Implementation of a next-generation electronic nursing records system based on detailed clinical models and integration of clinical practice guidelines.

PubMed

Min, Yul Ha; Park, Hyeoun-Ae; Chung, Eunja; Lee, Hyunsook

2013-12-01

The purpose of this paper is to describe the components of a next-generation electronic nursing records system ensuring full semantic interoperability and integrating evidence into the nursing records system. A next-generation electronic nursing records system based on detailed clinical models and clinical practice guidelines was developed at Seoul National University Bundang Hospital in 2013. This system has two components, a terminology server and a nursing documentation system. The terminology server manages nursing narratives generated from entity-attribute-value triplets of detailed clinical models using a natural language generation system. The nursing documentation system provides nurses with a set of nursing narratives arranged around the recommendations extracted from clinical practice guidelines. An electronic nursing records system based on detailed clinical models and clinical practice guidelines was successfully implemented in a hospital in Korea. The next-generation electronic nursing records system can support nursing practice and nursing documentation, which in turn will improve data quality.

Effect of mentoring on professional values in model C clinical nurse leader graduates.

PubMed

Gazaway, Shena B; Anderson, Lori; Schumacher, Autumn; Alichnie, Chris

2018-04-19

Nursing graduates acquire their nursing values by professional socialization. Mentoring is a crucial support mechanism for these novice nurses, yet little is known about the model C clinical nurse leader graduate and the effects of mentoring. This investigation examined how mentoring affected the development of professional nursing values in the model C clinical nurse leader graduate. A longitudinal design was used to survey model C clinical nurse leader graduates before and after graduation to determine how different types of mentoring relationships influenced professional values. Demographic surveys documented participant characteristics and the Nurses Professional Values Scale - Revised (NPVS-R) assessed professional nursing values. Mean NPVS-R scores increased after graduation for the formally mentored participants, while the NPVS-R scores decreased or remained unchanged for the other mentoring groups. However, no significant difference was found in NPVS-R scores over time (p = .092) or an interaction between the NPVS-R scores and type of mentoring relationships (p = .09). These results suggest that model C clinical nurse leader graduate participants experiencing formal mentoring may develop professional nursing values more than their colleagues. Formal mentoring relationships are powerful and should be used to promote professional values for model C clinical nurse leader graduates. © 2018 John Wiley & Sons Ltd.

A theoretical framework for psychiatric nursing practice.

PubMed

Onega, L L

1991-01-01

Traditionally, specific theoretical frameworks which are congruent with psychiatric nursing practice have been poorly articulated. The purpose of this paper is to identify and discuss a philosophical base, a theoretical framework, application to psychiatric nursing, and issues related to psychiatric nursing knowledge development and practice. A philosophical framework that is likely to be congruent with psychiatric nursing, which is based on the nature of human beings, health, psychiatric nursing and reality, is identified. Aaron Antonovsky's Salutogenic Model is discussed and applied to psychiatric nursing. This model provides a helpful way for psychiatric nurses to organize their thinking processes and ultimately improve the health care services that they offer to their clients. Goal setting and nursing interventions using this model are discussed. Additionally, application of the use of Antonovsky's model is made to nursing research areas such as hardiness, uncertainty, suffering, empathy and literary works. Finally, specific issues related to psychiatric nursing are addressed.

Content Validity of a Psychotherapeutic Intervention Model in Nursing: A Modified e-Delphi Study.

PubMed

Sampaio, Francisco Miguel Correia; Sequeira, Carlos; Lluch Canut, Teresa

2017-04-01

To estimate the content validity of a psychotherapeutic intervention model in nursing. Mental health nurses encounter great extrinsic difficulties when it comes to providing psychotherapeutic interventions due to the fact that they are not allowed to perform such practice in some countries. In this light, the pursuit of a psychotherapeutic intervention model in nursing seems germane to guide the professionals' psychotherapeutic practice, contributing hereof to increase mental health nurses' professional autonomy. Modified e-Delphi. Data were collected from October 2015 to January 2016 by means of three rounds of online questionnaires. The initial questionnaire was structured into five sections: general structure of the model, patients' exclusion criteria, assessment framework, nursing diagnoses, and nursing psychotherapeutic interventions. From the 42 experts invited, at least twenty (20) participated in each round. The experts achieved consensus with regard to the conclusion that nursing psychotherapeutic interventions should always seek to address a nursing diagnosis. These defined furthermore that a psychotherapeutic intervention model in nursing should be exercised by means of 3 to 12 sessions using Nursing Interventions Classification (NIC) as a resource. Finally, experts deemed that the model should follow the principles of integrative psychotherapy, so that techniques from different schools of psychotherapy could therefore be used in conjunction to promote the resolution of a nursing diagnosis. Achieving consensus about the structure of a psychotherapeutic intervention model in nursing is imperative to guide nurses in the provision of nursing psychotherapeutic interventions and to enable an effective evaluation of the health gains associated with its implementation. Copyright © 2016 Elsevier Inc. All rights reserved.

A nursing-specific model of EPR documentation: organizational and professional requirements.

PubMed

von Krogh, Gunn; Nåden, Dagfinn

2008-01-01

To present the Norwegian documentation KPO model (quality assurance, problem solving, and caring). To present the requirements and multiple electronic patient record (EPR) functions the model is designed to address. The model's professional substance, a conceptual framework for nursing practice is developed by examining, reorganizing, and completing existing frameworks. The model's methodology, an information management system, is developed using an expert group. Both model elements were clinically tested over a period of 1 year. The model is designed for nursing documentation in step with statutory, organizational, and professional requirements. Complete documentation is arranged for by incorporating the Nursing Minimum Data Set. A systematic and comprehensive documentation is arranged for by establishing categories as provided in the model's framework domains. Consistent documentation is arranged for by incorporating NANDA-I Nursing Diagnoses, Nursing Intervention Classification, and Nursing Outcome Classification. The model can be used as a tool in cooperation with vendors to ensure the interests of the nursing profession is met when developing EPR solutions in healthcare. The model can provide clinicians with a framework for documentation in step with legal and organizational requirements and at the same time retain the ability to record all aspects of clinical nursing.

A taxonomy of nursing care organization models in hospitals

PubMed Central

2012-01-01

Background Over the last decades, converging forces in hospital care, including cost-containment policies, rising healthcare demands and nursing shortages, have driven the search for new operational models of nursing care delivery that maximize the use of available nursing resources while ensuring safe, high-quality care. Little is known, however, about the distinctive features of these emergent nursing care models. This article contributes to filling this gap by presenting a theoretically and empirically grounded taxonomy of nursing care organization models in the context of acute care units in Quebec and comparing their distinctive features. Methods This study was based on a survey of 22 medical units in 11 acute care facilities in Quebec. Data collection methods included questionnaire, interviews, focus groups and administrative data census. The analytical procedures consisted of first generating unit profiles based on qualitative and quantitative data collected at the unit level, then applying hierarchical cluster analysis to the units’ profile data. Results The study identified four models of nursing care organization: two professional models that draw mainly on registered nurses as professionals to deliver nursing services and reflect stronger support to nurses’ professional practice, and two functional models that draw more significantly on licensed practical nurses (LPNs) and assistive staff (orderlies) to deliver nursing services and are characterized by registered nurses’ perceptions that the practice environment is less supportive of their professional work. Conclusions This study showed that medical units in acute care hospitals exhibit diverse staff mixes, patterns of skill use, work environment design, and support for innovation. The four models reflect not only distinct approaches to dealing with the numerous constraints in the nursing care environment, but also different degrees of approximations to an “ideal” nursing professional practice model described by some leaders in the contemporary nursing literature. While the two professional models appear closer to this ideal, the two functional models are farther removed. PMID:22929127

Statement on nursing: a personal perspective.

PubMed

McCutcheon, Tonna

2004-01-01

Contemporary nursing is based on a conglomerate of theoretical nursing models. These models each incorporate four central concepts: person, health, environment, and nursing. By defining these concepts, nurses develop an individual framework from which they base their nursing practice. As an aspiring nurse practitioner in the gastroenterology field, I have retrospectively assessed my personal definitions of person, health, environment, and nursing. From these definitions, I am able to incorporate specific theoretical frameworks into my personal belief system, thus formulating a basis for my nursing practice. This foundation is comprised of the influence of nursing theorists Jean Watson, Sister Callista Roy, Kolcaba, Florence Nightingale, and Ida J. Orlando; the Perioperative Patient-Focused Model; Watson's Theory of Human Caring; theories regarding transpersonal human caring and healing; and feminist theories. Therefore, this article describes self-examination of nursing care by defining central nursing concepts, acknowledging the influence of nursing theorists and theories, and developing a personal framework from which I base my nursing practice.

Results of an Oncology Clinical Trial Nurse Role Delineation Study.

PubMed

Purdom, Michelle A; Petersen, Sandra; Haas, Barbara K

2017-09-01

To evaluate the relevance of a five-dimensional model of clinical trial nursing practice in an oncology clinical trial nurse population. 
. Web-based cross-sectional survey.
. Online via Qualtrics.
. 167 oncology nurses throughout the United States, including 41 study coordinators, 35 direct care providers, and 91 dual-role nurses who provide direct patient care and trial coordination.
. Principal components analysis was used to determine the dimensions of oncology clinical trial nursing practice.
. Self-reported frequency of 59 activities.
. The results did not support the original five-dimensional model of nursing care but revealed a more multidimensional model.
. An analysis of frequency data revealed an eight-dimensional model of oncology research nursing, including care, manage study, expert, lead, prepare, data, advance science, and ethics.
. This evidence-based model expands understanding of the multidimensional roles of oncology nurses caring for patients with cancer enrolled in clinical trials.

The role of the clinical nurse specialist/neonatal nurse practitioner in a breastfeeding clinic: a model of advanced practice.

PubMed

Gibbins, S A; Green, P E; Scott, P A; MacDonell, J W

2000-03-01

A commitment to quality health care requires the development of innovative models of care. An example of such a model is the Clinical Nurse Specialist/Neonatal Nurse Practitioner in the role as consultant to Lactation Consultants in a large breastfeeding clinic. The role of the Clinical Nurse Specialist/Neonatal Nurse Practitioner in this ambulatory setting encompasses all the dimensions of the advanced practice model including research, leadership, education, and clinical practice. The evolution of this model of care is described. A conceptual framework of this advanced practice model is presented, supported by examples of the role in the clinic.

The Tidal Model: developing an empowering, person-centred approach to recovery within psychiatric and mental health nursing.

PubMed

Barker, P

2001-06-01

Nursing theories and nursing models have a low profile within psychiatric and mental health nursing in the United Kingdom. This paper describes the philosophical and theoretical background of the Tidal Model, which emerged from a 5-year study of the 'need for psychiatric nursing'. The Tidal Model extends and develops some of the traditional assumptions concerning the centrality of interpersonal relations within nursing practice. The model also integrates discrete processes for re-empowering the person who is disempowered by mental distress or psychiatric services or both. The paper reports briefly on the ongoing evaluation of the model in practice.

Towards a comprehensive theory of nurse/patient empowerment: applying Kanter's empowerment theory to patient care.

PubMed

Spence Laschinger, Heather K; Gilbert, Stephanie; Smith, Lesley M; Leslie, Kate

2010-01-01

The purpose of this theoretical paper is to propose an integrated model of nurse/patient empowerment that could be used as a guide for creating high-quality nursing practice work environments that ensure positive outcomes for both nurses and their patients. There are few integrated theoretical approaches to nurse and patient empowerment in the literature, although nurse empowerment is assumed to positively affect patient outcomes. The constructs described in Kanter's (1993) work empowerment theory are conceptually consistent with the nursing care process and can be logically extended to nurses' interactions with their patients and the outcomes of nursing care. We propose a model of nurse/patient empowerment derived from Kanter's theory that suggests that empowering working conditions increase feelings of psychological empowerment in nurses, resulting in greater use of patient empowerment strategies by nurses, and, ultimately, greater patient empowerment and better health outcomes. Empirical testing of the model is recommended prior to use of the model in clinical practice. We argue that empowered nurses are more likely to empower their patients, which results in better patient and system outcomes. Strategies for managers to empower nurses and for nurses to empower patients are suggested.

The nurse scheduling problem: a goal programming and nonlinear optimization approaches

NASA Astrophysics Data System (ADS)

Hakim, L.; Bakhtiar, T.; Jaharuddin

2017-01-01

Nurses scheduling is an activity of allocating nurses to conduct a set of tasks at certain room at a hospital or health centre within a certain period. One of obstacles in the nurse scheduling is the lack of resources in order to fulfil the needs of the hospital. Nurse scheduling which is undertaken manually will be at risk of not fulfilling some nursing rules set by the hospital. Therefore, this study aimed to perform scheduling models that satisfy all the specific rules set by the management of Bogor State Hospital. We have developed three models to overcome the scheduling needs. Model 1 is designed to schedule nurses who are solely assigned to a certain inpatient unit and Model 2 is constructed to manage nurses who are assigned to an inpatient room as well as at Polyclinic room as conjunct nurses. As the assignment of nurses on each shift is uneven, then we propose Model 3 to minimize the variance of the workload in order to achieve equitable assignment on every shift. The first two models are formulated in goal programming framework, while the last model is in nonlinear optimization form.

[Personalized nursing care in hospital and its effects on the patient-nurse trust relationship].

PubMed

García-Juárez, María del Rosario; López-Alonso, Sergio R; Moreno-Verdugo, Ana; Guerra-González, Sara; Fernández-Corchero, Juana; Márquez-Borrego, M José; Orozco-Cózar, M José; Ramos-Bosquet, Gádor

2013-01-01

To determine the level of implementation of an inpatient personalized nursing care model in four hospitals of the Andalusian Health Service, and to determine if there is an association between this model and the perception of trust in the nurse by the patient. An observational cross-sectional study included the patients discharged during a period of 12 months from hospital wards that used the Inpatient Personalized Nursing Care Model of the Andalusian Health Service (based on Primary Nursing Model). The level of implemention was evaluated using the Nursing Care Personalized Index (IPC), made by «patient report» methodology, and the nurse-patient trust relationship was evaluated at the same time as the IPC. Statistical analysis included descriptive data analysis, Chi-squared test, and bivariate and multivariate logistic regression, with and without stratifying by hospitals wards. A total of 817 patient were included. The implementation of the inpatient personalized nursing care model varied between 61 and 79%. The IPC values showed a strong association with the nurse-patient trust relationship, and that for each point increase in the IPC score, the probability of a nurse-patient trust relationship increased between 50 and 130% (0.120.58). The implementation of a personalized nursing care model in the wards studied was higher in the surgicals wards and at regular level in medical wards. Furthermore, the influence of the inpatient personalized nursing care model on the nurse-patient trust relationship has been demonstrated using the IPC model. This trust is the main component for the establishment of a therapeutic relationship. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Fundamental care guided by the Careful Nursing Philosophy and Professional Practice Model©.

