity about its nature. Therefore, the purpose of this manuscript is to address this knowledge gap by analyzing the concept of transitions of care at the population level. METHODOLOGY: To address the knowledge gap of what constitutes transitions of care at the population level, a concept analysis was done guided by the methodology of Walker and Avant. A comprehensive search of the literature yielded a small but relevant number of publications. RESULTS: This analysis identified four defining attributes, together with antecedents and consequences of transitions of care at the macro-system level of healthcare. A synthesized definition of transitions of care was developed. IMPLICATIONS FOR PRACTICE: This analysis provides conceptual clarity for the concept of transitions of care at the macro-system level of care. It can be used to guide the development of a middle-range theory to inform clinical practice and health policy.

3.
J Nurs Adm ; 49(11): 517-519, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31651608

RESUMO

Nurses who aspire to lead a professional nursing organization can significantly influence the future of the nursing profession. This article describes 4 essential responsibilities required in a board leadership position as identified by a group of nurse leaders who have each served as the board president of a national or international professional nursing organization.


Assuntos
Liderança , Enfermeiras Administradoras/organização & administração , Papel do Profissional de Enfermagem , Sociedades de Enfermagem/organização & administração , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
4.
J Nurs Adm ; 2019 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-31658215

RESUMO

Nurses who aspire to lead a professional nursing organization can significantly influence the future of the nursing profession. This article describes 4 essential responsibilities required in a board leadership position as identified by a group of nurse leaders who have each served as the board president of a national or international professional nursing organization.

5.
J Nurs Adm ; 49(3): 118-120, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30789554

RESUMO

The 2018 International Nursing Administration Research Conference, Grassroots to Global, was held in Atlanta, Georgia, with attendees from 38 US states, Canada, and China. Presenters discussed the need for nurse leaders to be prepared to partner with those inside and outside of healthcare to create innovative, interprofessional care delivery models; advocate for advancements in technology to address healthcare access shortages; and lead new areas of research that can drive policy change to support nurse leaders in long-term care and the essential role of the nurse manager in creating optimal practice environments for quality outcomes. This article will report on these important insights.


Assuntos
Competência Clínica/normas , Liderança , Enfermeiras Administradoras/tendências , Papel do Profissional de Enfermagem , Supervisão de Enfermagem/tendências , Qualidade da Assistência à Saúde/tendências , Congressos como Assunto , Humanos , Internacionalidade , Relações Interprofissionais , Enfermeiras Administradoras/organização & administração , Pesquisa em Administração de Enfermagem , Supervisão de Enfermagem/organização & administração , Qualidade da Assistência à Saúde/normas
6.
Nurs Adm Q ; 43(1): 32-39, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30516705

RESUMO

Addressing health inequities and the social determinants of health for all people of the world is a primary goal of the World Health Organization. This article describes how a "Connecting Communities educational program" enabled nurse leaders from academic institutions from different sides of the globe to develop a reciprocal relationship of mutual interest around the topics of the nursing role in population health and care delivery. Grant funding resulted in the sharing of knowledge, expertise, and experiences directed toward encouraging the development of nurses as global citizens, with a broader view on what influences health and well-being. This initiative demonstrates how nurses can contribute to the improvement of world health and address the social determinants of health while practicing locally but thinking and contributing globally.


Assuntos
Disparidades em Assistência à Saúde/tendências , Internacionalidade , Redes Comunitárias , Saúde Global/normas , Disparidades em Assistência à Saúde/estatística & dados numéricos , Humanos , Determinantes Sociais da Saúde/normas , Determinantes Sociais da Saúde/estatística & dados numéricos
7.
J Nurs Adm ; 48(5): 272-278, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29629909

RESUMO

OBJECTIVE: The study identifies what constitutes nurse manager (NM) support and other resources that enable clinical nurses (CNs) to engage in evidence-based practice (EBP). BACKGROUND: Clinical nurses report that NM support enables them to use EBP but what constitutes NM support is still unclear. METHODS: Nurse managers, CNs, and EBP mentors received specialized education and use a team approach for EBP. Data were collected preintervention, mid-intervention, and postintervention from observations, interviews, journaling, and surveys. RESULTS: Results demonstrate how NMs can perform their role responsibilities and still engage CNs to develop a spirit of inquiry, seek answers to their clinical questions using EBP, and advance their clinical performance to improve patient outcomes. Four NM supportive behaviors emerged: cultivating a shared EBP vision, ensuring use of EBP, communicating the value of EBP, and providing resources for EBP. CONCLUSION: Through education and support, NMs describe supportive behaviors necessary for the successful conduction of EBP by CNs.


