Qualifications of Executive Nurses for Service on Hospital Boards.

OBJECTIVE: The purpose of this qualitative survey was to document executive nurse leaders' perception of their own leadership qualities in the context of the American Hospital Association (AHA) recommended membership requirements for executive hospital board appointment. BACKGROUND: Hospital boards of trustees are increasingly responsible for the quality of care and its impact on financial performance. High-performing boards are focused on the accountability of chief executive officer for quality metrics. Nurse leaders have valuable insight into key shared governance issues such as quality of care, financial performance, legal requirements, and regulatory oversight. METHODS: Fifty senior-level nurse executive members polled from the American Organization of Nurse Leaders, the Texas Organization of Nurse Leaders, and the Texas Nurse Practitioners Association completed an online quantitative survey using The Center for Healthcare Governance (CHG) Assessment Tool© of the AHA, which details a list of skills, experience, and personal qualities for executive hospital board placement. Respondents ranked their individual knowledge and skills on a 4-point Likert scale. RESULTS: Participant responses indicated that senior-level nurse executives have significant expertise in the key areas of quality, patient safety and performance, healthcare administration and policy, and business management. Areas ranking lower are those associated with organizational specialties: legal, construction project management, and finance. CONCLUSION: This information can be used to educate executive hospital boards regarding the qualifications of nurse leaders members. Nursing leaders, professional organizations, and academia can use this information to assess the skills of senior nursing leaders as it relates to potential board appointments.

Does research help to inform a district health board's purpose? A qualitative thematic analysis of clinician researcher views.

AIM: The outcomes from research should guide the decisions of healthcare providers, policymakers and funders. This study sought the perspectives of senior hospital clinicians and researchers from a New Zealand district health board (DHB). METHOD: A series of interviews asked participants about the purpose and benefits of research to the DHB, and to reflect upon the enablers and barriers they had experienced in conducting and translating research in a DHB context. RESULTS: Three key themes were identified. The first theme suggested research should inform the DHB's purpose. The second theme identified how the general busyness, lack of research funding and the differing motivations of clinicians and business leaders doesn't make it easy to do research in a DHB. The third theme suggested that research barriers could be seen as opportunities. Participants placed importance on an environment that inspires enquiry; that permits staff to stop and question what they do; that overtly informs its community that research is done to improve the delivery of care; that communicates a purposeful research agenda; and that regularly discusses the intersection of research and the purpose of the DHB. CONCLUSION: This study found the absence of an organisation-wide research ethos affected staff engagement in and with research. As a consequence, the effective transfer and translation of knowledge from research was disrupted. Key recommendations were for the DHB to integrate research activity into practice, regularly discuss research evidence and celebrate research achievements.

The Value of Including the Nursing Perspective in the Boardroom.

In response to the Future of Nursing Report, the Nurses on Boards Coalition promotes the health of communities and the nation by engaging nurses in board service. Nurses possess knowledge and skills that when leveraged in boardroom discussions and decisions may impact the health of the populations served by the board. This article highlights the insights of organizational board leaders, as they describe the impact and influence of nurse board members within their organizations.

Guidelines as governance: Critical reflections from a documentary analysis of guidelines to support user involvement in research.

Although guidelines to regulate user involvement in research have been advocated and implemented for several years, literature still describes the process as challenging. In this qualitative study, we take a critical view on guidelines that are developed to regulate and govern the collaboration process of user involvement in research. We adapt a social constructivist view of guidelines and our aim is to explore how guidelines construct the perception of users and researchers and thus the process of involvement. Twenty-two guidelines published between 2006 and 2019 were analyzed iteratively. The analysis focuses on values which are emphasized in the guidelines on the distribution of entities, knowledge, and tasks between users and researchers. The analysis indicates that users and researchers are constructed differently; researchers are mainly constructed as responsible initiators and caretakers, while users are constructed as powerless and vulnerable. The guidelines portray the collaboration process as harmonious and assume a normative perspective. In doing so, challenges described in the literature related to power imbalances are not addressed. Based on these findings, we ask if these guidelines might function to maintain existing power imbalances between users and researchers.

The Journey: Nurses on Boards Coalition Preparation and Support Work Group.

Nurses have the knowledge, skills, and expertise to bring value and leadership to a myriad of boards throughout the United States, with nursing leadership critical to the transformation of complex health care systems. The 2011 Institute of Medicine Future of Nursing report calls on nurses to lead at all levels in systems as well as in board rooms. In 2014, the Nurses on Boards Coalition (NOBC) aligned its mission with this charge, creating a goal, as stated on its Web site, to "improve the health of communities and the nation through the service of nurses on boards and other bodies." A specific goal of NOBC was to have 10 000 nurses on boards by 2020. Through a partnership with the Robert Wood Johnson Foundation and the America Association of Retired Persons, NOBC worked strategically to achieve its goal. The accomplishments of one of its work groups, Preparation and Support, are highlighted.

