Impact of Enhanced Emergency Nursing Processes on the Rescue Outcomes of Emergency Patients with Chest Pain.

Background: Chest pain, a sudden and perilous symptom, is frequently encountered in the emergency department. Prompt and efficient first-aid measures and nursing interventions are crucial for effectively rescuing emergency patients experiencing chest pain. Objective: This study aims to investigate the impact of an enhanced emergency nursing process on the rescue outcomes of emergency patients with chest pain. Design: A randomized controlled study was conducted. Setting: The research was conducted at Suzhou Hospital of Integrated Traditional Chinese and Western Medicine. Participants: A total of 90 emergency chest pain patients admitted between December 2021 and June 2022 were selected and divided into two groups, with 45 cases in each group. Interventions: The control group received routine emergency nursing, while the observation group underwent an improved emergency nursing protocol. Primary Outcome Measures: (1) Treatment initiation time, emergency rescue time, recovery time of vital signs, and hospital stay; (2) curative effect; (3) pain scores; (4) incidence of adverse events; and (5) patient satisfaction. Results: Compared to the control group, the observation group exhibited shorter treatment initiation time, emergency rescue time, recovery time of vital signs, and hospital stay (P < .05). The effective rate in the observation group was higher (P < .05), and pain scores were lower at 30 min, 60 min, 120 min, and 240 min post-rescue (P < .05). The occurrence of adverse events was reduced in the observation group (P = .005), and patient satisfaction was higher at discharge (P < .05). Conclusion: The enhanced emergency nursing process effectively reduces the clinical rescue time for emergency patients with chest pain, enhances rescue efficiency, seizes crucial opportunities for saving lives, and improves patient satisfaction. These findings have significant positive implications for clinical applications.

Clinical decision-making and the nursing process in digital health systems: An integrated systematic review.

AIMS: To identify how the nursing process (assessment, planning, intervention and outcome evaluation) has been incorporated into digital health systems (electronic medical records, electronic care plans and clinical decision support systems) to gain an understanding of known benefits and challenges posed to nurses' decision-making processes. BACKGROUND: Nursing terminologies, including the International Classification for Nursing Practice (ICNP), and Nursing Minimum Data Set's (NMDS), have been developed to improve standardised language integration of components of nursing care into digital systems. However, there is limited evidence regarding whether the complete nursing process is effectively being incorporated into digital health systems. METHODS: An integrative systematic review following PRISMA guidelines. A search strategy was applied to extract articles from included databases: CINAHL, MEDLINE, SCOPUS and Web of Science Core Collection. Articles were limited to English language and published January 2007-March 2022 and assessed using a pre-determined eligibility criteria. Quality assessment and a narrative synthesis were conducted. RESULTS: A total of 3321 articles were identified, and 27 studies included. There were (n = 10) qualitative, (n = 4) quantitative non-randomised controlled trials, (n = 3) quantitative descriptive studies and (n = 10) mixed methods. Nurse assessment and planning components were the most comprehensive phases incorporated into digital health systems, and interventions and outcome evaluation were scarcely reported. CONCLUSIONS: Inadequate capture of nursing work is a problem unresolved by digital health systems. This omission may be hindering nurse clinical decision-making for patient care and limiting the visibility of the nursing role in health care interventions and the associated impact on patient outcomes. RELEVANCE TO CLINICAL PRACTICE: Further research is needed on how digital systems can support nurses to apply the full nursing process and to further evaluate patient outcomes. Digital systems can support health-service level evaluation through capturing missed nursing care and the consequences on patients utilising nurse-sensitive-outcomes; however, this is not yet being realised.

Registered nurses' reasoning process during care planning and documentation in the electronic health records: A concurrent think-aloud study.

