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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.
J Adv Nurs ; 2019 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-31162704

RESUMO

AIM: To establish a middle-range theory of organizational learning in hospitals. DESIGN: A realist review of the literature, conducted according to established standards for realist and meta-narrative evidence syntheses. Middle-range theory development was performed according to Smith and Liehr's recommendations. DATA SOURCES: Two comprehensive scientific databases and six discipline-focused databases spanning health care, life sciences, business, sociology, and psychology were searched from inception to 12 May 2016. REVIEW METHODS: Citations meeting the inclusion criteria were appraised using the Mixed Methods Appraisal Tool. Data extraction was guided by a focus on the contextual factors, mechanisms, and outcomes associated with organizational learning. RESULTS: The initial search yielded 2,332 citations, 147 of which were ultimately included in the review. The included citations were generally of high quality. Reviewed evidence indicates certain aspects of organizational context can be conducive to mechanisms of organizational learning, leading to a range of positive organizational outcomes. CONCLUSION: This review updates and expands on a previous review of the literature on organizational learning in hospitals, refines the concept of organizational learning in hospitals, and provides a middle-range theory of organizational learning in hospitals. IMPACT: This updated review provides a strong evidence base for future work on the topic of organizational learning in hospitals. The refined concept of organizational learning makes it possible to develop reliable, valid research instruments that better reflect of the full scope of organizational learning. Finally, the middle-range theory guides researchers and clinical leaders as they advance the science and practice of organizational learning.

3.
J Adv Nurs ; 75(2): 472-481, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30230010

RESUMO

AIMS: This paper presents a discussion of the learning history research method, including a description of how to conduct a learning history. Suggested applications of the method in research and clinical practice are also provided. BACKGROUND: Organizational learning has been linked to improved clinical performance and other positive outcomes in healthcare. Yet, the theoretical guidance available to researchers and clinical leaders who study and strive to foster organizational learning is sparse. Studying how organizational learning occurs in the healthcare context is a critical step toward addressing this knowledge gap. The learning history, a participatory research method, is specifically designed for studying the organizational learning process. Thus, it is precisely suited for the work of developing a theoretical foundation for organizational learning in healthcare. DESIGN: Discussion paper. DATA SOURCES: This discussion paper is based on relevant literature and the authors' experiences conducting learning histories. IMPLICATIONS FOR NURSING: Researchers can use learning histories to develop a better understanding of and a theoretical foundation for organizational learning in healthcare. Leaders in clinical practice can use learning histories to foster learning and improvement in their organizations. CONCLUSION: Learning histories are a promising approach to advancing the science and practice of organizational learning.


Assuntos
Pesquisa Participativa Baseada na Comunidade/organização & administração , Assistência à Saúde/história , Assistência à Saúde/organização & administração , Educação Médica/organização & administração , Aprendizagem , História do Século XXI , Humanos , Modelos Organizacionais , Projetos de Pesquisa
4.
J Nurs Manag ; 27(3): 633-646, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30294874

RESUMO

AIM: To provide a clear definition and description of organisational learning in hospitals. BACKGROUND: Organisational learning is a promising strategy nurse managers, and leaders can use to improve organisational performance. A clear definition and description of organisational learning is necessary to advance theory, research and practice in this field. METHODS: Walker & Avant's method was used to conduct a concept analysis of organisational learning in hospitals. Data sources included 147 empirical studies, 16 review articles, three dictionary entries and three book chapters. RESULTS: Organisational learning occurs when experiences are translated into positive changes in the organisation's collective knowledge, cognition and actions. Organisational context plays a key role in the learning process. Other manifestations of the concept are identified. CONCLUSIONS: This concept analysis provides a clear definition of organisational learning and a description of its defining attributes, antecedents, empirical referents and consequences. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers and leaders can improve patient and organisational outcomes by creating an environment conducive to translating experiences into organisational learning. Further research is needed to continue advancing the science of organisational learning in hospitals.


Assuntos
Formação de Conceito , Aprendizagem , Cultura Organizacional , Humanos , Liderança
5.
Nurse Educ Today ; 61: 134-139, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29197688

RESUMO

BACKGROUND: College of nursing leaders can foster organizational learning as a means of achieving their desired organizational outcomes. Organizational learning has not previously been studied in colleges of nursing, leaving college administrators and faculty little guidance as they strive to improve outcomes in their own colleges. OBJECTIVES: The purpose of this study was to discover new insights related to organizational learning in a college of nursing. DESIGN: The learning history method was used to document and describe organizational learning in a college of nursing. SETTING: This study was conducted with a college of nursing situated in a private, religious-based university in the western United States. PARTICIPANTS: Six stakeholders and 16 individuals familiar with the college's history were purposively recruited for this study. Participants included college administrators, faculty, students, alumni, and individuals with university-level responsibilities related to the college. METHODS: Semi-structured interviews and college artifacts were used to gather data. Data was reviewed and themes identified through a process called "distillation." FINDINGS: The college's vision, "Learning the Healer's Art" provides purpose and motivation within the college. Four themes provide additional insight into how the college established a learning culture and fosters behavior conducive to organizational learning: (1) Character and Quality, (2) Long-Term Perspective, (3) Collaborative Leadership and Adaptation, and (4) Mentoring. CONCLUSION: College of nursing leaders can foster organizational learning and pursue improvement within their colleges. Recommended actions include developing a shared vision for the college, building a cadre of qualified faculty and students who have strong personal character, maintaining a long-term perspective, using a collaborative approach to leadership and adaptation, and facilitating mentoring.