Assuntos
Enfermagem Baseada em Evidências/organização & administração , Prática Clínica Baseada em Evidências/organização & administração , Enfermeiras Clínicas/organização & administração , Supervisão de Enfermagem/organização & administração , Educação Continuada em Enfermagem , Humanos , Mentores , Enfermeiras Administradoras , Inovação Organizacional , Estados Unidos
8.
Nurs Econ ; 32(3 Suppl): 3-35, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25144948

RESUMO

The Patient Protection and Affordable Care Act (PPACA, 2010) and the Institute of Medicine's (IOM, 2011) Future of Nursing report have prompted changes in the U.S. health care system. This has also stimulated a new direction of thinking for the profession of nursing. New payment and priority structures, where value is placed ahead of volume in care, will start to define our health system in new and unknown ways for years. One thing we all know for sure: we cannot afford the same inefficient models and systems of care of yesterday any longer. The Data-Driven Model for Excellence in Staffing was created as the organizing framework to lead the development of best practices for nurse staffing across the continuum through research and innovation. Regardless of the setting, nurses must integrate multiple concepts with the value of professional nursing to create new care and staffing models. Traditional models demonstrate that nurses are a commodity. If the profession is to make any significant changes in nurse staffing, it is through the articulation of the value of our professional practice within the overall health care environment. This position paper is organized around the concepts from the Data-Driven Model for Excellence in Staffing. The main concepts are: Core Concept 1: Users and Patients of Health Care, Core Concept 2: Providers of Health Care, Core Concept 3: Environment of Care, Core Concept 4: Delivery of Care, Core Concept 5: Quality, Safety, and Outcomes of Care. This position paper provides a comprehensive view of those concepts and components, why those concepts and components are important in this new era of nurse staffing, and a 3-year challenge that will push the nursing profession forward in all settings across the care continuum. There are decades of research supporting various changes to nurse staffing. Yet little has been done to move that research into practice and operations. While the primary goal of this position paper is to generate research and innovative thinking about nurse staffing across all health care settings, a second goal is to stimulate additional publications. This includes a goal of at least 20 articles in Nursing Economic$ on best practices in staffing and care models from across the continuum over the next 3 years.


Assuntos
Modelos Organizacionais , Admissão e Escalonamento de Pessoal/organização & administração , Recursos Humanos de Enfermagem no Hospital/provisão & distribução , Patient Protection and Affordable Care Act , Admissão e Escalonamento de Pessoal/normas , Qualidade da Assistência à Saúde , Estados Unidos
9.
Nurs Adm Q ; 38(2): 133-7, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24569759

RESUMO

With the advent of the Affordable Care Act, new models of care are underway. Health care experts agree that to improve care, there will need to be improved partnerships across the care continuum, finally eliminating silos of care and services. WellStar Health System, a large health care system in the southeastern part of the United States, is demonstrating its early adoption of integration and the new rules of engagement. These rules will fundamentally change the course of how to provide health care and lead the way for a more accountable-based model of care delivery. This article describes the anticipated and successful preliminary outcomes achieved in the first year of this system's demonstration project in the Medicare Shared Savings Program or "Medicare ACO." WellStar Health System began with a focus on addressing the needs of the heart failure patient. In an effort to achieve the triple aim of improving access, reducing cost, and improving outcomes, the system designed a dedicated inpatient heart failure unit. This unit operates with a new and sustainable structure that actually links the interdisciplinary and multiple providers of care across the care continuum. In doing so, a significant improvement in achieving patient's compliance with care treatment and a reduction in hospital readmissions have been achieved.


Assuntos
Organizações de Assistência Responsáveis , Redução de Custos/métodos , Patient Protection and Affordable Care Act/normas , Reembolso de Incentivo/normas , Responsabilidade Social , Humanos , Estados Unidos
11.
Worldviews Evid Based Nurs ; 4(4): 187-99, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-18076462