AIMS AND OBJECTIVES: To explore the clinical reasoning process of experienced registered nurses during care planning and documentation of nursing in the electronic health records of residents in long-term dementia care. BACKGROUND: Clinical reasoning is an essential element in nursing practice. Registered nurses' clinical reasoning process during the documentation of nursing care in electronic health records has received little attention in nursing literature. Further research is needed to understand registered nurses' clinical reasoning, especially for care planning and documentation of dementia care due to its complexity and a large amount of information collected. DESIGN: A qualitative explorative design was used with a concurrent think-aloud technique. METHODS: The transcribed verbalisations were analysed using protocol analysis with referring phrase, assertional and script analyses. Data were collected over ten months in 2019-2020 from 12 registered nurses in three nursing homes offering special dementia care. The COREQ checklist for qualitative studies was used. RESULTS: The nurses primarily focused on assessments and interventions during documentation. Most registered nurses used their experience and heuristics when reasoning about the residents' current health and well-being. They also used logical thinking or followed local practice rules when reasoning about planned or implemented interventions. CONCLUSION: The registered nurses moved back and forth among all the elements in the nursing process. They used a variety of clinical reasoning attributes during care planning and nursing documentation. The most used clinical reasoning attributes were information processing, cognition and inference. The most focused information was planned and implemented interventions. RELEVANCE TO CLINICAL PRACTICE: Knowledge of the clinical reasoning process of registered nurses during care planning and documentation should be used in developing electronic health record systems that support the workflow of registered nurses and enhance their ability to disseminate relevant information.

Application of the Nursing Process Using Moulage as a Problem-Based Approach to Teaching Dermatologic Content.

ABSTRACT: Teaching dermatologic conditions can be challenging in lecture-style format. A class activity was implemented in a prelicensure nursing course to enhance learning of dermatologic conditions while emphasizing the nursing process, evidence-based treatments, transmission-based precautions, and teamwork. Students worked in teams to identify moulage-based dermatologic conditions and follow the nursing process to develop a plan of care. Students presented their findings to faculty and peers. Positive student feedback on the activity included enhanced teamwork, application of the nursing process, visual emphasis on content, and understanding of holistic care. This activity is an innovative alternative to traditional lecture format.

[Complexity of outpatient intensive care for ventilated people: Cross-mapping into the standardised NNN-taxonomy]. / Komplexität außerstationärer Intensivpflege beatmeter Menschen.

Complexity of outpatient intensive care for ventilated people: Cross-mapping into the standardised NNN-taxonomy Abstract. Background: In Germany, free text is the preferred method for recording the nursing process in outpatient intensive care, although classification systems could enable a more precise description. Research question: How is nursing care for people with outpatient ventilation represented by the NNN-taxonomy and what are the recommendations for nursing practice? Methods: A qualitative "multiple case" design was applied. Using deductive content analysis (data sources: nursing documentation and secondary analysis of interviews with affected persons), several cases, both individually and across all cases were linked to the NNN-taxonomy (cross-mapping). Results: In total, the nursing documentation of 16 invasively ventilated persons with a mean age of 58.4 years (SD = 16.3) was analysed. Seven persons additionally contributed interview data. Documentation was mainly based on the "Strukturmodell" (14/16) with a moderate to high accuracy (D-Catch Score: 16.6; SD = 4.1). Cross-mapping resulted in 4016 codes: 618 nursing diagnoses, 1956 interventions and 1442 outcomes. Documentation was strongly measure-oriented, not very person-centred and with a lack of differentiation between diagnosis and intervention. Conclusions: To improve nursing practice, a person-centred attitude and the ability to differentiate between nursing diagnoses, interventions and outcomes should be promoted.

Strengthening Critical Thinking Skills in Associate Degree Nursing Students Through Combined Pedagogies of Concept Mapping Using the Nursing Process and Simulation.

ABSTRACT: Combining the utility of concept maps using the nursing process with simulation in associate degree nursing programs may help develop the critical thinking and reasoning skills of novice learners. This qualitative case study explored the learning experiences of students enrolled in the first nursing course. Although results showed initial feelings of uncertainty, confusion, and an overwhelming experience, students found the combined pedagogies beneficial in developing essential competencies of critical thinking when utilized consistently across the program. Integrating concept maps into the simulation design as a framework for immersive learning presented both challenges and opportunities.

[Validity and Reliability of a Nursing Process Scale].

