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1.
J Nurs Manag ; 2020 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-31957125

RESUMO

AIM: To explore nurses' perceptions of nurse managers' (NMs') communicative relationships that encourage nurses' decisions to buy-in to organizational initiatives to enhance patients' experiences with care (PEC). BACKGROUND: The role of the nurse to patient experience is well established, yet little is known about how the communicative relationship between manager and nurse relates to nurse buy-in to PEC initiatives. METHOD: An exploratory qualitative descriptive study was conducted with 15 nurses from two inpatient medical-surgical units in a large acute care hospital using semi-structured interviews. RESULTS: Three themes were identified. The communicative relationship was developed and strengthened through the manager's: (a) multimodal approach to communicating and influencing, (b) engaging and supporting staff, and (c) promoting staff-led decision making. CONCLUSIONS: Nurses in our study who reported having a strong communicative relationship with their NM perceived that this relationship encouraged their buy-in and engagement in PEC initiatives. IMPLICATIONS FOR NURSING MANAGEMENT: An assessment of the communication between the frontline NM and his or her team is important for understanding why initiatives to support PEC are or are not yielding desired results.

2.
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
3.
J Pain Symptom Manage ; 59(1): 30-38, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31494177

RESUMO

CONTEXT: Patients with cancer experience many symptoms that disrupt quality of life, and symptom communication and management can be challenging. The Edmonton Symptom Assessment System (ESAS) was developed to standardize assessment and documentation of symptoms, yet research is needed to understand patients' and caregivers' experiences using the tool and its ability to impact patient-provider aligned care. OBJECTIVES: The objective of this study was to understand how the ESAS shapes communication between patients and providers by exploring patients' and caregivers' experiences using the ESAS and assessing the level of agreement in symptom assessment between patients and palliative care physicians. METHODS: This study used a mixed-methods design. Thirty-one semistructured interviews were conducted and audio-recorded with patients (n = 18) and caregivers (n = 13). Data were analyzed following a social constructionist grounded theory approach. Patient and provider ESAS scores were obtained by medical chart review. Intraclass correlation coefficients were used to assess the level of agreement between patient-completed ESAS scores and provider-completed ESAS scores. RESULTS: Participants reported that the ESAS was a beneficial tool in establishing priorities for symptom control and guiding the appointment with the palliative care physician, despite challenges in completing the ESAS. Filling out the ESAS can also help patients more clearly identify their priorities before meeting with their physician. There was a good to excellent level of agreement between patients and physicians in all symptoms analyzed. CONCLUSION: The ESAS is beneficial in enhancing symptom communication when used as a guide to identify and understand patients' main concerns.

4.
J Nurs Adm ; 49(4): 176-178, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30882607

RESUMO

Health systems produce vast amounts of complex, multidimensional data. Health systems nurse leaders, informaticians, and nurse researchers must partner to turn these data into actionable information to drive quality clinical outcomes. The authors review health systems in the era of big data, identify opportunities for health systems-nursing research partnerships, and introduce emerging approaches to data science education in nursing.


Assuntos
Conjuntos de Dados como Assunto , Informática em Enfermagem , Recursos Humanos de Enfermagem no Hospital/economia , Qualidade da Assistência à Saúde/economia , Humanos , Pesquisa em Administração de Enfermagem
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.
J Nurs Adm ; 48(5): 235-237, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29672371

RESUMO

The Institute of Medicine called for all health professionals to be educated in interprofessional teams. Accreditation bodies governing education of health professions responded by creating standards for interprofessional education (IPE) activities. Educators teaching in health professional programs implemented a variety of IPE activities, yet rigorous evaluation of IPE on interprofessional practice and patient outcomes is limited. The authors review the progress of IPE, introduce new trends in IPE, and identify the methods needed to evaluate IPE effectiveness.


Assuntos
Pessoal de Saúde/educação , Relações Interprofissionais , Cultura Organizacional , Equipe de Assistência ao Paciente/organização & administração , Qualidade da Assistência à Saúde , Comportamento Cooperativo , Feminino , Humanos , Masculino , Estados Unidos
7.
J Nurs Adm ; 48(3): 141-148, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29461350

RESUMO

OBJECTIVE: The aim of this study was to understand how nurses in a 25-bed critical-access hospital (CAH) led change to become the 1st to achieve Magnet®. BACKGROUND: Approximately 21% of the US population lives in rural areas served by CAHs. Rural nurse executives are particularly challenged with limited resources. METHODS: Staff nurses, nurse managers, interprofessional care providers, the chief nursing officer, and board of directors (n = 27) were interviewed. Observations of hospital units and administrative meetings were done, and hospital reports were analyzed. RESULTS: Nine themes emerged to support a conceptual model of leading change. The CAH spent 3 years of its 6-year journey establishing organizational readiness. Nurses overcame complex challenges by balancing operational support and fostering relationships. The Magnet journey led to significantly improved nurse and patient outcomes. A new organizational culture centered on shared governance, evidence-based practice, and higher education emerged. CONCLUSIONS: The journey to Magnet leads to improved nurse, patient, and organization outcomes.