RESUMO

BACKGROUND AND PURPOSE: Making evidence-based practice (EBP) a sustained reality is a difficult endeavor. This relates, among other factors, to lack of sufficient research upon which to base implementation efforts. Alternative sources of evidence therefore need to be considered, particularly where organizational level EBP is the goal. In this article a brief evaluation of a service-based initiative with the aim of obtaining insights regarding multiple types and levels of EBP-related outcomes is described. METHODS: A structured, retrospective improvement evaluation was conducted. Semi-structured interviews and available documents were chosen to obtain information regarding outcomes, perceived spread of reported individual changes, and factors related to the degree of progress. Underlying the method is an evaluation model that shows a progressive set of EBP outcomes at both individual and group levels. FINDINGS: Evaluative results, although limited by several factors, provided credible and sufficient internal evidence for this organization's leadership team to build upon past efforts and refine their approach to integrating research utilization (RU) throughout the department of nursing. For example, the evaluation indicated a set of RU outcomes at the individual nurse level not previously considered and also indicated limitations and challenges to full achievement of initial project-related goals. DISCUSSION AND IMPLICATIONS: The evaluation provided suggestive internal evidence regarding potential benefits of one component of a long-term, valued EBP initiative. However, the evaluation also raised questions regarding structural aspects of this initiative; identified barriers to progress; provided information for dialogue and planning; and highlighted future needs for a proactive, systematic evaluation and a documented trail of data related to all EBP program goals. For those in settings with similar characteristics and aims that have not built in such a prospective evaluation for EBP initiatives, this evaluative project can be assessed for its applicability.


Assuntos
Difusão de Inovações , Medicina Baseada em Evidências/educação , Pesquisa em Enfermagem/educação , Serviço Hospitalar de Enfermagem , Desenvolvimento de Pessoal , Connecticut , Medicina Baseada em Evidências/organização & administração , Humanos , Pesquisa em Enfermagem/organização & administração , Avaliação de Programas e Projetos de Saúde , Estudos Retrospectivos
12.
Online J Issues Nurs ; 9(1): 5, 2004 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-14998349

RESUMO

Shared Governance is the administration and deployment of the organization's services through a partnership model of managers and staff. A system is said to "live" where it provides service. In a health care organization this is the point of service known as the patient care unit. In that arena staff nurses engaged in a partnership model of governance should be acknowledged as the rightful owner of their clinical practice and the systems that support the delivery of patient care. This manuscript describes an acute care hospital's experience in the evolution of its governance structure that enabled staff nurses to assume greater levels of autonomy and control over their practice.


Assuntos
Tomada de Decisões Gerenciais , Prática Institucional/tendências , Modelos de Enfermagem , Modelos Organizacionais , Recursos Humanos de Enfermagem no Hospital/organização & administração , Connecticut , Implementação de Plano de Saúde/métodos , História do Século XX , História do Século XXI , Humanos , Enfermeiras Administradoras/organização & administração , Estudos de Casos Organizacionais , Autonomia Profissional , Responsabilidade Social
13.
Nurs Leadersh Forum ; 9(1): 13-7, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15682584

RESUMO

Hartford Hospital in Hartford, Connecticut made some important changes in redesigning its patient care delivery system with the development of a new role: the RN clinical leader. This role provides for RN accountabilities, such as mentoring, data management, evidence-based practice, and shared governance. This article describes the RN clinical leader and the education provided to nurses who assume this role. An evaluation process is underway to capture the impact of this new nursing role. The RN clinical leader is not part of a career ladder in the typical sense. It does, however, recognize nurses who possess additional competencies and want to take on greater responsibility to provide leadership while retaining their role at the bedside. Those competencies are obtained through a formal educational program with immediate application in the hospital itself.


Assuntos
Mobilidade Ocupacional , Competência Clínica , Liderança , Papel do Profissional de Enfermagem , Recursos Humanos de Enfermagem no Hospital/organização & administração , Connecticut , Currículo , Tomada de Decisões Gerenciais , Educação Continuada em Enfermagem/organização & administração , Reestruturação Hospitalar/organização & administração , Humanos , Modelos Educacionais , Modelos de Enfermagem , Pesquisa em Educação de Enfermagem , Recursos Humanos de Enfermagem no Hospital/educação , Avaliação de Programas e Projetos de Saúde , Desenvolvimento de Pessoal/organização & administração
14.
Nurs Adm Q ; 27(4): 336-43, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-14649026

RESUMO

The nurse's role in quality improvement and assurance is well established, but this is particularly true as hospitals engage in a culture of patient safety and view quality-related activities as important "safety checks." The role of the nurse in ensuring quality related to patient care and safety cannot be overstated. The achievement of quality and safety in patient care is the result of caregivers doing the right thing the right way the first time. Nurses serve as a critical link to the best quality health care organizations have to offer. This article describes four elements of a successful quality program in a large tertiary health care setting (alignment, collaboration, evidence-based practice, and excellence) and makes the connection between quality and safety in the provision of exemplary patient care. Three examples are provided that show how nurses and other members of the health care team grouped together as a governing council for quality (Performance Improvement Council) and at the bedside as direct caregivers in ensuring patient safety and quality patient care.