Assuntos
Aprendizagem , Objetivos Organizacionais , Escolas de Enfermagem/história , Educação em Enfermagem , Docentes , Feminino , História do Século XX , História do Século XXI , Humanos , Liderança , Masculino , Mentores , Melhoria de Qualidade , Estudantes de Enfermagem , Estados Unidos
6.
Orthop Nurs ; 36(6): 424-431, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29189626

RESUMO

The purpose of this study was to explore organizational learning in an orthopaedic hospital unit. Skill in organizational learning is necessary to achieve high reliability in a dynamic healthcare environment, yet organizational learning in hospital units is not well understood. A learning history was conducted with a high-performing orthopaedic unit. Findings were interpreted in the context of a previous learning history conducted with a critical care unit. Despite contextual differences, each unit progressed through the same four developmental stages to achieve its current state of high reliability. On both units, psychological safety and a healthy work environment proved essential for developmental progression. Hospital units may progress through distinct developmental stages to achieve their desired outcomes. Psychological safety and a healthy work environment appear foundational to organizational learning in hospital units. Nursing leaders should work with team members to evaluate their unit's development and use suggested strategies to facilitate organizational learning.


Assuntos
Modelos Organizacionais , Recursos Humanos de Enfermagem no Hospital/educação , Cultura Organizacional , Ortopedia/educação , Pesquisa sobre Serviços de Saúde , Humanos
7.
Dimens Crit Care Nurs ; 36(2): 78-86, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28151783

RESUMO

INTRODUCTION: Providing high-quality care to every patient is challenging, particularly in critical care units (CCUs). However, this standard can be achieved through organizational learning. Unfortunately, the process of organizational learning in CCUs is not well understood. OBJECTIVE: The objective of this study is to describe the developmental progression of a cardiac intensive care unit (CICU) to reach its current state of reliably excellent clinical performance. METHODS: The method selected for this study was a learning history. A total of 43 individuals with experience working on the CICU participated in small group interviews. Participants included nurses, surgeons, unit clerks, administrators, nursing assistants, a pharmacist, a respiratory therapist, and an administrative assistant. Relevant artifacts, including unit performance data, were also gathered to complement interview data. RESULTS: The CICU progressed through 4 distinct developmental stages to reach its current state. The CICU's early development involved establishing psychological safety on the unit, which prepared the unit for increased accountability, improved performance, and the pursuit of reliability. DISCUSSION/CONCLUSION: The findings validate the relationship between psychological safety and organizational learning, offer insight into how CCUs become high-reliability organizations, and provide clinical leaders with guidance for achieving high reliability in their organizations. The findings also help validate the American Association of Critical-Care Nurses position that a healthy work environment is essential to achieving clinical excellence. Critical care unit teams should use these findings as a framework for collective reflection and planning to achieve their desired future. Further research is needed to validate the applicability of these findings and to continue building the evidence base for organizational learning in hospital units.


Assuntos
Cardiologia/educação , Unidades de Terapia Intensiva , Recursos Humanos em Hospital/educação , Pesquisa sobre Serviços de Saúde , Humanos , Entrevistas como Assunto , Modelos Organizacionais , Cultura Organizacional
8.
Artigo em Inglês | MEDLINE | ID: mdl-25803087

RESUMO

Research has revealed the effectiveness of simulation for facilitating student development of self-efficacy, knowledge, clinical judgment, and proficiency in technical skills. This grounded theory study was conducted to describe the experience of nursing students in high-fidelity simulation and develop a model which explicates the experience of nursing students in simulation. Focus group interviews were conducted with three cohorts of students enrolled in a baccalaureate nursing program who experienced simulation four to twelve times per academic year. Five prominent themes emerged during analysis Emotional Processing; Anxiety; Making Connections; Fidelity; and Learning. The Simulation Learning Model - Student Experience (SLM-SE) was developed to illustrate the student's multi-dimensional experience of learning through high-fidelity simulation. Findings from this study suggest that students are better equipped to learn through increasing confidence and experience, continued reflection-on action and enhanced peer-to-peer interaction. Recommendations for future research include developing strategies to optimize students' experiences for learning in simulation.


Assuntos
Competência Clínica , Simulação por Computador , Currículo , Bacharelado em Enfermagem/métodos , Autoeficácia , Adulto , Ansiedade/psicologia , Estudos de Coortes , Medo/psicologia , Feminino , Grupos Focais , Humanos , Entrevistas como Assunto , Aprendizagem , Masculino , Determinação de Necessidades de Cuidados de Saúde , Simulação de Paciente , Psicometria , Medição de Risco , Estudantes de Enfermagem/psicologia , Estados Unidos
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