Assuntos
Hospitais Rurais/organização & administração , Enfermeiras Administradoras/organização & administração , Recursos Humanos de Enfermagem no Hospital/organização & administração , Atitude do Pessoal de Saúde , Hospitais Rurais/normas , Humanos , Relações Interprofissionais , Liderança , Enfermeiras Administradoras/normas , Recursos Humanos de Enfermagem no Hospital/normas , Estudos de Casos Organizacionais , Cultura Organizacional , Inovação Organizacional , Recursos Humanos
8.
J Nurs Adm ; 48(1): 31-37, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29219908

RESUMO

OBJECTIVE: The aim of this study is to examine characteristics of the nursing practice environment associated with lower RN turnover. BACKGROUND: Identifying characteristics of the practice environment that contribute to lower RN turnover is important for meeting the national quality strategy priority of reducing healthcare costs. METHODS: Data from 1002 adult care units in 162 National Database of Nursing Quality Indicators participating hospitals were analyzed using multivariate linear regression. The Practice Environment Scale of the Nursing Work Index was used to measure practice environment characteristics. RN turnover was measured at the unit level. RESULTS: Nursing units with higher overall ratings of the nursing practice environment had lower rates of RN turnover. Units with higher RN perceived staffing and resource adequacy experienced significantly lower RN turnover. CONCLUSIONS: Unit managers and hospital administrators should consider RN perception of staffing and resource adequacy and the overall practice environment when developing targeted strategies for decreasing RN turnover.


Assuntos
Hospitais , Cuidados de Enfermagem/organização & administração , Recursos Humanos de Enfermagem no Hospital/provisão & distribução , Admissão e Escalonamento de Pessoal/organização & administração , Reorganização de Recursos Humanos/estatística & dados numéricos , Qualidade da Assistência à Saúde/organização & administração , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recursos Humanos
9.
J Adv Nurs ; 73(4): 834-846, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27878849

RESUMO

AIM: To report an analysis of the concept of leading change. BACKGROUND: Nurses have been called to lead change to advance the health of individuals, populations, and systems. Conceptual clarity about leading change in the context of nursing and healthcare systems provides an empirical direction for future research and theory development that can advance the science of leadership studies in nursing. DESIGN: Concept analysis. DATA SOURCES: CINAHL, PubMed, PsycINFO, Psychology and Behavioral Sciences Collection, Health Business Elite and Business Source Premier databases were searched using the terms: leading change, transformation, reform, leadership and change. Literature published in English from 2001 - 2015 in the fields of nursing, medicine, organizational studies, business, education, psychology or sociology were included. METHODS: Walker and Avant's method was used to identify descriptions, antecedents, consequences and empirical referents of the concept. Model, related and contrary cases were developed. RESULTS: Five defining attributes of leading change were identified: (a) individual and collective leadership; (b) operational support; (c) fostering relationships; (d) organizational learning; and (e) balance. Antecedents were external or internal driving forces and organizational readiness. The consequences of leading change included improved organizational performance and outcomes and new organizational culture and values. CONCLUSION: A theoretical definition and conceptual model of leading change were developed. Future studies that use and test the model may contribute to the refinement of a middle-range theory to advance nursing leadership research and education. From this, empirically derived interventions that prepare and enable nurses to lead change to advance health may be realized.


Assuntos
Liderança , Papel do Profissional de Enfermagem/psicologia , Cuidados de Enfermagem/organização & administração , Cuidados de Enfermagem/psicologia , Recursos Humanos de Enfermagem/psicologia , Inovação Organizacional , Adulto , Atitude do Pessoal de Saúde , Formação de Conceito , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Enfermagem , Cultura Organizacional
10.
J Nurs Educ ; 55(3): 177-81, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26926221

RESUMO

BACKGROUND: Nursing faculty are challenged to create learning experiences that both reflect the complexities of the current health care system and are relevant. Experiential learning opportunities should promote engagement in health care that extends beyond direct patient care to advocacy in larger systems. METHOD: To meet this challenge, faculty developed course assignments for students at baccalaureate, master's, and doctoral levels in which students worked with state Action Coalitions to implement the Institute of Medicine Future of Nursing report's eight recommendations. With faculty guidance, student teams developed and implemented projects or conducted research to assist the coalitions in their grassroots initiatives. RESULTS: Students at all program levels reported high levels of satisfaction and engagement with these unique projects. Students reported understanding the importance of the Future of Nursing recommendations and intended to continue participating in statewide initiatives. CONCLUSION: Experiential learning opportunities at all program levels can engage students in learning more about advocacy, health care trends, and leadership.


Assuntos
Bacharelado em Enfermagem/métodos , Educação de Pós-Graduação em Enfermagem/métodos , Defesa do Paciente/educação
11.
J Nurs Adm ; 45(3): 130-2, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25689497

RESUMO

The 2014 International Nursing Administration Research Conference, "Pioneering Through Chaos: Leadership for a Changing World," was held at the Texas Woman's University in Dallas, Texas, in the fall of 2014. The program drew more than 100 attendees from 4 countries. The conference informed attendees from both academe and practice about the role of nursing administration in navigating the dynamic healthcare climate. This article will report on the insights from the conference presenters.


Assuntos
Política de Saúde , Liderança , Teoria de Enfermagem , Congressos como Assunto , Humanos , Texas
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