Regimento interno [CIES. CIB-TO] / Internal regulations [CIES. CIB-TO]

Regimento para estabelecer normas, competências e procedimentos da Comissão Permanente de Integração Ensino-Serviço do Estado do Tocantins - CIES Estadual/CIB-TO, que é uma instância intersetorial e interinstitucional permanente que participa da formulação, condução, monitoramento e avaliação da Política de Educação Permanente em Saúde ­ EPS e atende o disposto no artigo 14 da Lei 8.080/1990, regulamentada pelo Decreto Presidencial N°. 7.508, de 28 de junho de 2011, e a Norma Operacional Básica de Recursos Humanos em Saúde (NOB/RH-SUS).

Rules to establish rules, competences and procedures of the Permanent Commission for Teaching-Service Integration of the State of Tocantins - State CIES / CIB-TO, which is a permanent intersectoral and interinstitutional body that participates in the formulation, conduction, monitoring and evaluation of the Education Policy Permanent in Health - EPS and meets the provisions of article 14 of Law 8.080 / 1990, regulated by Presidential Decree N °. 7,508, of June 28, 2011, and the Basic Operational Standard for Human Resources in Health (NOB / RH-SUS).

Normas para establecer normas, competencias y procedimientos de la Comisión Permanente de Integración Docente-Servicio del Estado de Tocantins - Estatal CIES / CIB-TO, que es un órgano permanente intersectorial e interinstitucional que participa en la formulación, conducción, seguimiento y evaluación de la Política Educativa. Permanente en Salud - EPS y cumple con lo dispuesto en el artículo 14 de la Ley 8.080 / 1990, reglamentado por Decreto Presidencial N °. 7,508, del 28 de junio de 2011, y la Norma Básica Operativa de Recursos Humanos en Salud (NOB / RH-SUS).

Mapping the peer-reviewed literature on accommodating nurses' return to work after leaves of absence for mental health issues: a scoping review.

BACKGROUND: The complexity of nursing practice increases the risk of nurses suffering from mental health issues, such as substance use disorders, anxiety, burnout, depression, and posttraumatic stress disorder (PTSD). These mental health issues can potentially lead to nurses taking leaves of absence and may require accommodations for their return to work. The purpose of this review was to map key themes in the peer-reviewed literature about accommodations for nurses' return to work following leaves of absence for mental health issues. METHODS: A six-step methodological framework for scoping reviews was used to summarize the amount, types, sources, and distribution of the literature. The academic literature was searched through nine electronic databases. Electronic charts were used to extract code and collate the data. Findings were derived inductively and summarized thematically and numerically. RESULTS: Academic literature is scarce regarding interventions for nurses' return to work following leaves of absence for mental health issues, and most focused on substance use concerns. Search of the peer-reviewed literature yielded only six records. The records were primarily quantitative studies (n = 4, 68%), published between 1997 and 2018, and originated in the United States (n = 6, 100%). The qualitative thematic findings addressed three major themes: alternative to discipline programs (ADPs), peer support, and return to work policies, procedures, and practices. CONCLUSIONS: While the literature supports alternative to discipline programs as a primary accommodation supporting return to work of nurses, more on the effectiveness of such programs is required. Empirical evidence is necessary to develop, maintain, and refine much needed return to work accommodations for nurses after leaves of absence for mental health issues.

Diversity in Professionalism Framings Across U.S. Medical Boards.

Lapses in professionalism are a common cause of disciplinary action against physicians by U.S. medical boards. However, the exact definition of "professionalism" is unclear, making it likely that a physician will not train or practice under the same framing of professionalism and so may fail to develop certain skills. The goal of this study was to identify and compare the professionalism framings of medical boards. The medical board web pages for all 50 states, the District of Columbia, and four territories were examined in June 2017 for use of the word "professionalism" or "professional" in their application, rules, or laws, which was then coded as a best fit to one of six core framings of professionalism. Of the 55 states and territories, integrity was the most common professionalism framing (40.0%), followed by excellence (23.6%), behavior (12.7%), mixed (9.1%), unclear (9.1%), and absent (5.5%). Although integrity was the most common framing, diversity exists among medical boards, which could lead to board misunderstandings of incidents labeled as professionalism violations and ineffective remediation of offenses. In order to best communicate the nature of the offense and thus best facilitate remediation, the incident should be called by its true name rather than the all-encompassing term "professionalism."