PubMed

Meehan, Therese Connell; Timmins, Fiona; Burke, Jacqueline

2018-02-05

To propose the Careful Nursing Philosophy and Professional Practice Model © as a conceptual and practice solution to current fundamental nursing care erosion and deficits. There is growing awareness of the crucial importance of fundamental care. Efforts are underway to heighten nurses' awareness of values that motivate fundamental care and thereby increase their attention to effective provision of fundamental care. However, there remains a need for nursing frameworks which motivate nurses to bring fundamental care values to life in their practice and strengthen their commitment to provide fundamental care. This descriptive position paper builds on the Careful Nursing Philosophy and Professional Practice Model © (Careful Nursing). Careful Nursing elaborates explicit nursing values and addresses both relational and pragmatic aspects of nursing practice, offering an ideal guide to provision of fundamental nursing care. A comparative alignment approach is used to review the capacity of Careful Nursing to address fundamentals of nursing care. Careful Nursing provides a value-based comprehensive and practical framework which can strengthen clinical nurses' ability to articulate and control their practice and, thereby, more effectively fulfil their responsibility to provide fundamental care and measure its effectiveness. This explicitly value-based nursing philosophy and professional practice model offers nurses a comprehensive, pragmatic and engaging framework designed to strengthen their control over their practice and ability to provide high-quality fundamental nursing care. © 2018 John Wiley & Sons Ltd.

A Regional Collaboration for Educational and Career Mobility: The Nursing Education Mobility Action Group.

ERIC Educational Resources Information Center

Rolince, Patricia; Giesser, Nancy; Greig, Judith; Knittel, Kathleen; Mahowald, Jane F.; McAloney-Madden, Lisa; Schloss, Robert A.

2001-01-01

A collaborative group of 25 Northeast Ohio nursing deans/directors has developed an access model to provide new education and career mobility pathways into nursing. Model components describe the routes of licensed practical nurse to registered nurse and registered nurse to bachelor of science in nursing. Cost effectiveness and equity are…

Integration of Evidence into a Detailed Clinical Model-based Electronic Nursing Record System

PubMed Central

Park, Hyeoun-Ae; Jeon, Eunjoo; Chung, Eunja

2012-01-01

Objectives The purpose of this study was to test the feasibility of an electronic nursing record system for perinatal care that is based on detailed clinical models and clinical practice guidelines in perinatal care. Methods This study was carried out in five phases: 1) generating nursing statements using detailed clinical models; 2) identifying the relevant evidence; 3) linking nursing statements with the evidence; 4) developing a prototype electronic nursing record system based on detailed clinical models and clinical practice guidelines; and 5) evaluating the prototype system. Results We first generated 799 nursing statements describing nursing assessments, diagnoses, interventions, and outcomes using entities, attributes, and value sets of detailed clinical models for perinatal care which we developed in a previous study. We then extracted 506 recommendations from nine clinical practice guidelines and created sets of nursing statements to be used for nursing documentation by grouping nursing statements according to these recommendations. Finally, we developed and evaluated a prototype electronic nursing record system that can provide nurses with recommendations for nursing practice and sets of nursing statements based on the recommendations for guiding nursing documentation. Conclusions The prototype system was found to be sufficiently complete, relevant, useful, and applicable in terms of content, and easy to use and useful in terms of system user interface. This study has revealed the feasibility of developing such an ENR system. PMID:22844649

Nursing Approach Based on Roy Adaptation Model in a Patient Undergoing Breast Conserving Surgery for Breast Cancer.

PubMed

Ursavaş, Figen Erol; Karayurt, Özgül; İşeri, Özge

2014-07-01

The use of models in nursing provides nurses to focus on the role of nursing and its applications rather than medical practice. In addition, it helps patient care to be systematic, purposeful, controlled and effective. One of the commonly used models in nursing is Roy Adaptation Model. According to Roy adaptation model, the aim of nursing is to increase compliance and life expectancy. Roy Adaptation Model evaluates the patient in physiologic mode, self-concept mode, role function mode and interdependence mode aiming to provide holistic care. This article describes the use of Roy Adaptation Model in the care of a patient who has been diagnosed with breast cancer and had breast-conserving surgery. Patient data was evaluated in the four modes of Roy adaptation model (physiologic, self-concept, role function, and interdependence modes) and the nursing process was applied.

Similarity and accuracy of mental models formed during nursing handovers: A concept mapping approach.

PubMed

Drach-Zahavy, Anat; Broyer, Chaya; Dagan, Efrat

2017-09-01

Shared mental models are crucial for constructing mutual understanding of the patient's condition during a clinical handover. Yet, scant research, if any, has empirically explored mental models of the parties involved in a clinical handover. This study aimed to examine the similarities among mental models of incoming and outgoing nurses, and to test their accuracy by comparing them with mental models of expert nurses. A cross-sectional study, exploring nurses' mental models via the concept mapping technique. 40 clinical handovers. Data were collected via concept mapping of the incoming, outgoing, and expert nurses' mental models (total of 120 concept maps). Similarity and accuracy for concepts and associations indexes were calculated to compare the different maps. About one fifth of the concepts emerged in both outgoing and incoming nurses' concept maps (concept similarity=23%±10.6). Concept accuracy indexes were 35%±18.8 for incoming and 62%±19.6 for outgoing nurses' maps. Although incoming nurses absorbed fewer number of concepts and associations (23% and 12%, respectively), they partially closed the gap (35% and 22%, respectively) relative to expert nurses' maps. The correlations between concept similarities, and incoming as well as outgoing nurses' concept accuracy, were significant (r=0.43, p<0.01; r=0.68 p<0.01, respectively). Finally, in 90% of the maps, outgoing nurses added information concerning the processes enacted during the shift, beyond the expert nurses' gold standard. Two seemingly contradicting processes in the handover were identified. "Information loss", captured by the low similarity indexes among the mental models of incoming and outgoing nurses; and "information restoration", based on accuracy measures indexes among the mental models of the incoming nurses. Based on mental model theory, we propose possible explanations for these processes and derive implications for how to improve a clinical handover. Copyright © 2017 Elsevier Ltd. All rights reserved.

An investigation into the description of patients' problems by nurses using two different needs-based nursing models.

PubMed

Griffiths, P

1998-11-01

This paper describes an investigation into how nurses describe patients' problems and the possible effects of an espoused nursing model on these descriptions. A descriptive study was conducted on two medical wards in a Welsh District General Hospital. Data collected were subjected to content analysis using Gordon's Functional Health Patterns to order the data. The two wards investigated, whilst being very similar in many ways, utilized different nursing models. Findings showed that the nurses studied, when describing patients' problems, most commonly used medical diagnoses or the medical reasons for admission. Patients' problems identified predominately addressed bio-physical needs with scant attention given to psycho-social needs. Despite the use of two different nursing models the language and emphasis of problem description were very similar and there was no evidence of the application of the conceptual underpinnings of the two models. It is suggested that although the use of a ready-made nursing language may have drawbacks, the British nurse should understand and assess the value of the North American Nursing Diagnosis Association's (NANDA) nursing diagnoses. Without such involvement this system may be implemented in the United Kingdom (UK) without the input and influence of practising nurses.

Implementation of nursing conceptual models: observations of a multi-site research team.

PubMed

Shea, H; Rogers, M; Ross, E; Tucker, D; Fitch, M; Smith, I

1989-01-01

The general acceptance by nursing of the nursing process as the methodology of practice enabled nurses to have a common grounding for practice, research and theory development in the 1970s. It has become clear, however, that the nursing process is just that--a process. What is sorely needed is the nursing content for that process and consequently in the past 10 years nursing theorists have further developed their particular conceptual models (CM). Three major teaching hospitals in Toronto have instituted a conceptual model (CM) of nursing as a basis of nursing practice. Mount Sinai Hospital has adopted Roy's adaptation model; Sunnybrook Medical Centre, Kings's goal attainment model; and Toronto General Hospital, Orem's self-care deficit theory model. All of these hospitals are affiliated through a series of cross appointments with the Faculty of Nursing at the University of Toronto. Two community hospitals, Mississauga and Scarborough General, have also adopted Orem's model and are related to the University through educational, community and interest groups. A group of researchers from these hospitals and the University of Toronto have proposed a collaborative project to determine what impact using a conceptual model will make on nursing practice. Discussions among the participants of this research group indicate that there are observations associated with instituting conceptual models that can be identified early in the process of implementation. These observations may be of assistance to others contemplating the implementation of conceptually based practice in their institution.

The ongoing search for best practice in clinical teaching and learning: a model of nursing students' evolution to proficient novice registered nurses.

PubMed

Edgecombe, Kay; Bowden, Margaret

2009-03-01

This article describes the development of a model of nursing students as evolving registered nurses (RNs). It aims to generate critical debate about innovations in nursing teaching and learning. The model is the outcome of research conducted with undergraduate nursing students (n=111) from Flinders University, Adelaide, South Australia. It identifies the positive and negative intrinsic and extrinsic factors that impact on nursing students' clinical learning development and progression from students to proficient novice RNs. This model has implications for future curriculum development, staff development, placement approaches and research in relation to clinical teaching and learning.

A new hybrid model for exploring the adoption of online nursing courses.

PubMed

Tung, Feng-Cheng; Chang, Su-Chao

2008-04-01

With the advancement in educational technology and internet access in recent years, nursing academia is searching for ways to widen nurses' educational opportunities. The online nursing courses are drawing more attention as well. The online nursing courses are very important e-learning tools for nursing students. The research combines the innovation diffusion theory and technology acceptance model, and adds two research variables, perceived financial cost and computer self-efficacy to propose a new hybrid technology acceptance model to study nursing students' behavioral intentions to use the online nursing courses. Based on 267 questionnaires collected from six universities in Taiwan, the research finds that studies strongly support this new hybrid technology acceptance model in predicting nursing students' behavioral intentions to use the online nursing courses. This research finds that compatibility, perceived usefulness, perceived ease of use, perceived financial cost and computer self-efficacy are critical factors for nursing students' behavioral intentions to use the online nursing courses. By explaining nursing students' behavioral intentions from a user's perspective, the findings of this research help to develop more user friendly online nursing courses and also provide insight into the best way to promote new e-learning tools for nursing students. This research finds that compatibility is the most important research variable that affects the behavioral intention to use the online nursing courses.

New nurses' perceptions of professional practice behaviours, quality of care, job satisfaction and career retention.

PubMed

Spence Laschinger, Heather K; Zhu, Junhong; Read, Emily

2016-07-01

To test a model examining the effects of structural empowerment and support for professional practice on new graduate nurses' perceived professional practice behaviours, perceptions of care quality and subsequent job satisfaction and career turnover intentions. The nursing worklife model describes relationships between supportive nursing work environments and nurse and patient outcomes. The influence of support for professional practice on new nurses' perceptions of professional nursing behaviours within this model has not been tested. Structural equation modelling in Mplus was used to analyse data from a national survey of new nurses across Canada (n = 393). The hypothesised model was supported: χ²(122) = 346.726, P = 0.000; CFI = 0.917; TLI = 0.896; RMSEA = 0.069. Professional practice behaviour was an important mechanism through which empowerment and supportive professional practice environments influenced nurse-assessed quality of care, which was related to job satisfaction and lower intentions to leave nursing. Job satisfaction and career retention of new nurses are related to perceptions of work environment factors that support their professional practice behaviours and high-quality patient care. Nurse managers can support new graduate nurses' professional practice behaviour by providing empowering supportive professional practice environments. © 2016 John Wiley & Sons Ltd.

Understanding well-being and learning of Nigerian nurses: a job demand control support model approach.

PubMed

van Doorn, Yvonne; van Ruysseveldt, Joris; van Dam, Karen; Mistiaen, Wilhelm; Nikolova, Irina

2016-10-01

This study investigated whether Nigerian nurses' emotional exhaustion and active learning were predicted by job demands, control and social support. Limited research has been conducted concerning nurses' work stress in developing countries, such as Nigeria. Accordingly, it is not clear whether work interventions for improving nurses' well-being in these countries can be based on work stress models that are developed in Western countries, such as the job demand control support model, as well as on empirical findings of job demand control support research. Nurses from Nurses Across the Borders Nigeria were invited to complete an online questionnaire containing validated scales; 210 questionnaires were fully completed and analysed. Multiple regression analysis was used to test the hypotheses. Emotional exhaustion was higher for nurses who experienced high demands and low supervisor support. Active learning occurred when nurses worked under conditions of high control and high supervisor support. The findings suggest that the job demand control support model is applicable in a Nigerian nursing situation; the model indicates which occupational stressors contribute to poor well-being in Nigerian nurses and which work characteristics may boost nurses' active learning. Job (re)design interventions can enhance nurses' well-being and learning by guarding nurses' job demands, and stimulating job control and supervisor support. © 2016 John Wiley & Sons Ltd.

Use of 3D models of congenital heart disease as an education tool for cardiac nurses.

PubMed

Biglino, Giovanni; Capelli, Claudio; Koniordou, Despina; Robertshaw, Di; Leaver, Lindsay-Kay; Schievano, Silvia; Taylor, Andrew M; Wray, Jo

2017-01-01

Nurse education and training are key to providing congenital heart disease (CHD) patients with consistent high standards of care as well as enabling career progression. One approach for improving educational experience is the use of 3D patient-specific models. To gather pilot data to assess the feasibility of using 3D models of CHD during a training course for cardiac nurses; to evaluate the potential of 3D models in this context, from the nurses' perspective; and to identify possible improvements to optimise their use for teaching. A cross-sectional survey. A national training week for cardiac nurses. One hundred cardiac nurses (of which 65 pediatric and 35 adult). Nurses were shown nine CHD models within the context of a specialized course, following a lecture on the process of making the models themselves, starting from medical imaging. Participants were asked about their general learning experience, if models were more/less informative than diagrams/drawings and lesion-specific/generic models, and their overall reaction to the models. Possible differences between adult and pediatric nurses were investigated. Written feedback was subjected to content analysis and quantitative data were analyzed using nonparametric statistics. Generally models were well liked and nurses considered them more informative than diagrams. Nurses found that 3D models helped in the appreciation of overall anatomy (86%), spatial orientation (70%), and anatomical complexity after treatment (66%). There was no statistically significant difference between adult and pediatric nurses' responses. Thematic analysis highlighted the need for further explanation, use of labels and use of colors to highlight the lesion of interest amongst improvements for optimizing 3D models for teaching/training purposes. 3D patient-specific models are useful tools for training adult and pediatric cardiac nurses and are particularly helpful for understanding CHD anatomy after repair. © 2016 Wiley Periodicals, Inc.

Lessons learned from the implementation of a bedside handoff model.

PubMed

Hagman, Jan; Oman, Kathleen; Kleiner, Catherine; Johnson, Elizabeth; Nordhagen, Jamie

2013-06-01

At the University of Colorado Hospital, nurse-to-nurse shift reports traditionally occurred in a conference room setting and consisted of nurse-to-nurse verbal communication. Evidence supports moving this information exchange to the patient bedside. This model of report improves clinical effectiveness, patient safety, nurse efficiency, and staff satisfaction. Bedside reporting empowers patients and families to ask questions and contribute to their plan of care and increases patient satisfaction. This article describes the process of implementing and evaluating a model of nurse-to-nurse bedside handoff report.

The use of decision analysis to examine ethical decision making by critical care nurses.