Assuntos
Papel do Profissional de Enfermagem , Serviço Hospitalar de Enfermagem/normas , Garantia da Qualidade dos Cuidados de Saúde/organização & administração , Gestão da Qualidade Total/organização & administração , Connecticut , Comportamento Cooperativo , Medicina Baseada em Evidências , Hospitais com mais de 500 Leitos , Hospitais de Ensino , Humanos , Determinação de Necessidades de Cuidados de Saúde , Auditoria de Enfermagem/organização & administração , Cultura Organizacional
15.
Obstet Gynecol ; 101(3): 504-10, 2003 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-12636954

RESUMO

OBJECTIVE: To evaluate a peer counseling intervention for pregnant smokers. METHODS: One hundred forty-two pregnant, predominantly Hispanic women were assigned to a peer-led smoking cessation program or to usual care. RESULTS: Compared with usual care, peer counseling reduced smoking (-9.1 versus -4.5 cigarettes daily, P =.03), but did not affect absolute quit rates (24% versus 21%) at 36 weeks' gestation. Infant birth weight negatively correlated with cigarettes smoked per day (r = -0.29, P <.01) and expired carbon monoxide (r = -0.39, (P <.001) at delivery. Birth weight for infants born to women who quit smoking averaged 7.2 lb versus 6.8 and 6.3 lb for mothers smoking one to six and more than six cigarettes per day at delivery (P <.01). CONCLUSION: Peer counseling reduced the number of cigarettes smoked daily but did not increase cigarette abstinence rates. Infant birth weight increases with both smoking cessation and smoking reduction, suggesting that peer counseling intervention programs may improve newborn health despite their failure to affect smoking cessation.


Assuntos
Aconselhamento/métodos , Grupo Associado , Cuidado Pré-Natal , Abandono do Hábito de Fumar , Adulto , Connecticut , Feminino , Humanos , Gravidez , Trimestres da Gravidez , Cuidado Pré-Natal/métodos , Serviços Preventivos de Saúde , Estudos Prospectivos
16.
J Nurs Adm ; 32(2): 85-90, 2002 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-11984234

RESUMO

Numerous articles describe barriers to nurses conducting research and achieving evidence-based practice as well as strategies for overcoming barriers. The Research Roundtable format is one such strategy. It is an interactive means for providing novice nurse researchers and nursing students with the skill sets required to drive application of existing evidence to nursing practice and conduct outcome studies to derive new evidence. The authors discuss their Research Roundtable series that addressed a number of barriers to research, research utilization, and evidence-based practice and how the series increased nurses knowledge and skills, demystified the research process, provided role models, demonstrated managerial and collegial support, and provided library, fiscal, and other resource support to complete staff projects. The details of the Research Roundtable series will guide others in replicating the process in their own organizations and academic communities.


Assuntos
Educação Continuada em Enfermagem/organização & administração , Medicina Baseada em Evidências , Relações Interprofissionais , Pesquisa em Enfermagem/educação , Pesquisa em Enfermagem/organização & administração , Recursos Humanos de Enfermagem/educação , Recursos Humanos de Enfermagem/psicologia , Competência Profissional/normas , Pesquisadores/educação , Pesquisadores/psicologia , Estudantes de Enfermagem/psicologia , Atitude do Pessoal de Saúde , Currículo , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Mentores/psicologia , Apoio Social
17.
J Nurs Adm ; 32(1): 27-30, 2002 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-11802636

RESUMO

This first article in a two-part series describes a collaboration between healthcare and academic organizations that supports evidence-based nursing practice. The multifaceted activities resulting from this collaboration include an annual research and research utilization conference, a series of research roundtables, talks with nurse authors, and a website. Maintaining such a sustained collaboration encourages more rapid dissemination of research findings into practice, enriching nursing practice, and ultimately benefiting patient outcomes.


Assuntos
Medicina Baseada em Evidências , Hospitais Comunitários , Relações Interinstitucionais , Serviço Hospitalar de Enfermagem/normas , Dor/enfermagem , Escolas de Enfermagem , Congressos como Assunto , Connecticut , Comportamento Cooperativo , Humanos , Pesquisa em Administração de Enfermagem
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