Nurses at the table: A naturalistic inquiry of nurses on governing boards.

In an environment in which there is little or no nursing presence on governing boards in healthcare organizations (HCOs), physicians, and nonclinicians take responsibility for keeping the other board members apprised of the quality of patient care, including nursing-generated, patient safety initiatives. Governing boards in HCOs are either not appointing nurses to governing boards or are not appointing nurses in numbers that are commensurate with the size and vital contributions of the profession. As a result, competent nursing professionals with an intimate understanding of quality care and patient safety are not in decision-making roles that may redesign health care and improve patient care. The purpose of this qualitative study was to describe experiences of nurse board members who hold governing board appointments in HCOs, and to describe the facilitators of and barriers to holding governing board appointments, as experienced by those nurse board members. This novel research employed naturalistic inquiry to explore the experiences of 12 nurse board members who held appointments with voting privileges in HCOs. From the interview data emerged four distinct themes: leveraging relationships and networking, valuing the mission of the board, feeling respected for my participation, and committing to board work. Facilitators of and barriers to governing board appointments were suggested. Findings validated the few previous research studies found in the literature and have implications for nursing leadership and governance.

Protocol for a mixed methods realist evaluation of regional District Health Board groupings in New Zealand.

INTRODUCTION: Achieving effective integration of healthcare across primary, secondary and tertiary care is a key goal of the New Zealand (NZ) Health Strategy. NZ's regional District Health Board (DHB) groupings are fundamental to delivering integration, bringing the country's 20 DHBs together into four groups to collaboratively plan, fund and deliver health services within their defined geographical regions. This research aims to examine how, for whom and in what circumstances the regional DHB groupings work to improve health service integration, healthcare quality, health outcomes and health equity, particularly for Maori and Pacific peoples. METHODS AND ANALYSIS: This research uses a mixed methods realist evaluation design. It comprises three linked studies: (1) formulating initial programme theory (IPT) through developing programme logic models to describe regional DHB working; (2) empirically testing IPT through both a qualitative process evaluation of regional DHB working using a case study design; and (3) a quantitative analysis of the impact that DHB regional groupings may have on service integration, health outcomes, health equity and costs. The findings of these three studies will allow refinement of the IPT and should lead to a programme theory which will explain how, for whom and in what circumstances regional DHB groupings improve service integration, health outcomes and health equity in NZ. ETHICS AND DISSEMINATION: The University of Otago Human Ethics Committee has approved this study. The embedding of a clinician researcher within a participating regional DHB grouping has facilitated research coproduction, the research has been jointly conceived and designed and will be jointly evaluated and disseminated by researchers and practitioners. Uptake of the research findings by other key groups including policymakers, Maori providers and communities and Pacific providers and communities will be supported through key strategic relationships and dissemination activities. Academic dissemination will occur through publication and conference presentations.

Comparison of the h-indices of the editorial board members of seven ophthalmic subspecialty journals.

PURPOSE: To investigate and compare the h-indices of the editorial board members of ophthalmic subspecialty journals. STUDY DESIGN: Descriptive Cross Sectional Research. METHODS: Bibliometric indices were calculated for the editorial board members of seven ophthalmic subspecialty journals. Correlations between the median h-indexes and journal impact factors (JIF), average citations per article and JIF, and publication count and JIF were analyzed. RESULTS: The median h-indices of the board members of Retina, Journal of Glaucoma, Journal of Cataract and Refractive Surgery, Cornea, Ophthalmic Plastic and Reconstructive Surgery, Journal of Neuroophthalmology and Journal of the American Academy of Pediatric Ophthalmology and Strabismus (J AAPOS) were 34, 26, 23, 17, 15, 14 and 13, respectively. H-indices and publication count were correlated with JIF (P<0.05, for each). CONCLUSION: The board members of Retina have the highest h-index and average citations per article, and J AAPOS have the least. These data provide useful benchmarks for comparison of the various subspecialty areas in ophthalmology.

How to Join a Board: A Practical Guide.

In October 2010, the Institute of Medicine and the Robert Wood Johnson Foundation released The Future of Nursing report. One way that "Recommendation 7: Prepare and enable nurses to lead change and advance health" has been operationalized has been placing nurses on boards, and nursing organizations have urged their constituents to serve in this capacity. This article outlines steps for obtaining an invitation to join a board. [J Contin Educ Nurs. 2018;49(12):559-562.].