PubMed

Hughes, K K; Dvorak, E M

1997-01-01

To examine the extent to which critical care staff nurses make ethical decisions that coincide with those recommended by a decision analytic model. Nonexperimental, ex post facto. Midwestern university-affiliated 500 bed tertiary care medical center. One hundred critical care staff nurses randomly selected from seven critical care units. Complete responses were obtained from 82 nurses (for a final response rate of 82%). The dependent variable--consistent decision making--was measured as staff nurses' abilities to make ethical decisions that coincided with those prescribed by the decision model. Subjects completed two instruments, the Ethical Decision Analytic Model, a computer-administered instrument designed to measure staff nurses' abilities to make consistent decisions about a chemically-impaired colleague; and a Background Inventory. The results indicate marked consensus among nurses when informal methods were used. However, there was little consistency between the nurses' informal decisions and those recommended by the decision analytic model. Although 50% (n = 41) of all nurses chose a course of action that coincided with the model's least optimal alternative, few nurses agreed with the model as to the most optimal course of action. The findings also suggest that consistency was unrelated (p > 0.05) to the nurses' educational background or years of clinical experience; that most subjects reported receiving little or no education in decision making during their basic nursing education programs; but that exposure to decision-making strategies was related to years of nursing experience (p < 0.05). The findings differ from related studies that have found a moderate degree of consistency between nurses and decision analytic models for strictly clinical decision tasks, especially when those tasks were less complex. However, the findings partially coincide with other findings that decision analysis may not be particularly well-suited to the critical care environment. Additional research is needed to determine whether critical care nurses use the same decision-making methods as do other nurses; and to clarify the effects of decision task (clinical versus ethical) on nurses' decision making. It should not be assumed that methods used to study nurses' clinical decision making are applicable for all nurses or all types of decisions, including ethical decisions.

Development of a leadership competency model.

PubMed

Sherman, Rose O; Bishop, Mary; Eggenberger, Terry; Karden, Ruth

2007-02-01

Although research findings support that the nurse manager has a pivotal role in influencing all aspects of the nursing environment, recruiting talented staff into these nursing leadership positions has become increasingly more difficult. There is a need to better understand the competencies needed by contemporary nurse managers and the challenges in the role. The purpose of this research was to explore the viewpoints of 120 nurse manager study participants on the contemporary nurse manager role and to gain perspective on the critical leadership skills and competencies to build a nursing leadership competency model. A grounded theory methodology was used in this study to capture the perspectives of the nurse managers interviewed about their role. Six competency categories emerged from the research findings to form a nursing leadership competency model. Two major themes identified from the data included the nurse manager role as a career choice and the stressors and challenges in the role. The results of this study led to the design of a nursing leadership competency model and confirmed that there is a need to formally develop and mentor our next generation of nurse leaders.

Integrating nursing diagnostic concepts into the medical entities dictionary using the ISO Reference Terminology Model for Nursing Diagnosis.

PubMed

Hwang, Jee-In; Cimino, James J; Bakken, Suzanne

2003-01-01

The purposes of the study were (1) to evaluate the usefulness of the International Standards Organization (ISO) Reference Terminology Model for Nursing Diagnoses as a terminology model for defining nursing diagnostic concepts in the Medical Entities Dictionary (MED) and (2) to create the additional hierarchical structures required for integration of nursing diagnostic concepts into the MED. The authors dissected nursing diagnostic terms from two source terminologies (Home Health Care Classification and the Omaha System) into the semantic categories of the ISO model. Consistent with the ISO model, they selected Focus and Judgment as required semantic categories for creating intensional definitions of nursing diagnostic concepts in the MED. Because the MED does not include Focus and Judgment hierarchies, the authors developed them to define the nursing diagnostic concepts. The ISO model was sufficient for dissecting the source terminologies into atomic terms. The authors identified 162 unique focus concepts from the 266 nursing diagnosis terms for inclusion in the Focus hierarchy. For the Judgment hierarchy, the authors precoordinated Judgment and Potentiality instead of using Potentiality as a qualifier of Judgment as in the ISO model. Impairment and Alteration were the most frequently occurring judgments. Nursing care represents a large proportion of health care activities; thus, it is vital that terms used by nurses are integrated into concept-oriented terminologies that provide broad coverage for the domain of health care. This study supports the utility of the ISO Reference Terminology Model for Nursing Diagnoses as a facilitator for the integration process.

Integrating Nursing Diagnostic Concepts into the Medical Entities Dictionary Using the ISO Reference Terminology Model for Nursing Diagnosis

PubMed Central

Hwang, Jee-In; Cimino, James J.; Bakken, Suzanne

2003-01-01

Objective: The purposes of the study were (1) to evaluate the usefulness of the International Standards Organization (ISO) Reference Terminology Model for Nursing Diagnoses as a terminology model for defining nursing diagnostic concepts in the Medical Entities Dictionary (MED) and (2) to create the additional hierarchical structures required for integration of nursing diagnostic concepts into the MED. Design and Measurements: The authors dissected nursing diagnostic terms from two source terminologies (Home Health Care Classification and the Omaha System) into the semantic categories of the ISO model. Consistent with the ISO model, they selected Focus and Judgment as required semantic categories for creating intensional definitions of nursing diagnostic concepts in the MED. Because the MED does not include Focus and Judgment hierarchies, the authors developed them to define the nursing diagnostic concepts. Results: The ISO model was sufficient for dissecting the source terminologies into atomic terms. The authors identified 162 unique focus concepts from the 266 nursing diagnosis terms for inclusion in the Focus hierarchy. For the Judgment hierarchy, the authors precoordinated Judgment and Potentiality instead of using Potentiality as a qualifier of Judgment as in the ISO model. Impairment and Alteration were the most frequently occurring judgments. Conclusions: Nursing care represents a large proportion of health care activities; thus, it is vital that terms used by nurses are integrated into concept-oriented terminologies that provide broad coverage for the domain of health care. This study supports the utility of the ISO Reference Terminology Model for Nursing Diagnoses as a facilitator for the integration process. PMID:12668692

The Influence of Work-Related Fatigue, Work Conditions, and Personal Characteristics on Intent to Leave Among New Nurses.

PubMed

Liu, Yi; Wu, Li-Min; Chou, Pi-Ling; Chen, Mei-Hsin; Yang, Li-Chien; Hsu, Hsin-Tien

2016-01-01

This study aimed to (a) test the fit of the hypothesized model for new nurses' intent to leave and (b) determine the extent to which personal characteristics, work conditions, and work-related fatigue predict intent to leave among new nurses. This study was a cross-sectional survey study. A total of 162 new nurses were recruited. A hypothesized model was proposed for model testing. Structural equation modelling was used for data analysis. Work conditions only had an effect through work-related fatigue on new nurses' intent to leave. Personal characteristics did not have a significant effect on new nurses' intent to leave. The final model showed a good fit. Work-related fatigue, work conditions, and health explained 65% of the variance in new nurses' intent to leave. Work-related fatigue was a major determinant of new nurses' intent to leave. More attention should be paid to fatigue reduction strategies among new nurses. Work-related fatigue should be monitored, particularly for new nurses who work more than 10 hr per day and who have greater workloads. © 2015 Sigma Theta Tau International.

Strengthening the Role of Nurses in Medical Device Development.

PubMed

Castner, Jessica; Sullivan, Suzanne S; Titus, Albert H; Klingman, Karen J

2016-01-01

Medical devices and innovative technology promise to revolutionize health care. Despite the importance of involving nurses in the collaborative medical device development processes, there are few learning opportunities in nursing programs. The purpose of this article is to provide a conceptual guide for nurse educators and researchers to engage nursing expertise in medical device development processes. A review of the literature guided the creation of the "Strengthening the Role of Nurses in Medical Device Development Roadmap" model. The model was used to describe how nurses can be engaged in multidisciplinary design of medical devices. An academic transdisciplinary team piloted the application of the model. The model includes the stages of needs assessment, planned brainstorm, feasibility determination, concept design, and prototype building. A transdisciplinary team case study of improving an asthma home-monitoring devices illustrates effective application of the model. Nurse leaders in the academic setting can effectively use the "Strengthening the Role of Nurses in Medical Device Development Roadmap" to inform their engagement of nurses in early medical device development and innovation processes. Copyright © 2016 Elsevier Inc. All rights reserved.

A supply model for nurse workforce projection in Malaysia.

PubMed

Abas, Zuraida Abal; Ramli, Mohamad Raziff; Desa, Mohamad Ishak; Saleh, Nordin; Hanafiah, Ainul Nadziha; Aziz, Nuraini; Abidin, Zaheera Zainal; Shibghatullah, Abdul Samad; Rahman, Ahmad Fadzli Nizam Abdul; Musa, Haslinda

2017-08-18

The paper aims to provide an insight into the significance of having a simulation model to forecast the supply of registered nurses for health workforce planning policy using System Dynamics. A model is highly in demand to predict the workforce demand for nurses in the future, which it supports for complete development of a needs-based nurse workforce projection using Malaysia as a case study. The supply model consists of three sub-models to forecast the number of registered nurses for the next 15 years: training model, population model and Full Time Equivalent (FTE) model. In fact, the training model is for predicting the number of newly registered nurses after training is completed. Furthermore, the population model is for indicating the number of registered nurses in the nation and the FTE model is useful for counting the number of registered nurses with direct patient care. Each model is described in detail with the logical connection and mathematical governing equation for accurate forecasting. The supply model is validated using error analysis approach in terms of the root mean square percent error and the Theil inequality statistics, which is mportant for evaluating the simulation results. Moreover, the output of simulation results provides a useful insight for policy makers as a what-if analysis is conducted. Some recommendations are proposed in order to deal with the nursing deficit. It must be noted that the results from the simulation model will be used for the next stage of the Needs-Based Nurse Workforce projection project. The impact of this study is that it provides the ability for greater planning and policy making with better predictions.

School nurse summer institute: a model for professional development.

PubMed

Neighbors, Marianne; Barta, Kathleen

2004-06-01

The components of a professional development model designed to empower school nurses to become leaders in school health services is described. The model was implemented during a 3-day professional development institute that included clinical and leadership components, especially coalition building, with two follow-up sessions in the fall and spring. Coalition building is an important tool to enhance the influence of the school nurse in improving the health of individuals, families, and communities. School nurses and nursing educators with expertise in the specialty of school nursing could replicate this model in their own regions.

The Historical Evolution of Theories and Conceptual Models for Nursing.

ERIC Educational Resources Information Center

Hawkins, Joellen W.

The development of nursing models can be traced to the inception of nursing as a profession. Florence Nightingale laid the foundation for current nursing practice and differentiated nursing from medicine. The late 19th and early 20th centuries contributed a number of important nurse theorists, better known for other contributions to the neophyte…

Conceptualizing Telehealth in Nursing Practice: Advancing a Conceptual Model to Fill a Virtual Gap.

PubMed

Nagel, Daniel A; Penner, Jamie L

2016-03-01

Increasingly nurses use various telehealth technologies to deliver health care services; however, there has been a lag in research and generation of empirical knowledge to support nursing practice in this expanding field. One challenge to generating knowledge is a gap in development of a comprehensive conceptual model or theoretical framework to illustrate relationships of concepts and phenomena inherent to adoption of a broad range of telehealth technologies to holistic nursing practice. A review of the literature revealed eight published conceptual models, theoretical frameworks, or similar entities applicable to nursing practice. Many of these models focus exclusively on use of telephones and four were generated from qualitative studies, but none comprehensively reflect complexities of bridging nursing process and elements of nursing practice into use of telehealth. The purpose of this article is to present a review of existing conceptual models and frameworks, discuss predominant themes and features of these models, and present a comprehensive conceptual model for telehealth nursing practice synthesized from this literature for consideration and further development. This conceptual model illustrates characteristics of, and relationships between, dimensions of telehealth practice to guide research and knowledge development in provision of holistic person-centered care delivery to individuals by nurses through telehealth technologies. © The Author(s) 2015.

[The electronic use of the NANDA-, NOC- and NIC- classifications and implications for nursing practice].

PubMed

Bernhart-Just, Alexandra; Hillewerth, Kathrin; Holzer-Pruss, Christina; Paprotny, Monika; Zimmermann Heinrich, Heidi

2009-12-01

The data model developed on behalf of the Nursing Service Commission of the Canton of Zurich (Pflegedienstkommission des Kantons Zürich) is based on the NANDA nursing diagnoses, the Nursing Outcome Classification, and the Nursing Intervention Classification (NNN Classifications). It also includes integrated functions for cost-centered accounting, service recording, and the Swiss Nursing Minimum Data Set. The data model uses the NNN classifications to map a possible form of the nursing process in the electronic patient health record, where the nurse can choose nursing diagnoses, outcomes, and interventions relevant to the patient situation. The nurses' choice is guided both by the different classifications and their linkages, and the use of specific text components pre-defined for each classification and accessible through the respective linkages. This article describes the developed data model and illustrates its clinical application in a specific patient's situation. Preparatory work required for the implementation of NNN classifications in practical nursing such as content filtering and the creation of linkages between the NNN classifications are described. Against the background of documentation of the nursing process based on the DAPEP(1) data model, possible changes and requirements are deduced. The article provides a contribution to the discussion of a change in documentation of the nursing process by implementing nursing classifications in electronic patient records.

A picture is worth a thousand words: helping students visualize a conceptual model.

PubMed

Johnson, S E

1989-01-01

Communicating the functional applicability of a conceptual framework to nursing students can be a challenge of considerable magnitude. Nurse educators are convinced that nursing practice and process should stem from theory. However, when attempting to teach this, many educators have struggled with the expressions of confused, skeptical students. To provide a better understanding of a nursing model, the author uses a visual representation of the Neuman Systems Model variables. The student can then visualize application of the Model to nursing practice.

Formalizing nursing knowledge: from theories and models to ontologies.

PubMed

Peace, Jane; Brennan, Patricia Flatley

2009-01-01

Knowledge representation in nursing is poised to address the depth of nursing knowledge about the specific phenomena of importance to nursing. Nursing theories and models may provide a starting point for making this knowledge explicit in representations. We combined knowledge building methods from nursing and ontology design methods from biomedical informatics to create a nursing representation of family health history. Our experience provides an example of how knowledge representations may be created to facilitate electronic support for nursing practice and knowledge development.

The clinical nurse educator as leader.

PubMed

Adelman-Mullally, Theresa; Mulder, Cindy K; McCarter-Spalding, Deborah E; Hagler, Debra A; Gaberson, Kathleen B; Hanner, Mary Beth; Oermann, Marilyn H; Speakman, Elizabeth T; Yoder-Wise, Patricia S; Young, Patricia K

2013-01-01

The National League for Nursing recognizes leadership as an important aspect of the educator role. The purpose of this article is to describe leadership in the context of clinical nursing education and how clinical nurse educators enact leadership. The article identifies particular nursing practice skills and strengths that clinicians bring to nursing education that enhance leadership knowledge, skills, and abilities. After review of several leadership models, we identified five overarching themes that demonstrate how clinical nurse educators exemplify the various models including role modeling, providing vision, helping students to learn, challenging the system or status quo, and seeking relational integrity. We explicate the themes with examples affirming the leadership potential of clinical nurse educators, and suggest ways in which nursing faculty members and administrators might draw on the leadership capital of clinical nurse educators. Copyright © 2012 Elsevier Ltd. All rights reserved.

Instantiating informatics in nursing practice for integrated patient centred holistic models of care: a discussion paper.

PubMed

Hussey, Pamela A; Kennedy, Margaret Ann

2016-05-01

A discussion on how informatics knowledge and competencies can enable nursing to instantiate transition to integrated models of care. Costs of traditional models of care are no longer sustainable consequent to the spiralling incidence and costs of chronic illness. The international community looks towards technology-enabled solutions to support a shift towards integrated patient-centred models of care. Discussion paper. A search of the literature was performed dating from 2000-2015 and a purposeful data sample based on relevance to building the discussion was included. The holistic perspective of nursing knowledge can support and advance integrated healthcare models. Informatics skills are key for the profession to play a leadership role in design, implementation and operation of next generation health care. However, evidence suggests that nursing engagement with informatics strategic development for healthcare provision is currently variable. A statistically significant need exists to progress health care towards integrated models of care. Strategic and tactical plans that are robustly pragmatic with nursing insights and expertise are an essential component to achieve effective healthcare provision. To avoid exclusion in the discourse dominated by management and technology experts, nursing leaders must develop and actively promote the advancement of nursing informatics skills. For knowledge in nursing practice to flourish in contemporary health care, nurse leaders will need to incorporate informatics for optimal translation and interpretation. Defined nursing leadership roles informed by informatics are essential to generate concrete solutions sustaining nursing practice in integrated care models. © 2016 John Wiley & Sons Ltd.