BACKGROUND: A valid and reliable nursing record audit tool can simplify nursing records and provide a basis for quality auditing. PURPOSE: To ensure the validity and reliability of the Nursing Process Scale to promote accurate monitoring of nursing record quality. METHODS: This study employed structural equation modeling to examine the content validity and reliability of the current Nursing Process Scale. A total of 660 results from a medical center were used to revise the content and then the validity and reliability of the revised scale were analyzed. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used in three stages, namely item generation and content validity testing, item analysis and validity testing, and reliability testing. RESULTS: Validity, reliability, and organization based on clinical practice were used to identify and remove scale items with low factor loadings. The remaining items were organized under several factors in the revised Nursing Process Scale, which had good internal consistency with a Cronbach's α of .653 in the EFA, a Kaiser-Meyer-Olkin value of .614, and a significant Bartlett's test of sphericity value. Five factors and 22 questions were extracted from the original 32 questions. The CFA conducted after the model correction reduced the number of questions to 10 and the number of factors to 3, with each index reaching the ideal level. To improve ease-of-use in clinical settings, the important items were reduced from 32 to 22 questions, including the 10 questions suggested by the CFA. CONCLUSIONS: The validity, reliability, and organization based on clinical practice were considered in the removal of items with low factor loadings. Axial conversion was used to generate a component matrix, which allowed item rearrangement across factors and the revision of the Nursing Process Scale. The development of simple valid and reliable audit tools will save auditor time and allow the effective evaluation of nursing record quality and improvement in record integrity. This revised scale was reviewed and approved for implementation in 42 clinical wards.

Attitude of nursing students following the implementation of comprehensive computer-based nursing process in medical surgical internship: a quasi-experimental study.

BACKGROUND: The nursing process is the core and the standard of practice in nursing profession. Nowadays, the use of information technology in the field of nursing processes, education and practice has been emphasized. Since nurse's attitudes towards clinical information systems are considered as an indicator of the success rate of information systems, and nurse's attitudes about the nursing process can affect their execution of the process. So the purpose of this study was to evaluate nursing students' attitudes towards the nursing process software. METHODS: In this quasi-experimental study, 160 undergraduate nursing students (terms 4-8) in Tabriz University of Medical Sciences were selected by convenience sampling. To evaluate the effectiveness of nursing process software in this study, Mazlom and Rajabpoor (IJME 14(4):312-322, 2014) a questionnaire consisting of 21 components based on a five-point Likert scale was completed by students after using the software. Data were then analyzed by SPSS 19 software. RESULTS: The mean score of students' attitude toward nursing process software was high (80.70 ± 5.58). The nursing students' highest scoring attitudes were respectively related to "Effectiveness of software in prioritizing patient care and problems", "Completeness of patient's electronic information compared to handwritten mode" and "Software's effectiveness in saving your time". The lowest scoring attitudes towards the software was respectively related to the "feeling of fairness in labor division", "the effectiveness of the software in determining your workload" and "the feeling of satisfaction in labor division". There was a statistically significant relationship between gender and age, and student's attitude toward nursing process software. CONCLUSIONS: According to the results and analysis of nursing student's attitudes toward nursing process software, the use of such software would be welcomed by students. It seems that changing policies in the educational and clinical substructure of nursing in order to develop, adapt and use the nursing process software is an important responsibility for nursing authorities to consider. Providing educational and clinical technology equipment, periodic evaluation of software by stakeholders and promoting the use of this software, can be fundamental steps in operationalizing the findings of this research.

The Ms. Olsen test: Measurement properties of a short test of nursing staffs' competence in clinical decision-making.

AIMS: To assess the measurement properties of the Ms. Olsen test for registered nurses and assistant nurses, respectively, and suggest cut-off points between competence levels. DESIGN: Cross-sectional study. The results were analysed by implementing the Rasch Measurement Theory. METHODS: Nursing staff working in various health care settings participated (n = 757). To measure the competence of nursing staff in clinical decision-making, a 19-item scale from the Nursing Older People-Competence Evaluation Tool-the 'Ms. Olsen test'-was used. Data were collected in October 2017, 2018 and 2019. RESULTS: The Ms. Olsen test showed reasonably good measurement properties for registered nurses and assistant nurses respectively. Results show slightly better measurement properties for registered nurses than for assistant nurses. The cut-off for registered nurses, 0.62, corresponds to managing approximately two-thirds of the items while, for assistant nurses, the cut-off of 0.01 corresponds to managing approximately half of the items. CONCLUSION: The Ms. Olsen test is a short (7- to 10-min) test measuring competence in clinical decision-making among nursing staff working in older people nursing. Despite reasonably good measurement properties, this should be considered an initial validation in the development of a short test for assessing clinical decision-making among nursing staff in various health care setting. IMPACT: Several scales aiming to measure nursing competence have been developed over the last decade, but measurement properties (beyond classical test theory) are seldom evaluated, few scales concern other staff groups than registered nurses and few scales have proposed or established cut-offs for safe practice. The Ms. Olsen test is a short test of clinical decision-making that demonstrates reasonably good measurement properties. Cut-off points for registered nurses and assistant nurses were established. The Ms. Olsen test may be used to measure and evaluate competence in clinical decision-making among nursing staff working in older people nursing and educational settings.