A Conceptual Model of the Information Requirements of Nursing Organizations

PubMed Central

Miller, Emmy

1989-01-01

Three related issues play a role in the identification of the information requirements of nursing organizations. These issues are the current state of computer systems in health care organizations, the lack of a well-defined data set for nursing, and the absence of models representing data and information relevant to clinical and administrative nursing practice. This paper will examine current methods of data collection, processing, and storage in clinical and administrative nursing practice for the purpose of identifying the information requirements of nursing organizations. To satisfy these information requirements, database technology can be used; however, a model for database design is needed that reflects the conceptual framework of nursing and the professional concerns of nurses. A conceptual model of the types of data necessary to produce the desired information will be presented and the relationships among data will be delineated.

A Contextual Work-Life Experiences Model to Understand Nurse Commitment and Turnover.

PubMed

Aluwihare-Samaranayake, Dilmi; Gellatly, Ian; Cummings, Greta; Ogilvie, Linda

2018-05-17

To present a discussion and model depicting most effecting work life experience contextual factors that influence commitment and turnover intentions for nurses in Sri Lanka. Increasing demand for nurses has made the retention of experienced, qualified nursing staff a priority for health care organizations and highlights the need to capture contextual work-life experiences that influence nurses' turnover decisions. Discussion paper. This discussion paper and model is based on our experiences and knowledge of Sri Lanka and represents an integration of classic turnover research and commitment theory and others published between 1958 - 2017, contextualized to reflect the reality faced by Sri Lanka nurses. The model presents a high-level view of intrinsic, extrinsic, personal and professional antecedents to nurse turnover where relevance can be used by researchers, policy makers, clinicians and educators to establish focused and limited scope models and examine comprehensive contexts. This model emphasizes the role that work-life experiences play to fortify (or weaken) nurses' motivation to remain committed to their organization, profession, family, and country. Understanding of contextual work-life influences on nurses' intent to stay should lead to evidence-based strategies that result in a higher number of nurses wanting to remain in the nursing profession and work in the health sector in Sri Lanka. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Nurse characteristics, leadership, safety climate, emotional labour and intention to stay for nurses: a structural equation modelling approach.

PubMed

Liang, Hui-Yu; Tang, Fu-In; Wang, Tze-Fang; Lin, Kai-Ching; Yu, Shu

2016-12-01

The aim of this study was to propose a theoretical model and apply it to examine the structural relationships among nurse characteristics, leadership characteristics, safety climate, emotional labour and intention to stay for hospital nurses. Global nursing shortages negatively affect the quality of care. The shortages can be reduced by retaining nurses. Few studies have independently examined the relationships among leadership, safety climate, emotional labour and nurses' intention to stay; more comprehensive theoretical foundations for examining nurses' intention to stay and its related factors are lacking. Cross-sectional. A purposive sample of 414 full-time nurses was recruited from two regional hospitals in Taiwan. A structured questionnaire was used to collect data from November 2013-June 2014. Structural equation modelling was employed to test the theoretical models of the relationships among the constructs. Our data supported the theoretical model. Intention to stay was positively correlated with age and the safety climate, whereas working hours per week and emotional labour were negatively correlated. The nursing position and transformational leadership indirectly affected intention to stay; this effect was mediated separately by emotional labour and the safety climate. Our data supported the model fit. Our findings provide practical implications for healthcare organizations and administrators to increase nurses' intent to stay. Strategies including a safer climate, appropriate working hours and lower emotional labour can directly increase nurses' intent to stay. Transformational leadership did not directly influence nurses' intention to stay; however, it reduced emotional labour, thereby increasing intention to stay. © 2016 John Wiley & Sons Ltd.

Nurse Practitioner-Physician Comanagement: A Theoretical Model to Alleviate Primary Care Strain.

PubMed

Norful, Allison A; de Jacq, Krystyna; Carlino, Richard; Poghosyan, Lusine

2018-05-01

Various models of care delivery have been investigated to meet the increasing demands in primary care. One proposed model is comanagement of patients by more than 1 primary care clinician. Comanagement has been investigated in acute care with surgical teams and in outpatient settings with primary care physicians and specialists. Because nurse practitioners are increasingly managing patient care as independent clinicians, our study objective was to propose a model of nurse practitioner-physician comanagement. We conducted a literature search using the following key words: comanagement; primary care; nurse practitioner OR advanced practice nurse. From 156 studies, we extracted information about nurse practitioner-physician comanagement antecedents, attributes, and consequences. A systematic review of the findings helped determine effects of nurse practitioner-physician comanagement on patient care. Then, we performed 26 interviews with nurse practitioners and physicians to obtain their perspectives on nurse practitioner-physician comanagement. Results were compiled to create our conceptual nurse practitioner-physician comanagement model. Our model of nurse practitioner-physician comanagement has 3 elements: effective communication; mutual respect and trust; and clinical alignment/shared philosophy of care. Interviews indicated that successful comanagement can alleviate individual workload, prevent burnout, improve patient care quality, and lead to increased patient access to care. Legal and organizational barriers, however, inhibit the ability of nurse practitioners to practice autonomously or with equal care management resources as primary care physicians. Future research should focus on developing instruments to measure and further assess nurse practitioner-physician comanagement in the primary care practice setting. © 2018 Annals of Family Medicine, Inc.

Is Nursing a Viable Career for Blacks? (A Study of Black and White Freshman Nursing Students).

ERIC Educational Resources Information Center

Miller, Michael H.

It has been suggested that underrepresentation of blacks in professional nursing results from insufficient black-nurse role models. This study of 331 black and white freshman nursing students in three, two year, associate degree programs argues that blacks are not professional nurses for reasons other than a lack of role models. The results show…

Development and validation of a nursing professionalism evaluation model in a career ladder system.

PubMed

Kim, Yeon Hee; Jung, Young Sun; Min, Ja; Song, Eun Young; Ok, Jung Hui; Lim, Changwon; Kim, Kyunghee; Kim, Ji-Su

2017-01-01

The clinical ladder system categorizes the degree of nursing professionalism and rewards and is an important human resource tool for managing nursing. We developed a model to evaluate nursing professionalism, which determines the clinical ladder system levels, and verified its validity. Data were collected using a clinical competence tool developed in this study, and existing methods such as the nursing professionalism evaluation tool, peer reviews, and face-to-face interviews to evaluate promotions and verify the presented content in a medical institution. Reliability and convergent and discriminant validity of the clinical competence evaluation tool were verified using SmartPLS software. The validity of the model for evaluating overall nursing professionalism was also analyzed. Clinical competence was determined by five dimensions of nursing practice: scientific, technical, ethical, aesthetic, and existential. The structural model explained 66% of the variance. Clinical competence scales, peer reviews, and face-to-face interviews directly determined nursing professionalism levels. The evaluation system can be used for evaluating nurses' professionalism in actual medical institutions from a nursing practice perspective. A conceptual framework for establishing a human resources management system for nurses and a tool for evaluating nursing professionalism at medical institutions is provided.

Leadership Competence Educational Model for a Twenty-First Century Nursing Doctoral Education in Contemporary Turkey

ERIC Educational Resources Information Center

Terzioglu, Fusun

2011-01-01

In this article, the author proposes a nursing education model about leadership that can be used to improve the leadership skills of nursing doctoral students. This model is developed at the University of Michigan School of Nursing. In developing this model, the author had the opportunity to observe the University of Michigan, School of Nursing…

Developing the green house nursing care team: variations on development and implementation.

PubMed

Bowers, Barbara J; Nolet, Kimberly

2014-02-01

A core component of the Green House nursing home model is an altered supervisory relationship between the nurse and direct care workers. Some have expressed concern that the Green House model might weaken professional nursing oversight, threatening the quality of clinical care. This qualitative research study explores the role of the nurse as implemented in the Green House model, focusing on how variations in the nursing team influence clinical care practices. Dimensional analysis, a "second generation" grounded theory methodology, was used to conduct this study. Data were collected through observations and interviews with 37 nurses, 68 CNAs, and 11 Guides working at 11 Green House sites. Implementation of the nursing role within the Green House model varied both within and across sites. Four nursing model types were identified: Traditional, Visitor, Parallel, and Integrated. Care processes, CNA/Shahbaz skill development, and worker stress varied with each nursing model. Government policies have been enacted to support culture change. However, there is currently little guidance for regulators, providers, or consumers regarding variability in how culture change practices are implemented and consequences of these variations. This article outlines the importance of understanding these practices at a level of detail that distinguishes and supports those that are most promising.

Developing the Green House Nursing Care Team: Variations on Development and Implementation

PubMed Central

Bowers, Barbara J.

2014-01-01

Purpose of the Study: A core component of the Green House nursing home model is an altered supervisory relationship between the nurse and direct care workers. Some have expressed concern that the Green House model might weaken professional nursing oversight, threatening the quality of clinical care. This qualitative research study explores the role of the nurse as implemented in the Green House model, focusing on how variations in the nursing team influence clinical care practices. Design and Methods: Dimensional analysis, a “second generation” grounded theory methodology, was used to conduct this study. Data were collected through observations and interviews with 37 nurses, 68 CNAs, and 11 Guides working at 11 Green House sites. Results: Implementation of the nursing role within the Green House model varied both within and across sites. Four nursing model types were identified: Traditional, Visitor, Parallel, and Integrated. Care processes, CNA/Shahbaz skill development, and worker stress varied with each nursing model. Implications: Government policies have been enacted to support culture change. However, there is currently little guidance for regulators, providers, or consumers regarding variability in how culture change practices are implemented and consequences of these variations. This article outlines the importance of understanding these practices at a level of detail that distinguishes and supports those that are most promising. PMID:24443606

Washington State Nursing Home Administrator Model Curriculum. Final Report.

ERIC Educational Resources Information Center

Cowan, Florence Kelly

The course outlines presented in this final report comprise a proposed Fort Steilacoom Community College curriculum to be used as a statewide model two-year associate degree curriculum for nursing home administrators. The eight courses described are introduction to nursing, home administration, financial management of nursing homes, nursing home…

A theoretical model of job retention for home health care nurses.

PubMed

Ellenbecker, Carol Hall

2004-08-01

Predicted severe nursing shortages and an increasing demand for home health care services have made the retention of experienced, qualified nursing staff a priority for health care organizations. The purpose of this paper is to describe a theoretical model of job retention for home health care nurses. The theoretical model is an integration of the findings of empirical research related to intent to stay and retention, components of Neal's theory of home health care nursing practice and findings from earlier work to develop an instrument to measure home health care nurses' job satisfaction. The theoretical model identifies antecedents to job satisfaction of home health care nurses. The antecedents are intrinsic and extrinsic job characteristics. The model also proposes that job satisfaction is directly related to retention and indirectly related to retention though intent to stay. Individual nurse characteristics are indirectly related to retention through intent to stay. The individual characteristic of tenure is indirectly related to retention through autonomy, as an intrinsic characteristic of job satisfaction, and intent to stay. The proposed model can be used to guide research that explores gaps in knowledge about intent to stay and retention among home health care nurses.

The Effects of the Green House Nursing Home Model on ADL Function Trajectory: A Retrospective Longitudinal Study

PubMed Central

YOON, Ju Young; BROWN, Roger L.; BOWERS, Barbara J.; SHARKEY, Siobhan S.; HORN, Susan D.

2015-01-01

Background Growing attention in the past few decades has focused on improving care quality and quality of life for nursing home residents. Many traditional nursing homes have attempted to transform themselves to become more homelike emphasizing individualized care. This trend is referred to as nursing home culture change in the U.S. A promising culture change nursing home model, the Green House (GH) nursing home model, has shown positive psychological outcomes. However, little is known about whether the GH nursing home model has positive effects on physical function compared to traditional nursing homes. Objectives To examine the longitudinal effects of the GH nursing home model by comparing change patterns of ADL function over time between GH home residents and traditional nursing home residents. Design A retrospective longitudinal study. Settings Four GH organizations (nine GH units and four traditional units). Participants A total of 242 residents (93 GH residents and 149 traditional home residents) who had stayed in the nursing home at least six months from admission. Methods The outcome was ADL function, and the main independent variable was the facility type in which the resident stayed: a GH or traditional unit. Age, gender, comorbidity score, cognitive function, and depressive symptoms at baseline were controlled. All of these measures were from a minimum dataset. Growth curve modeling and growth mixture modeling were employed in this study for longitudinal analyses. Results The mean ADL function showed deterioration over time, and the rates of deterioration between GH and traditional home residents were not different over time. Four different ADL function trajectories were identified for 18 months, but there was no statistical difference in the likelihood of being in one of the four trajectory classes between the two groups. Conclusions Although GH nursing homes are considered to represent an innovative model changing the nursing home environment into more person-centered, this study did not demonstrate significant differences in ADL function changes for residents in the GH nursing homes compared to traditional nursing homes. Given that the GH model continues to evolve as it is being implemented and variations within and across GH homes are identified, large-scale longitudinal studies are needed to provide further relevant information on the effects of the GH model. PMID:26260709

Community of inquiry model: advancing distance learning in nurse anesthesia education.

PubMed

Pecka, Shannon L; Kotcherlakota, Suhasini; Berger, Ann M

2014-06-01

The number of distance education courses offered by nurse anesthesia programs has increased substantially. Emerging distance learning trends must be researched to ensure high-quality education for student registered nurse anesthetists. However, research to examine distance learning has been hampered by a lack of theoretical models. This article introduces the Community of Inquiry model for use in nurse anesthesia education. This model has been used for more than a decade to guide and research distance learning in higher education. A major strength of this model learning. However, it lacks applicability to the development of higher order thinking for student registered nurse anesthetists. Thus, a new derived Community of Inquiry model was designed to improve these students' higher order thinking in distance learning. The derived model integrates Bloom's revised taxonomy into the original Community of Inquiry model and provides a means to design, evaluate, and research higher order thinking in nurse anesthesia distance education courses.

[L'impiego dell'ICNP® nella formazione infermieristica con modelli teorici infermieristici: una revisione della letteratura].

PubMed

Macchi, Barbara; Sironi, Cecilia; Di Mauro, Stefania; Ausili, Davide

2016-01-01

The International Classification for Nursing Practice (ICNP®) is the only nursing terminology that has been accepted within the Family of International Classification of the World Health Organization. The academic teaching of ICNP® could contribute to improve nursing clinical practice. However, standards for its implementation in undergraduate nursing education together with a nursing theoretical model are not available. To know the state of the art about the use of ICNP® in undergraduate nursing education and its use with a nursing theoretical model. A narrative literature review was conducted searching main health scientific databases and including monographs, statements from international associations, and published conference papers. Available literature about ICNP® implementation in nursing education and its use with theoretical models is limited. Results supported the organization of a specific course on ICNP® before clinical teaching programs, the development of paper or electronic ICNP® based educational tools, and the use of active learning strategies. Only three experiences reporting the use of ICNP® with theoretical models have been found. Both the use of ICNP® in nursing undergraduate education and its use according to one or more nursing theoretical models, could help students to learn nursing process. However, weak recommendations can be found in the literature to orient ICNP® implementation in undergraduate nursing education and/or with an explicit theoretical framework. Further studies focusing on these issues are strongly needed.

The influence of role models in undergraduate nurse education.

PubMed

Jack, Kirsten; Hamshire, Claire; Chambers, Alison

2017-12-01

To explore the concept of role modelling in undergraduate nurse education and its effect on the personal and professional development of student nurses. Effective educative strategies are important for student nurses, who have to cope with learning in both clinical and university settings. Given the contemporary issues facing nurse education and practice in the United Kingdom (UK), it is timely and important to undertake pedagogical research into the concept of role modelling as an effective educative method. A descriptive narrative approach. Unstructured interviews were conducted with 14 current/recently discontinued students from Adult and Mental Health branches of nursing degree programmes in the north-west region of England, United Kingdom (UK). Data were thematically analysed. Students valued exposure to positive role models in clinical and university settings and viewed them as beneficial to their learning. Exposure to negative role models occurred, and this provided students with opportunities to consider the type of nurse they aspired to become. In some cases, students' exposure to perceived poor practice had an adverse effect on their learning and led to negative feelings about nursing work. Clinical staff might be perceived as more relevant role models than those in the university setting although there were still opportunities for academic staff to model professional behaviours. The study found that role modelling is an effective way to support learning and led to student satisfaction across both clinical and university settings. The findings support the use of role models in nurse education, and further research about conscious positive modelling of practice is required. Exploring the use of role models is important when examining ways in which the quality of nurse education might be developed. © 2017 John Wiley & Sons Ltd.

Growing up and role modeling: a theory in Iranian nursing students' education.

PubMed

Mokhtari Nouri, Jamileh; Ebadi, Abbas; Alhani, Fatemeh; Rejeh, Nahid

2014-11-16

One of the key strategies in students' learning is being affected by models. Understanding the role-modeling process in education will help to make greater use of this training strategy. The aim of this grounded theory study was to explore Iranian nursing students and instructors' experiences about role modeling process. Data was analyzed by Glaserian's Grounded Theory methodology through semi-structured interviews with 7 faculty members, 2 nursing students; the three focus group discussions with 20 nursing students based on purposive and theoretical sampling was done for explaining role modeling process from four nursing faculties in Tehran. Through basic coding, an effort to comprehensive growth and excellence was made with the basic social process consisting the core category and through selective coding three phases were identified as: realizing and exposure to inadequate human and professional growth, facilitating human and professional growth and evolution. The role modeling process is taking place unconscious, involuntary, dynamic and with positive progressive process in order to facilitate overall growth in nursing student. Accordingly, the design and implementation of the designed model can be used to make this unconscious to conscious, active and voluntarily processes a process to help education administrators of nursing colleges and supra organization to prevent threats to human and professional in nursing students' education and promote nursing students' growth.

Towards an integrated model of nursing competence: an overview of the literature reviews and concept analysis.

PubMed

Caruso, Roberto; Fida, Roberta; Sili, Alessandro; Arrigoni, Cristina

2016-01-01

Competence is considered a fundamental element when measuring a nurse's or student's ability to provide nursing care, but there is no consensus on what competence really is. This paper aims to review the existing meanings and models of nursing competence. The overview of literature reviews and concept analysis was performed through a search on Pubmed, Cinahl and PsychINFO from January 2005 to September 2014. It included key words, such as: Competence Model; Professional Competence; Nursing Competence; Competency Model; Professional Competency; Nursing Competency. A total of 14 papers were found, coming from educational or clinical nursing field. It was possible to identify some common themes: description of competence determinants; confu- sion around the competence concept; lack in competence evaluation; lack when competence have to be operationalized. The overview results, enriched by the literature coming out from the organiza- tional studies, build the conceptual basis of an integrated model of nursing competence. More empirical research is needed to test the theoretical assumptions.

Transformational leadership in nursing: towards a more critical interpretation.

PubMed

Hutchinson, Marie; Jackson, Debra

2013-03-01

Effective nurse leadership is positioned as an essential factor in achieving optimal patient outcomes and workplace enhancement. Over the last two decades, writing and research on nursing leadership has been dominated by one conceptual theory, that of transformational leadership. This theoretical framework has provided insight into various leader characteristics, with research findings presented as persuasive evidence. While elsewhere there has been robust debate on the merits of the transformational model of leadership, in the nursing literature, there has been little critical review of the model and the commonly used assessment instruments. In this article, we critically review more than a decade of nursing scholarship on the transformational model of leadership and its empirical evidence. Applying a critical lens to the literature, the conceptual and methodological weaknesses of much nursing research on this topic, we question whether the uncritical adoption of the transformational model has resulted in a limited interpretation of nursing leadership. Given the limitations of the model, we advocate embracing new ways of thinking about nursing leadership. © 2012 Blackwell Publishing Ltd.

Associations of patient safety outcomes with models of nursing care organization at unit level in hospitals.

PubMed

Dubois, Carl-Ardy; D'amour, Danielle; Tchouaket, Eric; Clarke, Sean; Rivard, Michèle; Blais, Régis

2013-04-01

To examine the associations of four distinct nursing care organizational models with patient safety outcomes. Cross-sectional correlational study. Using a standardized protocol, patients' records were screened retrospectively to detect occurrences of patient safety-related events. Binary logistic regression was used to assess the associations of those events with four nursing care organizational models. Twenty-two medical units in 11 hospitals in Quebec, Canada, were clustered into 4 nursing care organizational models: 2 professional models and 2 functional models. Two thousand six hundred and ninety-nine were patients hospitalized for at least 48 h on the selected units. Composite of six safety-related events widely-considered sensitive to nursing care: medication administration errors, falls, pneumonia, urinary tract infection, unjustified restraints and pressure ulcers. Events were ultimately sorted into two categories: events 'without major' consequences for patients and events 'with' consequences. After controlling for patient characteristics, patient risk of experiencing one or more events (of any severity) and of experiencing an event with consequences was significantly lower, by factors of 25-52%, in both professional models than in the functional models. Event rates for both functional models were statistically indistinguishable from each other. Data suggest that nursing care organizational models characterized by contrasting staffing, work environment and innovation characteristics may be associated with differential risk for hospitalized patients. The two professional models, which draw mainly on registered nurses (RNs) to deliver nursing services and reflect stronger support for nurses' professional practice, were associated with lower risks than are the two functional models.

Nurses' intention to leave: critically analyse the theory of reasoned action and organizational commitment model.

PubMed

Liou, Shwu-Ru

2009-01-01

To systematically analyse the Organizational Commitment model and Theory of Reasoned Action and determine concepts that can better explain nurses' intention to leave their job. The Organizational Commitment model and Theory of Reasoned Action have been proposed and applied to understand intention to leave and turnover behaviour, which are major contributors to nursing shortage. However, the appropriateness of applying these two models in nursing was not analysed. Three main criteria of a useful model were used for the analysis: consistency in the use of concepts, testability and predictability. Both theories use concepts consistently. Concepts in the Theory of Reasoned Action are defined broadly whereas they are operationally defined in the Organizational Commitment model. Predictability of the Theory of Reasoned Action is questionable whereas the Organizational Commitment model can be applied to predict intention to leave. A model was proposed based on this analysis. Organizational commitment, intention to leave, work experiences, job characteristics and personal characteristics can be concepts for predicting nurses' intention to leave. Nursing managers may consider nurses' personal characteristics and experiences to increase their organizational commitment and enhance their intention to stay. Empirical studies are needed to test and cross-validate the re-synthesized model for nurses' intention to leave their job.

Nurse-Performed Endoscopy: Implications for the Nursing Profession in Australia.

PubMed

Duffield, Christine; Chapman, Susan; Rowbotham, Samantha; Blay, Nicole

2017-02-01

Increasing demands for health care globally often lead to discussions about expanding the involvement of nurses in a range of nontraditional roles. Several countries have introduced nurse endoscopists as a means of easing the burden of demand for a range of endoscopic procedures. A shortage of medical staff in Australia combined with increasing demand for endoscopy led to the implementation of nurse endoscopists as a pilot program in the state of Queensland, where a nurse practitioner model was implemented, and Victoria, where an advanced practice model was used. This article will discuss the implementation of and responses from the nursing, medical, and policy community to nurse-performed endoscopy in this country. Regarding health policy, access to cancer screening may be improved by providing nurses with advanced training to safely perform endoscopy procedures. Moreover, issues of nurse credentialing and payment need to be considered appropriate to each country's health system model.

Dedicated Education Unit: an innovative clinical partner education model.

PubMed

Moscato, Susan Randles; Miller, Judith; Logsdon, Karen; Weinberg, Stephen; Chorpenning, Lori

2007-01-01

This article describes the implementation and evaluation of the Dedicated Education Unit (DEU) as an innovative model of clinical nursing education. A partnership of nurse executives, staff nurses and faculty transformed patient care units into environments of support for nursing students and staff nurses while continuing the critical work of providing quality care to acutely ill adults. Various methods were used to obtain formative data during the implementation of this model in which staff nurses assumed the role of nursing instructors. Results showed high student and nurse satisfaction and a marked increase in clinical capacity that allowed for increased enrollment. This article reports on a 3-year project to operationalize the DEU concept with 6 nursing units in 3 hospitals. The development of staff nurses as clinical instructors, best practices to teach and evaluate critical thinking in students, and the mix of student learners continue as focus areas.

[Service productivity in hospital nursing--conceptual framework of a productivity analysis].

PubMed

Thomas, D; Borchert, M; Brockhaus, N; Jäschke, L; Schmitz, G; Wasem, J

2015-01-01

Decreasing staff numbers compounded by an increasing number of cases is regarded as main challenge in German hospital nursing. These input reductions accompanied by output extensions imply that hospital nursing services have had to achieve a continuous productivity growth in the recent years. Appropriately targeted productivity enhancements require approved and effective methods for productivity acquisition and measurement. However, there is a lack of suitable productivity measurement instruments for hospital nursing services. This deficit is addressed in the present study by the development of an integrated productivity model for hospital nursing services. Conceptually, qualitative as well as quantitative aspects of nursing services productivity are equally taken into consideration. Based on systematic literature reviews different conceptual frameworks of service productivity and the current state of research in hospital nursing services productivity were analysed. On this basis nursing sensitive inputs, processes and outputs were identified and integrated into a productivity model. As an adequate framework for a hospital nursing services productivity model the conceptual approach by Grönroos/Ojasalo was identified. The basic structure of this model was adapted stepwise to our study purpose by integrating theoretical and empirical findings from the research fields of service productivity, nursing productivity as well as national and international nursing research. Special challenges existed concerning the identification of relevant influencing factors as well as the representation of nursing sensitive outputs. The final result is an integrated productivity model, which can be used as an adequate framework for further research in hospital nursing productivity. Research on hospital nursing services productivity is rare, especially in Germany. The conceptual framework developed in this study builds on established knowledge in service productivity research. The theoretical findings have been advanced and adapted to the context of German hospital nursing services. The presented productivity model represents a unique combination of services and nursing services research, which did not exist so far. By operationalisation of the model's components it can be used as the basis for further empirical -research. © Georg Thieme Verlag KG Stuttgart · New York.

An Introduction to the Partial Credit Model for Developing Nursing Assessments.

ERIC Educational Resources Information Center

Fox, Christine

1999-01-01

Demonstrates how the partial credit model, a variation of the Rasch Measurement Model, can be used to develop performance-based assessments for nursing education. Applies the model using the Practical Knowledge Inventory for Nurses. (SK)

Modeling the Distribution of Nursing Effort Using Structured Labor and Delivery Documentation

PubMed Central

Hall, Eric S.; Poynton, Mollie R.; Narus, Scott P.; Thornton, Sidney N.

2008-01-01

Our study objectives included the development and evaluation of models for representing the distribution of shared unit-wide nursing care resources among individual Labor and Delivery patients using quantified measurements of nursing care, referred to as Nursing Effort. The models were intended to enable discrimination between the amounts of care delivered to patient subsets defined by attributes such as patient acuity. For each of five proposed models, scores were generated using an analysis set of 686,402 computerized nurse-documented events associated with 1,093 patients at three hospitals during January and February 2006. Significant differences were detected in Nursing Effort scores according to patient acuity, care facility, and in scores generated during shift-change versus non shift-change hours. The development of nursing care quantification strategies proposed in this study supports outcomes analysis by establishing a foundation for measuring the effect of patient-level nursing care on individual patient outcomes. PMID:18495549

The Prince Edward Island Conceptual Model for Nursing: a nursing perspective of primary health care.

PubMed

Munro, M; Gallant, M; MacKinnon, M; Dell, G; Herbert, R; MacNutt, G; McCarthy, M J; Murnaghan, D; Robertson, K

2000-06-01

The philosophy of primary health care (PHC) recognizes that health is a product of individual, social, economic, and political factors and that people have a right and a duty, individually and collectively, to participate in the course of their own health. The majority of nursing models cast the client in a dependent role and do not conceptualize health in a social, economic, and political context. The Prince Edward Island Conceptual Model for Nursing is congruent with the international move towards PHC. It guides the nurse in practising in the social and political environment in which nursing and health care take place. This model features a nurse/client partnership, the goal being to encourage clients to act on their own behalf. The conceptualization of the environment as the collective influence of the determinants of health gives both nurse and client a prominent position in the sociopolitical arena of health and health care.

[American participation in the creation of a nurse model in Brazilian society in the 1920's].

PubMed

Santos, Tânia Cristina Franco; Barreira, Ieda de Alencar; da Fonte, Aline Silva; de Oliveira, Alexandre Barbosa

2011-08-01

The objectives of this historical-social study are: to describe the circumstances that determined the participation of North American nurses in the formation of the Brazilian nurse; and analyse the process of implementing institutional rituals as a strategy of symbolic fight, to confer visibility to the nurse profession and discuss the symbolic effects of institutional rituals for the consecration of a nurse model for Brazilian society at the time. The primary sources are constituted of pertaining written and photographic documents relative to the studied theme. By reading the documentary corpus an analysis was made of the symbols that had distinguished and established the hierarchies of the actions, as well as the strategies undertaken for the North American nurses, towards implementing a new model of nurses in Brazilian society, coherent with the model of the North American schools of nursing. Institutional rituals, conducted or testified by prestigious figures of the history of Brazil and nursing, were fundamental for the construction of professional identity.

Integration of nursing assessment concepts into the medical entities dictionary using the LOINC semantic structure as a terminology model.

PubMed

Cieslowski, B J; Wajngurt, D; Cimino, J J; Bakken, S

2001-01-01

Recent investigations have tested the applicability of various terminology models for the representing nursing concepts including those related to nursing diagnoses, nursing interventions, and standardized nursing assessments as a prerequisite for building a reference terminology that supports the nursing domain. We used the semantic structure of Clinical LOINC (Logical Observations, Identifiers, Names, and Codes) as a reference terminology model to support the integration of standardized assessment terms from two nursing terminologies into the Medical Entities Dictionary (MED), the concept-oriented, metadata dictionary at New York Presbyterian Hospital. Although the LOINC semantic structure was used previously to represent laboratory terms in the MED, selected hierarchies and semantic slots required revisions in order to incorporate the nursing assessment concepts. This project was an initial step in integrating nursing assessment concepts into the MED in a manner consistent with evolving standards for reference terminology models. Moreover, the revisions provide the foundation for adding other types of standardized assessments to the MED.