Chronic wound care delivery in wound clinics, community nursing and residential aged care settings: A qualitative analysis using Levine's Conservation Model.

AIMS AND OBJECTIVES: To explore patient experience of chronic wound care across diverse models of outpatient wound care delivery. BACKGROUND: Chronic wounds represent a significant personal, family and healthcare system burden. Evidence suggests specialist wound clinics are more effective and less expensive, however, most outpatient wound care is delivered by general community nurses. There is little understanding of how patients experience diverse models of wound care delivery and the subsequent impact on their capacity to adapt to imbalances in their internal/external environment. DESIGN: Descriptive, qualitative study. METHODS: Eighteen patients with chronic wounds from three wound services were engaged in semi-structured interviews. Initial inductive analysis was refined deductively using Levine's Conservation Model. RESULTS: Chronic wounds lead to imbalances and subsequent adaptions in energy conservation and personal, social and structural integrity. Nursing process and wound care system responses suggest specialist wound clinics provide access to the right person and care at the right time, with less care variation. The community nursing model is most effective with a small team of nurses and a documented care plan, with specialist wound nurse oversight. Residential aged care facilities emerged as important sites for wound care delivery revealing higher variance in care and less specialist wound oversight. CONCLUSIONS: The application of Levine's conservation model provides a theoretical understanding and important insights into the patient experience of nurse and system elements across diverse models of wound care delivery. Specialist oversight by expert wound nurses with the capacity for medical specialist referral is the cornerstone of good wound care. A frequently reviewed wound care plan and skill development for nurses in primary, aged care and community settings are vital. RELEVANCE TO CLINICAL PRACTICE: Shared care between specialist and primary care should include evidence-based pain assessment, clear referral pathways, collaborative relationships, telehealth capacity, patient-held wound plans and upskilling of frontline clinicians.

Nursing Praxis for Reducing Documentation Burden Within Nursing Admission Assessments.

The purpose of this quality improvement project was to conduct a scholarly assessment of the information collected within the nursing admission encounter and implement content revisions across three pilot medical surgical units. The guiding principles were to preserve regulatory information, identify nurse-sensitive data, and eliminate nonessential information. The goal was to decrease the number of clicks and time expended to document electronically an acute admission encounter by 20% and to project the number of hours returned to patient care as a result of decreasing computer clicks. A second goal was to quantify the projected costs of completing a nursing admission encounter. This quality improvement project leveraged nurse executive competencies to intersect the nursing process to develop a nursing documentation praxis. This author's praxis reduced nursing documentation burden in clicks by 29% and reduced time to document on an admission encounter by 34%. This restored the focus on nurse-patient interactions by returning 1016 hours per year to patient care activities, across three pilot units, as well as quantified the costs of completing a nursing admission assessment to utilize in future cost analysis of nursing tasks.

Using Newly Developed Software to Enhance the Efficiency of the Nursing Process in Patient Care: A Randomized Clinical Trial.

The nursing process is a systematic decision-making method of problem-solving that increases the quality of patient care. Implementation of modern technology in nursing can reduce documentation time, make nursing care safer, and improve the quality of patient care. This study aimed to determine the effectiveness of applying newly developed nursing process software on the efficiency of the nursing process in patient care. In this randomized clinical trial, 80 nursing students were randomly allocated into intervention (n = 40) and control (n = 40) groups. The student in the intervention group used the software to care for patients for two semesters. Students in the control group used routine hospital protocol to care for their patients. Modified Brooking nursing process measuring scale was used to evaluate the effectiveness of software before and after the intervention. The results showed a statistically significant difference in the mean efficiency score of the nursing process in the two groups after the intervention (P < .001). Using nursing process software leads to increasing the efficiency of the nursing process in patient care. Thus, providing executive support and electronic resources with relevant training for nursing students can be beneficial in students' education and be a practical application of the nursing process in caring for patients.

Automating Time-Consuming and Error-Prone Manual Nursing Management Documentation Processes.