Integration of nursing assessment concepts into the medical entities dictionary using the LOINC semantic structure as a terminology model.

PubMed Central

Cieslowski, B. J.; Wajngurt, D.; Cimino, J. J.; Bakken, S.

2001-01-01

Recent investigations have tested the applicability of various terminology models for the representing nursing concepts including those related to nursing diagnoses, nursing interventions, and standardized nursing assessments as a prerequisite for building a reference terminology that supports the nursing domain. We used the semantic structure of Clinical LOINC (Logical Observations, Identifiers, Names, and Codes) as a reference terminology model to support the integration of standardized assessment terms from two nursing terminologies into the Medical Entities Dictionary (MED), the concept-oriented, metadata dictionary at New York Presbyterian Hospital. Although the LOINC semantic structure was used previously to represent laboratory terms in the MED, selected hierarchies and semantic slots required revisions in order to incorporate the nursing assessment concepts. This project was an initial step in integrating nursing assessment concepts into the MED in a manner consistent with evolving standards for reference terminology models. Moreover, the revisions provide the foundation for adding other types of standardized assessments to the MED. PMID:11825165

Clinical leadership and pre-registration nursing programmes: A model for clinical leadership and a prospective curriculum implementation and evaluation research strategy.

PubMed

Brown, Angela; Dewing, Jan; Crookes, Patrick

2016-07-01

To present for wider debate a conceptual model for clinical leadership development in pre-registration nursing programmes and a proposed implementation plan. Globally, leadership in nursing has become a significant issue. Whilst there is continued support for leadership preparation in pre-registration nursing programmes, there have been very few published accounts of curriculum content and/or pedagogical approaches that foster clinical leadership development in pre-registration nursing. A doctoral research study has resulted in the creation of an overarching model for clinical leadership. A multi-method research study using theoretical and empirical literature 1974-2015, a focus group, expert opinion and a national on-line survey. A conceptual model of clinical leadership development in pre-registration nursing programme is presented, including the infinity loop of clinical leadership, an integral curriculum thread and a conceptual model: a curriculum-pedagogy nexus for clinical leadership. In order to test out usability and evaluate effectiveness, a multi method programme of research in one school of nursing in Australia is outlined. Implementation of the proposed conceptual model for clinical leadership development in pre-registration nursing programmes and a programme of (post-doctoral) research will contribute to what is known about curriculum content and pedagogy for nurse academics. Importantly, for nursing students and the profession as a whole, there is a clearer expectation of what clinical leadership might look like in the novice registered nurse. For nurse academics a model is offered for consideration in curriculum design and implementation with an evaluation strategy that could be replicated. Copyright © 2016 Elsevier Ltd. All rights reserved.

Modeling a Nursing Guideline with Standard Terminology and Unified Modeling Language for a Nursing Decision Support System: A Case Study.

PubMed

Choi, Jeeyae; Jansen, Kay; Coenen, Amy

In recent years, Decision Support Systems (DSSs) have been developed and used to achieve "meaningful use". One approach to developing DSSs is to translate clinical guidelines into a computer-interpretable format. However, there is no specific guideline modeling approach to translate nursing guidelines to computer-interpretable guidelines. This results in limited use of DSSs in nursing. Unified modeling language (UML) is a software writing language known to accurately represent the end-users' perspective, due to its expressive characteristics. Furthermore, standard terminology enabled DSSs have been shown to smoothly integrate into existing health information systems. In order to facilitate development of nursing DSSs, the UML was used to represent a guideline for medication management for older adults encode with the International Classification for Nursing Practice (ICNP®). The UML was found to be a useful and sufficient tool to model a nursing guideline for a DSS.

Reconstructing marginality: a new model of cultural diversity in nursing.

PubMed

Southwick, Margaret; Polaschek, Nick

2014-05-01

This article presents a new model of cultural diversity in nursing that critically reconstructs the concept of marginality that underpins other models. Rather than viewing the marginal as "other," marginality is redefined as the space in between the dominant cultural reality and the cultural realities of minority groups located within a society. Members of a minority cultural group who become skilled in the difficult process of negotiating this in-between space open the possibility of transformation within nursing education and practice. This model has been applied in a study of the experience of nursing students of Pacific ethnicity in New Zealand. Subsequently, an undergraduate Pacific nursing program was developed, with greatly increased success rates in registration of Pacific nurses. This model of cultural diversity can also be used to understand nursing practice involving people from minority cultures or other socially excluded categories. Copyright 2014, SLACK Incorporated.

Critical thinking in clinical nurse education: application of Paul's model of critical thinking.

PubMed

Andrea Sullivan, E

2012-11-01

Nurse educators recognize that many nursing students have difficulty in making decisions in clinical practice. The ability to make effective, informed decisions in clinical practice requires that nursing students know and apply the processes of critical thinking. Critical thinking is a skill that develops over time and requires the conscious application of this process. There are a number of models in the nursing literature to assist students in the critical thinking process; however, these models tend to focus solely on decision making in hospital settings and are often complex to actualize. In this paper, Paul's Model of Critical Thinking is examined for its application to nursing education. I will demonstrate how the model can be used by clinical nurse educators to assist students to develop critical thinking skills in all health care settings in a way that makes critical thinking skills accessible to students. Copyright © 2012 Elsevier Ltd. All rights reserved.

Modeling a Nursing Guideline with Standard Terminology and Unified Modeling Language for a Nursing Decision Support System: A Case Study

PubMed Central

Choi, Jeeyae; Jansen, Kay; Coenen, Amy

2015-01-01

In recent years, Decision Support Systems (DSSs) have been developed and used to achieve “meaningful use”. One approach to developing DSSs is to translate clinical guidelines into a computer-interpretable format. However, there is no specific guideline modeling approach to translate nursing guidelines to computer-interpretable guidelines. This results in limited use of DSSs in nursing. Unified modeling language (UML) is a software writing language known to accurately represent the end-users’ perspective, due to its expressive characteristics. Furthermore, standard terminology enabled DSSs have been shown to smoothly integrate into existing health information systems. In order to facilitate development of nursing DSSs, the UML was used to represent a guideline for medication management for older adults encode with the International Classification for Nursing Practice (ICNP®). The UML was found to be a useful and sufficient tool to model a nursing guideline for a DSS. PMID:26958174

Workplace Bullying, Job Stress, Intent to Leave, and Nurses' Perceptions of Patient Safety in South Korean Hospitals.

PubMed

Oh, Hyunjin; Uhm, Dong-Choon; Yoon, Young Joo

2016-01-01

Negative work environments influence the ability of nurses to provide optimal patient care in a safe environment. The purpose of the study was to test a model linking workplace bullying (WPB) and lateral violence (LV) with job stress, intent to leave, and, subsequently, nurse-assessed patient adverse outcomes (safety issues). This descriptive-correlational study examined the relationships between study variables and used a structural equation model to test the validity of the proposed theoretical framework. A convenience sample of 508 clinical nurses working in eight general hospitals in Daejeon, South Korea, completed a questionnaire on measures of WPB, LV, job stress, intent to leave, and nurse-assessed patient safety. Analysis of moment structures was used to estimate a set of three models with competing measurement structures for WPB and LV and the same structural model. Akaike Information Criterion was used for model selection. Among the three proposed models, the model with complex factor loadings was selected (WPB and LV were both associated with verbal abuse and physical threat). WPB directly and indirectly influenced nurse-assessed patient safety. Job stress directly influenced intent to leave, and intent to leave directly influenced nurse-assessed patient safety. The results of the study support the proposition that WPB, job stress, and intent to leave may be associated with nurse-perceived adverse outcomes (patient safety issues) in hospitals. Nurse perceptions of WPB were associated with nurse-assessed patient safety outcomes (adverse events) directly and through mediating job stress and intent to leave. LV was not associated with the mediators or nurse-assessed adverse outcomes (safety).

Balancing the seen and unseen: Nurse educator as role model for critical thinking.

PubMed

Raymond, Christy; Profetto-McGrath, Joanne; Myrick, Florence; Strean, William B

2018-05-04

Critical thinking is an important indicator of student learning and is an essential outcome of baccalaureate nursing education. The role of nurse educators in the development of students' critical thinking has been overlooked despite the importance of their actions to facilitate critical thinking in nursing education. We used a constructivist grounded theory approach within a larger mixed methods triangulation study to explore how nurse educators revealed their critical thinking in practice. From the grounded theory approach, a model emerged from our research, outlining the important aspects of nurse educators' critical thinking and how it is revealed in the clinical setting. The important categories of this model include: a) fostering the student-educator relationship; b) role modeling critical thinking; c) mobilizing and operationalizing resources; as well as d) balancing factors that impact nurse educators' critical thinking. Our findings inform what is known about nurse educators' critical thinking and how it can be implemented in nurse educators' teaching practice. Given our findings, we offer recommendations for future nursing education practice and research, including the need to apply our findings in additional settings and further develop nurse educators' awareness of their own critical thinking. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

The motivation to care: application and extension of motivation theory to professional nursing work.

PubMed

Moody, Roseanne C; Pesut, Daniel J

2006-01-01

The purpose of this research is to describe a model of nurses' work motivation relevant to the human caring stance of professional nursing work. The model was derived from selected theories of behavioral motivation and work motivation. Evidence-based theory addressing nurses' work motivation and nurses' motivational states and traits in relation to characteristics of organizational culture and patient health outcomes is suggested in an effort to make a distinct contribution to health services research. An integrated review of selected theories of motivation is presented, including conceptual analyses, theory-building techniques, and the evidence supporting the theoretical propositions and linkages among variables intrinsic to nurses' work motivation. The model of the Motivation to Care for Professional Nursing Work is a framework intended for empirical testing and theory building. The model proposes specific leadership and management strategies to support a culture of motivational caring and competence in health care organizations. Attention to motivation theory and research provides insights and suggests relationships among nurses' motivation to care, motivational states and traits, individual differences that influence nurses' work motivation, and the special effects of nurses' work motivation on patient care outcomes. Suggestions for nursing administrative direction and research are proposed.

A research-based didactic model for education to promote culturally competent nursing care in Sweden.

PubMed

Gebru, Kerstin; Willman, Ania

2003-01-01

As Sweden changes toward a multicultural society, scientific knowledge of transcultural nursing care becomes increasingly important. Earlier studies in Swedish nursing education have demonstrated a lack of knowledge base in transcultural nursing. Through an extensive review of the literature, a didactic model was developed to help facilitate the establishment of this body of knowledge in transcultural nursing. The article demonstrates how the model applies the content and structure of Leininger's theory of culture care diversity and universality and ethnonursing method in a 3-year nursing program in theory as well as clinical education. The model includes a written guide for faculty members, with references to scientific articles and documents to be used.

The Development of a Model to Analyze the Communication Behavior of Staff Nurses.

ERIC Educational Resources Information Center

Totusek, Patsy F.

Little has been done to identify the communication needs of nurses. The development of a model to use in examining their communication behavior can be an important first step in identifying those needs. The proposed model identifies four members of the staff nurse's role-set: patients, doctors, family members, and other nursing personnel. Each…

Nurses' intention to resign and avoidance of emergency department violence: A moderated mediation model.

PubMed

Li, Yu-Fang; Chao, Minston; Shih, Chih-Ting

2017-10-10

Studies that examined the negative impact of violence in emergency departments on nurses' leave and avoidance behavior are well-documented. However, few studies provided an integrated model of how and when violence influences their leave and avoidance behavior. The study adopted Affective Events Theory to propose and examine a model of violent events, negative emotions, and (leave and avoidance) behaviors on nurses in emergency departments and further analyzed whether the model is salient to nurses' occupational burnout, nursing experience, and nursing rank. The sample included 123 emergency department nurses at a teaching hospital in northern, Taiwan. All participants had experienced violent incidents within the preceding 6 months. Moderated mediation analysis suggested that nurses experienced one of two emotional processes following violent incidents: "violence-negative feelings toward work-intention to resign" or "violence-negative emotion and physical symptoms-avoidance tendencies." Moreover, nurses with high burnout levels expressed weaker intention to resign after violent incidents, while nurses with more experience and higher rank were less likely to avoid violence after violent incidents. Emergency nurses do not simply elect to escape but may engage in avoidance behavior. This study revealed that how violent incidents affect nurses' resignation or avoidance behaviors depends on how they feel. Occupational burnout and nurses' attributes affected their behavior. Copyright © 2017 Elsevier Ltd. All rights reserved.

Caring and competency.

PubMed

Mustard, Lewis W

2002-06-01

The long-term crisis in nursing, particularly in acute care hospitals, is demonstrated in studies on negligence by the Institute of Medicine in To Err is Human: Building a Safer Health System1 and Crossing the Quality Chasm: A New Health System for the 21st Century.2 A review of the nursing literature reflects unclear definitions of competency and its component caring, and no single theory of competency has been adopted from the literature and used in the education of nurses. The American Nurses 2001 Code of Ethics does not resolve this confusion, because it does not correct the individual acts of nursing incompetencies in acute care hospitals. The author defines caring and competency by providing examples of what they are not in examining 200 actual cases of hospital nursing acts of incompetence by nursing discipline. None of these examples of imputed negligence was reported to the National Practitioner Data Bank because the "corporate shield" protected the nurses by not being named in the complaint nor named as part of the settlement against the hospital.A new model of the hospitalist, the nurse hospitalist, is presented to act as a daily teacher and facilitator for hospital nurses based on a curriculum of day-to-day examples of substandard patient care. This nurse specialist is an inpatient generalist advanced practice nurse who is employed by the hospital and reports to the chief nurse executive. The author proposes that this new model of the nurse hospitalist be devoted entirely to collaborating with nurse leaders, educators, charge nurses, and floor nurses throughout disciplines in advancing the competency of nursing. This daily proactive and prospective model of improving nursing performance in a facultative manner offers strategies to mitigate the limitations of the retrospective model of quality control. Total quality improvement practiced retroactively is ineffective. The author recommends no structural change in the institution but an educational agenda by the nurse hospitalist, with hospital administration to assist nurses in a new learning environment.

An international study of hospitalized cancer patients' health status, nursing care quality, perceived individuality in care and trust in nurses: A path analysis.

PubMed

Charalambous, Andreas; Radwin, Laurel; Berg, Agneta; Sjovall, Katarina; Patiraki, Elisabeth; Lemonidou, Chryssoula; Katajisto, Jouko; Suhonen, Riitta

2016-09-01

Providing high quality nursing care for patients with malignancies is complex and driven by many factors. Many of the associations between nursing care quality, trust, health status and individualized care remain obscure. To empirically test a model of association linking hospitalized cancer patients' health status, nursing care quality, perceived individuality in care and trust in nurses. A cross-sectional, exploratory and correlational study design was used. This multi-site study was conducted in cancer care clinics, in-patient wards of five tertiary care hospitals in Cyprus, Finland, Greece and Sweden. Out of 876 hospitalized patients with a confirmed histopathological diagnosis of cancer approached to participate in the study in consecutive order, 599 (response rate 68%) agreed to participate and the data from 590 were used for path analysis. Data were collected in 2012-2013 with the Individualized Care Scale-Patient (ICS-Patient), the Oncology Patients' Perceptions of Quality Nursing Care Scale (OPPQNCS), the Euro-Qol (EQ-5D-3L) and the Trust in Nurses Scale. Data were analysed statistically using descriptive and inferential statistics. Mplus version 7.11 was used to determine the best Trust model with path analysis. Although the model fit indices suggested that the hypothesized model did not perfectly to the data, a slightly modified model which includes the reciprocal path between individualized care and nursing care quality demonstrated a good fit. A model of trust in nurses was developed. Health status, individualized care, and nursing care quality were found to be associated with trust. The model highlights the complexity of caring for cancer patients. Trust in nurses is influenced by the provision of individualized care. Generating and promoting trust requires interventions, which promote nursing care quality, individuality and patients' health status. Copyright © 2016 Elsevier Ltd. All rights reserved.

Growing up and Role Modeling: A Theory in Iranian Nursing Students’ Education

PubMed Central

Nouri, Jamileh Mokhtari; Ebadi, Abbas; Alhani, Fatemeh; Rejeh, Nahid

2015-01-01

One of the key strategies in students’ learning is being affected by models. Understanding the role-modeling process in education will help to make greater use of this training strategy. The aim of this grounded theory study was to explore Iranian nursing students and instructors’ experiences about role modeling process. Data was analyzed by Glaserian’s Grounded Theory methodology through semi-structured interviews with 7 faculty members, 2 nursing students; the three focus group discussions with 20 nursing students based on purposive and theoretical sampling was done for explaining role modeling process from four nursing faculties in Tehran. Through basic coding, an effort to comprehensive growth and excellence was made with the basic social process consisting the core category and through selective coding three phases were identified as: realizing and exposure to inadequate human and professional growth, facilitating human and professional growth and evolution. The role modeling process is taking place unconscious, involuntary, dynamic and with positive progressive process in order to facilitate overall growth in nursing student. Accordingly, the design and implementation of the designed model can be used to make this unconscious to conscious, active and voluntarily processes a process to help education administrators of nursing colleges and supra organization to prevent threats to human and professional in nursing students’ education and promote nursing students’ growth. PMID:25716391

[The evolution of national health and the development of the nursing practice in Taiwan].

PubMed

Yin, Teresa J C

2014-08-01

Nursing is an applied science. While there is a wide range of nursing theories and nursing care models, resolving the health problems and meeting the health needs of clients is the common objective of all in the nursing profession. The nursing profession may be subdivided into hospital clinical nursing and community health nursing (CHN). CHN is further subdivided into public health nursing, school health nursing, and industrial health nursing. The past 60 years has been a period of significant growth and improvement in Taiwan that has enhanced the nation's socioeconomic condition, general living standards, and general public health. The nursing profession has seen profound progress as well, not only in terms of content but also in terms of nursing care models, which are increasingly framed around core public health needs and take into consideration different health perspectives. Nursing in Taiwan has gradually established its own professional function and autonomy.

The effects of the Green House nursing home model on ADL function trajectory: A retrospective longitudinal study.

PubMed

Yoon, Ju Young; Brown, Roger L; Bowers, Barbara J; Sharkey, Siobhan S; Horn, Susan D

2016-01-01

Growing attention in the past few decades has focused on improving care quality and quality of life for nursing home residents. Many traditional nursing homes have attempted to transform themselves to become more homelike emphasizing individualized care. This trend is referred to as nursing home culture change in the U.S. A promising culture change nursing home model, the Green House nursing home model, has shown positive psychological outcomes. However, little is known about whether the Green House nursing home model has positive effects on physical function compared to traditional nursing homes. To examine the longitudinal effects of the Green House nursing home model by comparing change patterns of activities of daily living function over time between Green House home residents and traditional nursing home residents. A retrospective longitudinal study. Four Green House organizations (nine Green House units and four traditional units). A total of 242 residents (93 Green House residents and 149 traditional home residents) who had stayed in the nursing home at least 6 months from admission. The outcome was activities of daily living function, and the main independent variable was the facility type in which the resident stayed: a Green House or traditional unit. Age, gender, comorbidity score, cognitive function, and depressive symptoms at baseline were controlled. All of these measures were from a minimum dataset. Growth curve modeling and growth mixture modeling were employed in this study for longitudinal analyses. The mean activities of daily living function showed deterioration over time, and the rates of deterioration between Green House and traditional home residents were not different over time. Four different activities of daily living function trajectories were identified for 18 months, but there was no statistical difference in the likelihood of being in one of the four trajectory classes between the two groups. Although Green House nursing homes are considered to represent an innovative model changing the nursing home environment into more person-centered, this study did not demonstrate significant differences in activities of daily living function changes for residents in the Green House nursing homes compared to traditional nursing homes. Given that the Green House model continues to evolve as it is being implemented and variations within and across Green House homes are identified, large-scale longitudinal studies are needed to provide further relevant information on the effects of the Green House model. Copyright © 2015 Elsevier Ltd. All rights reserved.

Productive work groups in complex hospital units. Proposed contributions of the nurse executive.

PubMed

Sheafor, M

1991-05-01

The Fiedler and Garcia cognitive resources contingency model of leadership offers a new approach for nurse executives to influence the productivity of work groups led by nurse managers. The author offers recommendations toward achieving the relatively stress-free environment for nurse managers specified by the model using Schmeiding's application of Orlando's communication theory to nursing administration. Suggestions for incorporating these insights into graduate education for nursing administration follow.

Development and evaluation of nursing user interface screens using multiple methods.

PubMed

Hyun, Sookyung; Johnson, Stephen B; Stetson, Peter D; Bakken, Suzanne

2009-12-01

Building upon the foundation of the Structured Narrative Electronic Health Record (EHR) model, we applied theory-based (combined Technology Acceptance Model and Task-Technology Fit Model) and user-centered methods to explore nurses' perceptions of functional requirements for an electronic nursing documentation system, design user interface screens reflective of the nurses' perspectives, and assess nurses' perceptions of the usability of the prototype user interface screens. The methods resulted in user interface screens that were perceived to be easy to use, potentially useful, and well-matched to nursing documentation tasks associated with Nursing Admission Assessment, Blood Administration, and Nursing Discharge Summary. The methods applied in this research may serve as a guide for others wishing to implement user-centered processes to develop or extend EHR systems. In addition, some of the insights obtained in this study may be informative to the development of safe and efficient user interface screens for nursing document templates in EHRs.

Modeling attitudinal antecedents of nurses' decisions to report impaired colleagues.

PubMed

Beckstead, Jason W

2002-08-01

Nurses whose professional functioning is impaired due to substance abuse represent a threat to the health and safety of patients, other health care staff, and themselves. The major means for identifying impaired nurses is nonimpaired coworkers. Yet, only 37% of nurses who have had experiences working with impaired colleagues reported them to supervisors. A cross-sectional correlational research design, employing structural equation modeling, was used to explicate the relationships among the latent attitudinal constructs: permissiveness, morality, treatment efficacy regarding substance abuse, and punitive attitudes toward impaired nurses. The influences of these attitudes on perceived severity of impairment in fictitious coworkers and subsequent intentions to report these coworkers to nursing supervisors were modeled in a sample of 126 nurses. Permissiveness and positive attitude toward treatment were significantly related to intentions to report nurses. Moralistic attitude was not related to intention. Moralistic attitude was, however, strongly associated with a punitive attitude toward impaired nurses.

Improving care requires leadership in nursing.

PubMed

Cook, M J

1999-05-01

The purpose of this paper is to provide a model of leadership in nursing. The model outlines factors that influence leadership styles, discusses approaches to leadership and the impact of the leadership style on nursing care. The model is based on a critical examination of the current leadership themes from nursing literature in the UK, USA and Australia, between 1992 and 1997, and the findings from semi-structured interviews with five leaders in nursing. These findings help support the proposed leadership model as a basis for further exploration and as a framework for thinking about leadership and leadership preparation.

Model construction of nursing service satisfaction in hospitalized tumor patients.

PubMed

Chen, Yongyi; Liu, Jingshi; Xiao, Shuiyuan; Liu, Xiangyu; Tang, Xinhui; Zhou, Yujuan

2014-01-01

This study aims to construct a satisfaction model on nursing service in hospitalized tumor patients. Using questionnaires, data about hospitalized tumor patients' expectation, quality perception and satisfaction of hospital nursing service were obtained. A satisfaction model of nursing service in hospitalized tumor patients was established through empirical study and by structural equation method. This model was suitable for tumor specialized hospital, with reliability and validity. Patient satisfaction was significantly affected by quality perception and patient expectation. Patient satisfaction and patient loyalty was also affected by disease pressure. Hospital brand was positively correlated with patient satisfaction and patient loyalty, negatively correlated with patient complaint. Patient satisfaction was positively correlated with patient loyalty, patient complaints, and quality perception, and negatively correlated with disease pressure and patient expectation. The satisfaction model on nursing service in hospitalized tumor patients fits well. By this model, the quality of hospital nursing care may be improved.

Model construction of nursing service satisfaction in hospitalized tumor patients

PubMed Central

Chen, Yongyi; Liu, Jingshi; Xiao, Shuiyuan; Liu, Xiangyu; Tang, Xinhui; Zhou, Yujuan

2014-01-01

This study aims to construct a satisfaction model on nursing service in hospitalized tumor patients. Using questionnaires, data about hospitalized tumor patients’ expectation, quality perception and satisfaction of hospital nursing service were obtained. A satisfaction model of nursing service in hospitalized tumor patients was established through empirical study and by structural equation method. This model was suitable for tumor specialized hospital, with reliability and validity. Patient satisfaction was significantly affected by quality perception and patient expectation. Patient satisfaction and patient loyalty was also affected by disease pressure. Hospital brand was positively correlated with patient satisfaction and patient loyalty, negatively correlated with patient complaint. Patient satisfaction was positively correlated with patient loyalty, patient complaints, and quality perception, and negatively correlated with disease pressure and patient expectation. The satisfaction model on nursing service in hospitalized tumor patients fits well. By this model, the quality of hospital nursing care may be improved. PMID:25419410

Preliminary clinical nursing leadership competency model: a qualitative study from Thailand.

PubMed

Supamanee, Treeyaphan; Krairiksh, Marisa; Singhakhumfu, Laddawan; Turale, Sue

2011-12-01

This qualitative study explored the clinical nursing leadership competency perspectives of Thai nurses working in a university hospital. To collect data, in-depth interviews were undertaken with 23 nurse administrators, and focus groups were used with 31 registered nurses. Data were analyzed using content analysis, and theory development was guided by the Iceberg model. Nurses' clinical leadership competencies emerged, comprising hidden characteristics and surface characteristics. The hidden characteristics composed three elements: motive (respect from the nursing and healthcare team and being secure in life), self-concept (representing positive attitudes and values), and traits (personal qualities necessary for leadership). The surface characteristics comprised specific knowledge of nurse leaders about clinical leadership, management and nursing informatics, and clinical skills, such as coordination, effective communication, problem solving, and clinical decision-making. The study findings help nursing to gain greater knowledge of the essence of clinical nursing leadership competencies, a matter critical for theory development in leadership. This study's results later led to the instigation of a training program for registered nurse leaders at the study site, and the formation of a preliminary clinical nursing leadership competency model. © 2011 Blackwell Publishing Asia Pty Ltd.

Faculty mentorship: support for nurse practitioner students and staff within the rural community health setting.

PubMed

Hanson, C M; Hilde, E

1989-01-01

As pointed out in the introduction, there are certain practical concepts within our base of nursing knowledge that can only be taught through experience. Many things are easier to teach by example. As we turn back the clock in nursing, we can see how Florence Nightingale, Clara Barton, and Lillian Wald were role models to their nursing peers in their era. They taught nursing by example, by role modeling their clinical expertise. Today, this model is still effective and faculty mentoring of nurse practitioner students and CHNs in a compassionate and collegial leadership results in higher quality of health care for our nation's needy clients and their families. But greater yet are the opportunities for flexible nurse practitioner faculty practice and personal interactions on many levels for nursing faculty who wish to share their expertise. Mentorship by nurse practitioner faculty for nurse practitioner students and CHNs in a rural clinical setting has revealed many positive aspects in providing quality care for rural clients and growth for nurses. Exposure to the rural community health system helps us, as nurses, to identify the many strengths it possesses for innovative rural nursing practice.

Nurse practice environment, workload, burnout, job outcomes, and quality of care in psychiatric hospitals: a structural equation model approach.

PubMed

Van Bogaert, Peter; Clarke, Sean; Willems, Riet; Mondelaers, Mieke

2013-07-01

To study the relationships between nurse practice environment, workload, burnout, job outcomes and nurse-reported quality of care in psychiatric hospital staff. Nurses' practice environments in general hospitals have been extensively investigated. Potential variations across practice settings, for instance in psychiatric hospitals, have been much less studied. A cross-sectional design with a survey. A structural equation model previously tested in acute hospitals was evaluated using survey data from a sample of 357 registered nurses, licensed practical nurses, and non-registered caregivers from two psychiatric hospitals in Belgium between December 2010-April 2011. The model included paths between practice environment dimensions and outcome variables, with burnout in a mediating position. A workload measure was also tested as a potential mediator between the practice environment and outcome variables. An improved model, slightly modified from the one validated earlier in samples of acute care nurses, was confirmed. This model explained 50% and 38% of the variance in job outcomes and nurse-reported quality of care respectively. In addition, workload was found to play a mediating role in accounting for job outcomes and significantly improved a model that ultimately explained 60% of the variance in these variables. In psychiatric hospitals as in general hospitals, nurse-physician relationship and other organizational dimensions such as nursing and hospital management were closely associated with perceptions of workload and with burnout and job satisfaction, turnover intentions, and nurse-reported quality of care. Mechanisms linking key variables and differences across settings in these relationships merit attention by managers and researchers. © 2012 Blackwell Publishing Ltd.

Nurse work engagement impacts job outcome and nurse-assessed quality of care: model testing with nurse practice environment and nurse work characteristics as predictors.

PubMed

Van Bogaert, Peter; van Heusden, Danny; Timmermans, Olaf; Franck, Erik

2014-01-01

To explore the mechanisms through which nurse practice environment dimensions, such as nurse-physician relationship, nurse management at the unit level and hospital management and organizational support, are associated with job outcomes and nurse-assessed quality of care. Mediating variables included nurse work characteristics of workload, social capital, decision latitude, as well as work engagement dimensions of vigor, dedication and absorption. Understanding how to support and guide nurse practice communities in their daily effort to answer complex care most accurate, alongside with the demand of a stable and healthy nurse workforce, is challenging. Cross-sectional survey. Based on earlier empirical findings, a structural equation model, designed with valid measurement instruments, was tested. The study population included registered acute care hospital nurses (N = 1201) in eight hospitals across Belgium. Nurse practice environment dimensions predicted nurses' ratings of job outcome variables as well as quality of care. Features of nurses' work characteristics, e.g., perceived workload, decision latitude, social capital, and the three dimension of work engagement, played mediating roles between nurse practice environment and outcomes. A revised model, using various fit measures, explained 60% of job outcomes and 47% of nurse-assessed quality of care. The findings in this study show that nurse work characteristics as workload, decision latitude, and social capital, alongside with nurse work engagement (e.g., vigor, dedication, and absorption) influence nurses' perspective of their nurse practice environment, job outcomes, and quality of care. The results underline aspects to considerate for various stakeholders, such as executives, nurse managers, physicians, and staff nurses, in setting up and organizing health care services.

Theory-based practice in a major medical centre.