A German regulation requires nursing managers to document patient-nurse ratios. They have to combine heterogeneous hospital data from different sources. Missing documentation or ratios that are too high lead to sanctions. Automated approaches are needed to accelerate the time-consuming and error-prone documentation process. A documentation and visualization system was implemented. The system allows nursing managers to quickly and automatically create the documentation required by the regulation. Interactive visualization dashboards assist with the analysis of patient and staff numbers. The developed method was effectively used in nursing management tasks. No changes to the information technology infrastructure were needed. The new process is around 35 hours per month faster and less error-prone. The documentation functionality automatically reads the required information and correctly calculates the documentation. The visualization functionality allows nursing managers to assess the current patient-nurse ratios before the documentation is submitted. The method scales to multiple wards and locations. It calculates the sanctions to expect and is easily updatable. The proposed method is expected to decrease nursing administration workloads and facilitate the analysis of nursing management data in a cost-effective way.

Nursing surveillance and immediate jeopardy in Veteran Health Administration community living centers unannounced survey program 2018 to 2019.

BACKGROUND: The VA Community Living Center (CLC) Unannounced Survey Program aims to assess standards of care set by the government to protect residents. PURPOSE: To describe patterns of practice failures in nursing surveillance causing or having potential to cause immediate jeopardy, as defined by the Centers for Medicare and Medicaid Services. METHODS: Using CLC survey data consisting of 200 statements of deficiency (SODs) for 2018 to 2019, we collected a SOD sample (n = 20) of immediate jeopardy events. They were described using descriptive statistics and discourse content analysis. FINDINGS: We identified clinical events, their duration, work shift, and nursing skill mix for each SOD. Most to least common themes about failures in nursing surveillance were acquisition/transfer of information; decision-making; and early recognition of problems. DISCUSSION: Our analysis of nursing surveillance failures in CLC immediate jeopardy SODs provides insight into opportunities for registered nurses and the nursing skill mix to reduce avoidable harms.

Guardians of humanity? The challenges of nursing practice in the digital age.

Digital technologies have become a crucial factor in nursing. Given the fact that many tasks could also be done by robots or AI systems, the place for the nurse in this scenario is unclear. In what way and to what extent will the implementation of ever more sophisticated technology affect nursing practice? It is the aim of this paper to analyse the potential challenges of nursing practice in the digital age. The analysis is conducted through the lens of new materialism, a set of theoretical models that understand the relationship between humans and technology as dynamic and performative. According to this view, there is no prefixed essence of technology. Rather, the meaning of technology is enacted in concrete practice. The analysis shows that in past debates on technology use in nursing, the nurses' role has been defined as guardians of humanity, defending the patient against the dehumanizing effects of technology. This role has been transferred to the digital age, where it is the duty of nurses to cushion the negative effects of digital technology. As an alternative to this outdated role, nurses should be included in processes of technology design and policymaking. Enabling nursing professionals to shape the circumstances of a digitally enhanced holistic practice may empower their status within the healthcare system and also benefit the patient by contributing to a more person-centred care.

Critical thinking in nursing clinical practice, education and research: From attitudes to virtue.

Critical thinking is a complex, dynamic process formed by attitudes and strategic skills, with the aim of achieving a specific goal or objective. The attitudes, including the critical thinking attitudes, constitute an important part of the idea of good care, of the good professional. It could be said that they become a virtue of the nursing profession. In this context, the ethics of virtue is a theoretical framework that becomes essential for analyse the critical thinking concept in nursing care and nursing science. Because the ethics of virtue consider how cultivating virtues are necessary to understand and justify the decisions and guide the actions. Based on selective analysis of the descriptive and empirical literature that addresses conceptual review of critical thinking, we conducted an analysis of this topic in the settings of clinical practice, training and research from the virtue ethical framework. Following JBI critical appraisal checklist for text and opinion papers, we argue the need for critical thinking as an essential element for true excellence in care and that it should be encouraged among professionals. The importance of developing critical thinking skills in education is well substantiated; however, greater efforts are required to implement educational strategies directed at developing critical thinking in students and professionals undergoing training, along with measures that demonstrate their success. Lastly, we show that critical thinking constitutes a fundamental component in the research process, and can improve research competencies in nursing. We conclude that future research and actions must go further in the search for new evidence and open new horizons, to ensure a positive effect on clinical practice, patient health, student education and the growth of nursing science.

[The Neumarkt concept of nursing case responsibility: A framework for consequent and person-centred realization of the nursing process]. / Fallverantwortung Pflege am Klinikum Neumarkt.

The Neumarkt concept of nursing case responsibility: A framework for consequent and person-centred realization of the nursing process Abstract. Background: An essential requirement for the realization of person-centred practice is a practice environment, that supports the forming of professional nurse-patient-relationships. Therefore, Klinikum Neumarkt implemented in context of practice development a concept for nursing case responsibility, that offers a framework for a person-centred and systematic coordination of the nursing process. Because of the existing conflict between economic and nursing interests, it is essential to prove the effectiveness of the concept. Aim: Our aim was the exploration of the effects of the concept implementation from the patient's as well as the interprofessional team's perspective, including the economic implications. Methods: The multiperspective evaluation was conducted with individual interviews and an economic analysis of hospital routine data. Results: The patients and the interprofessional team perceive a person-centred care and coordination of the nursing process. They also point out the required resources. The economic results show a significantly increased revenue through better documentation of complex nursing situations of patients included in the concept (Odds ratio: 4.00, 95%-Confidence Interval [2.15; 8.01], p < 0.001). Discussion: The results provide evidence of the efficacy of the concept for a systematic, person-centred coordination of the nursing process and justify an increased use of resources needed. Limitations and transfer: The implementation of the concept is a drastic change for everyone involved and needs to be embedded in a strategic practice development.

Effekte von Guided Clinical Reasoning auf die Qualität des Advanced Nursing Process.

Effects of Guided Clinical Reasoning on the Advanced Nursing Process quality - An experimental intervention study Abstract. Background: The correctly applied Advanced Nursing Process leads demonstrably to more accurate nursing diagnoses and better nursing outcomes. It requires nurses' knowledge, clinical decision-making competency, and a positive attitude. Former Guided Clinical Reasoning (GCR) trainings significantly enhanced the Advanced Nursing Process quality. However, the congruence between nursing records, care situations, and patient interviews was not yet investigated. Research question: Which effects has GCR on nurses' knowledge, attitude, clinical performance, and on the quality of the Advanced Nursing Process? Methods: An experimental intervention study was carried out from 2016 until 2018 in a Swiss hospital. The 5-month intervention contained four seminar days and GCR-case meetings and was investigated by an evaluation model (n = 95 nurses, n = 24 patients, n = 225 nursing records). Results: After GCR training, nurses showed greater knowledge (p < 0,0001) and a more positive attitude (p = 0,004) on the Advanced Nursing Process than the control group. The congruence of nursing diagnoses, interventions, and outcomes between observations, interviews, and nursing records was higher in the intervention group. At the last measurement point, nursing diagnoses were stated significantly more accurate, interventions were more effective, and better patient outcomes were achieved (all p < 0,0005). Conclusions: GCR trainings should be used to enhance the Advanced Nursing Process quality, so that based on more accurate nursing diagnoses better patient outcomes are achieved.

Data Entry Automation Improves Cost, Quality, Performance, and Job Satisfaction in a Hospital Nursing Unit.

OBJECTIVE: An Automated Data Entry Process Technology tool was developed to free nurses from data entry tasks, thus creating time for patient care and other activities associated with improvements in performance and job satisfaction. BACKGROUND: Manually transferring data from patient measurement devices to electronic health records (EHRs) is an intensive, error-prone task that diverts nurses from patient care while adversely affecting job performance and employee satisfaction. METHODS: Performance improvement analytics were used to compare matched sets of manual and automated EHR data entries for 1933 consecutive vital signs records created by 49 RNs and certified nursing assistants in a 23-bed medical-surgical unit at a large tertiary hospital. Performance and quality effects were evaluated via nurses' responses to a postintervention survey. RESULTS: Data errors decreased from approximately 20% to 0; data transfer times were reduced by 5 minutes to 2 hours per measurement event; nurses had more time for direct patient care; and job satisfaction improved. CONCLUSION: Data entry automation eliminates data errors, substantially reduces delays in getting data into EHRs, and improves job satisfaction by giving nurses more time for direct patient care. Findings are associated with improvements in quality, work performance, and job satisfaction, key goals of nursing leaders.

Leadership in Nursing Excellence: The Magnet Recognition® Journey Experiences in Europe.

Improving work conditions and the provision of high-quality care and patient safety is an issue in European hospitals. Inspired by a US program for nursing excellence, Magnet Recognition, a Belgian hospital shared their experiences by organizing a summer school in 2019 with nurses of 21 hospitals from 9 countries. This article explains the hospital's research program, the link between the journey and the content of the summer school, lessons learned, and the extent to which participants of European hospitals were interested in nursing excellence and Magnet designation.