PubMed

Alligood, Martha Raile

2011-11-01

This project was designed to improve care quality and nursing staff satisfaction. Nursing theory structures thought and action as demonstrated by evidence of improvement in complex health-care settings. Nursing administrators selected Modelling and Role-Modelling (MRM) for the theory-based practice goal in their strategic plan. An action research approach structured implementation of MRM in a 1-year consultation project in 2001-2002. Quality of health care improved according to national quality assessment ratings, as well as patient satisfaction and nurse satisfaction. Modelling and Role-Modelling demonstrated capacity to structure nursing thought and action in patient care in a major medical centre. Uniformity of patient care language was valued by nurses as well as by allied health providers who wished to learn the holistic MRM style of practice. The processes of MRM and action research contributed to project success. A positive health-care change project was carried out in a large medical centre with action research. Introducing MRM theory-based practice was a beneficial decision by nursing administration that improved care and nurse satisfaction. Attention to nursing practice stimulated career development among the nurses to pursue bachelors, masters, and doctoral degrees. © 2011 Blackwell Publishing Ltd.

Mixing methodology, nursing theory and research design for a practice model of district nursing advocacy.

PubMed

Reed, Frances M; Fitzgerald, Les; Rae, Melanie

2016-01-01

To highlight philosophical and theoretical considerations for planning a mixed methods research design that can inform a practice model to guide rural district nursing end of life care. Conceptual models of nursing in the community are general and lack guidance for rural district nursing care. A combination of pragmatism and nurse agency theory can provide a framework for ethical considerations in mixed methods research in the private world of rural district end of life care. Reflection on experience gathered in a two-stage qualitative research phase, involving rural district nurses who use advocacy successfully, can inform a quantitative phase for testing and complementing the data. Ongoing data analysis and integration result in generalisable inferences to achieve the research objective. Mixed methods research that creatively combines philosophical and theoretical elements to guide design in the particular ethical situation of community end of life care can be used to explore an emerging field of interest and test the findings for evidence to guide quality nursing practice. Combining philosophy and nursing theory to guide mixed methods research design increases the opportunity for sound research outcomes that can inform a nursing model of care.

Nurse-Led Competency Model for Emergency Physicians: A Qualitative Study.

PubMed

Daouk-Öyry, Lina; Mufarrij, Afif; Khalil, Maya; Sahakian, Tina; Saliba, Miriam; Jabbour, Rima; Hitti, Eveline

2017-09-01

To develop a competency model for emergency physicians from the perspective of nurses, juxtapose this model with the widely adopted Accreditation Council for Graduate Medical Education (ACGME) model, and identify competencies that might be unique to the nurses' perspective. The study relied on secondary data originally collected as part of nurses' assessment of emergency physicians' nonclinical skills in the emergency department (ED) of an academic medical center in the Middle East. Participants were 36 registered nurses who had worked in the ED for at least 2 years and had worked for at least 2 shifts per month with the physician being evaluated. Through content analysis, a nurse-led competency model was identified, including 8 core competencies encompassing 33 subcompetencies. The 8 core competencies were emotional intelligence; problem-solving and decisionmaking skills; operations management; patient focus; patient care, procedural skills, and medical knowledge; professionalism; communication skills; and team leadership and management. When the developed model was compared with the ACGME model, the 2 models diverged more than they converged. The nurses' perspective offered distinctive insight into the competencies needed for physicians in an emergency medicine environment, indicating the value of nurses' perspective and shedding light on the need for more systematic and more methodologically sound studies to examine the issue further. The differences between the models highlighted the competencies that were unique to the nurse perspective, and the similarities were indicative of the influence of different perspectives and organizational context on how competencies manifest. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Working to Full Scope: The Reorganization of Nursing Work in Two Canadian Community Hospitals

PubMed Central

MacKinnon, Karen; Butcher, Diane L.; Bruce, Anne

2018-01-01

Work relationships between registered nurses (RNs) and practical nurses (LPNs) are changing as new models of nursing care delivery are introduced to create more flexibility for employers. In Canada, a team-based, hospital nursing care delivery model, known as Care Delivery Model Redesign (CDMR), redesigned a predominantly RN-based staffing model to a functional team consisting of fewer RNs and more LPNs. The scope of practice for LPNs was expanded, and unregulated health care assistants introduced. This study began from the standpoint of RNs and LPNs to understand their experiences working on redesigned teams by focusing on discourses activated in social settings. Guided by institutional ethnography, the conceptual and textual resources nurses are drawing on to understand these changing work relationships are explicated. We show how the institutional goals embedded in CDMR not only mediate how nurses work together, but how they subordinate holistic standards of nursing toward fragmented, task-oriented, divisions of care. PMID:29410976

Changing essay writing in undergraduate nursing education through action research: a Swedish example.

PubMed

Friberg, Febe; Lyckhage, Elisabeth Dahlborg

2013-01-01

This article describes the development of literature-based models for bachelor degree essays in Swedish undergraduate nursing education. Students' experiences in a course with literature-based models for bachelor degree essays are discussed. The ever-growing body of nursing research and specialized and complex health care practices make great demands on nursing education in terms of preparing students to be both skilled practitioners and users of research. Teaching to help students understand evidence-based practice is a challenge for nursing education. Action research was used to generate knowledge of and practical solutions to problems in everyday locations. Six models were developed: concept analysis, contributing to evidence-based nursing by means of quantitative research, contributing to evidence-based nursing by means of qualitative research, discourse analysis, analysis of narratives, and literature review. Action research was found to be a relevant procedure for changing ways of working with literature-based, bachelor degree essays. The models that were developed increased students' confidence in writing essays and preparedness for the nursing role.

Working to Full Scope: The Reorganization of Nursing Work in Two Canadian Community Hospitals.

PubMed

MacKinnon, Karen; Butcher, Diane L; Bruce, Anne

2018-01-01

Work relationships between registered nurses (RNs) and practical nurses (LPNs) are changing as new models of nursing care delivery are introduced to create more flexibility for employers. In Canada, a team-based, hospital nursing care delivery model, known as Care Delivery Model Redesign (CDMR), redesigned a predominantly RN-based staffing model to a functional team consisting of fewer RNs and more LPNs. The scope of practice for LPNs was expanded, and unregulated health care assistants introduced. This study began from the standpoint of RNs and LPNs to understand their experiences working on redesigned teams by focusing on discourses activated in social settings. Guided by institutional ethnography, the conceptual and textual resources nurses are drawing on to understand these changing work relationships are explicated. We show how the institutional goals embedded in CDMR not only mediate how nurses work together, but how they subordinate holistic standards of nursing toward fragmented, task-oriented, divisions of care.

A task force model for statewide change in nursing education: building quality and safety.

PubMed

Mundt, Mary H; Clark, Margherita Procaccini; Klemczak, Jeanette Wrona

2013-01-01

The purpose of this article was to describe a statewide planning process to transform nursing education in Michigan to improve quality and safety of patient care. A task force model was used to engage diverse partners in issue identification, consensus building, and recommendations. An example of a statewide intervention in nursing education and practice that was executed was the Michigan Quality and Safety in Nursing Education Institute, which was held using an integrated approach to academic-practice partners from all state regions. This paper describes the unique advantage of leadership by the Michigan Chief Nurse Executive, the existence of a nursing strategic plan, and a funding model. An overview of the Task Force on Nursing Education is presented with a focus on the model's 10 process steps and resulting seven recommendations. The Michigan Nurse Education Council was established to implement the recommendations that included quality and safety. Copyright © 2013 Elsevier Inc. All rights reserved.

A model (CMBP) for collaboration between university college and nursing practice to promote research utilization in students' clinical placements: a pilot study.

PubMed

Elsborg Foss, Jette; Kvigne, Kari; Wilde Larsson, Bodil; Athlin, Elsy

2014-08-01

A collaborative project was initiated in Norway between a university college and a hospital in order to improve RNs' and nursing students' research utilization in clinical placements. This paper describes the model (CMBP) that was developed, its first application, and evaluation. The evaluation aimed at describing nurses' and students' experiences of the CMBP related to collaboration, facilitation, learning, and impact on nursing care. Thirty-eight students from the second and third year of nursing education, and four nurses answered questionnaires with closed and open ended questions. In addition two of the nurses wrote diaries. Data were subjected to qualitative and quantitative analysis. Almost all participants reported that collaboration between nursing college and nursing practice had been beneficial. Most students and all nurses reported about valuable learning, increased understanding of research utilization, and improved quality of nursing care. Both students and RNs recommended the CMBP to be used in all clinical placements to support academic learning and increase research utilization in clinical practice. Despite study limitations the findings indicate that the CMBP has a potential to be a useful model for teaching RNs' and students EBP. However, further refinement of the model is needed, followed by a more comprehensive implementation and evaluation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Nursing research: can a feminist perspective make any contribution?

PubMed

Ehlers, V

1999-03-01

As more than 90% of the RSA's nurses are women and as at least 50% of the health care clients are also women, nursing research can definitely benefit by incorporating feminist research approaches. Specific feminist research issues which could be relevant to nursing research include: inherent themes in feminist research feminist research methodology gender stereotypes and nursing research gender-based stereotypes of researchers potential benefits of incorporating feminist research approaches in nursing research. Most formal models of nursing, and thus also most nursing research based on these models, ignore gender issues. Thus they ignore part of the social reality of nursing and might provide distorted images of nursing. A feminist approach to nursing research could enhance the reality-based gender issues relevant to nursing specifically, and health care generally, and contribute towards rendering effective health care within a multidisciplinary health care context.

Nurse managers' role in older nurses' intention to stay.

PubMed

Armstrong-Stassen, Marjorie; Freeman, Michelle; Cameron, Sheila; Rajacic, Dale

2015-01-01

The purpose of this paper is to propose and test a model of the underlying mechanisms linking perceived availability of human resource (HR) practices relevant to older nurses and older nurses' intentions to stay with their hospitals. Quantitative data were collected from randomly selected older registered nurses (N=660) engaged in direct patient care in hospitals in Canada. Structural equation modelling was used to test the hypothesized model. The relationship between perceptions of HR practices (performance evaluation, recognition/respect) and intentions to stay was mediated by the perceived fairness with which nurse managers managed these HR practices and nurse manager satisfaction. When nurse managers were perceived to administer the HR practices fairly (high perceived procedural justice), older nurses were more satisfied with their nurse manager and, in turn, more likely to intend to stay. The cross-sectional research design does not allow determination of causality. It is important that nurse managers receive training to increase their awareness of the needs of older nurses and that nurse managers be educated on how to manage HR practices relevant to older nurses in a fair manner. Equally important is that hospital administrators and HR managers recognize the importance of providing such HR practices and supporting nurse managers in managing these practices. The findings increase the understanding of how HR practices tailored to older nurses are related to the intentions of these nurses to remain with their hospital, and especially the crucial role that first-line nurse managers play in this process.

Reconsidering the conceptualization of nursing workload: literature review.

PubMed

Morris, Roisin; MacNeela, Padraig; Scott, Anne; Treacy, Pearl; Hyde, Abbey

2007-03-01

This paper reports a literature review that aimed to analyse the way in which nursing intensity and patient dependency have been considered to be conceptually similar to nursing workload, and to propose a model to show how these concepts actually differ in both theoretical and practical terms. The literature on nursing workload considers the concepts of patient 'dependency' and nursing 'intensity' in the realm of nursing workload. These concepts differ by definition but are used to measure the same phenomenon, i.e. nursing workload. The literature search was undertaken in 2004 using electronic databases, reference lists and other available literature. Papers were sourced from the Medline, Psychlit, CINAHL and Cochrane databases and through the general search engine Google. The keywords focussed on nursing workload, nursing intensity and patient dependency. Nursing work and workload concepts and labels are defined and measured in different and often contradictory ways. It is vitally important to understand these differences when using such conceptualizations to measure nursing workload. A preliminary model is put forward to clarify the relationships between nursing workload concepts. In presenting a preliminary model of nursing workload, it is hoped that nursing workload might be better understood so that it becomes more visible and recognizable. Increasing the visibility of nursing workload should have a positive impact on nursing workload management and on the provision of patient care.

Nursing home case mix in Wisconsin. Findings and policy implications.

PubMed

Arling, G; Zimmerman, D; Updike, L

1989-02-01

Along with many other states, Wisconsin is considering a case mix approach to Medicaid nursing home reimbursement. To support this effort, a nursing home case mix model was developed from a representative sample of 410 Medicaid nursing home residents from 56 facilities in Wisconsin. The model classified residents into mutually exclusive groups that were homogeneous in their use of direct care resources, i.e., minutes of direct care time (weighted for nurse skill level) over a 7-day period. Groups were defined initially by intense, Special, or Routine nursing requirements. Within these nursing requirement categories, subgroups were formed by the presence/absence of behavioral problems and dependency in activities of daily living (ADL). Wisconsin's current Skilled/Intermediate Care (SNF/ICF) classification system was analyzed in light of the case mix model and found to be less effective in distinguishing residents by resource use. The case mix model accounted for 48% of the variance in resource use, whereas the SNF/ICF classification system explained 22%. Comparisons were drawn with nursing home case mix models in New York State (RUG-II) and Minnesota. Despite progress in the study of nursing home case mix and its application to reimbursement reform, methodologic and policy issues remain. These include the differing operational definitions for nursing requirements and ADL dependency, the inconsistency in findings concerning psychobehavioral problems, and the problem of promoting positive health and functional outcomes based on models that may be insensitive to change in resident conditions over time.

Measuring the impact of a team model of nursing practice using work sampling.

PubMed

Walker, Kim; Donoghue, Judith; Mitten-Lewis, Suzanne

2007-02-01

The increasing number of inexperienced graduates, as well as other levels of nurse such as the enrolled nurse and assistant-in-nursing, requires health service and nursing managers in the acute care sector to rethink the long-preferred "patient allocation" model of care provision. As well, the escalating shortage of registered nurses and subsequent low morale among those remaining in the workforce require hospitals to re-examine skills mix and staffing ratios. This paper presents the results of two work-sampling studies conducted in a major metropolitan private hospital, the first of which was to provide a rationale for changing from the patient allocation model to a team model of care. The second study aimed to evaluate and provide data on the impact of the change. Staff were heavily involved in both studies as well as the change process. The findings highlight how effective the new model has been in redistributing certain aspects of care to make better use of each nurse level's knowledge and skills.

Effectiveness of team nursing compared with total patient care on staff wellbeing when organizing nursing work in acute care wards: a systematic review.

PubMed

King, Allana; Long, Lesley; Lisy, Karolina

2015-11-01

The organization of the work of nurses, according to recognized models of care, can have a significant impact on the wellbeing and performance of nurses and nursing teams. This review focuses on two models of nursing care delivery, namely, team and total patient care, and their effect on nurses' wellbeing. To examine the effectiveness of team nursing compared to total patient care on staff wellbeing when organizing nursing work in acute care wards. Participants were nurses working on wards in acute care hospitals.The intervention was the use of a team nursing model when organizing nursing work. The comparator was the use of a total patient care model.This review considered quantitative study designs for inclusion in the review.The outcome of interest was staff wellbeing which was measured by staff outcomes in relation to job satisfaction, turnover, absenteeism, stress levels and burnout. The search strategy aimed to find both published and unpublished studies from 1995 to April 21, 2014. Quantitative papers selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute. Data was extracted from papers included in the review using the standardized data extraction tool from the Joanna Briggs Institute. The data extracted included specific details about the interventions, populations, study methods and outcomes of significance to the review question and its specific objectives. Due to the heterogeneity of the included quantitative studies, meta-analysis was not possible. Results have been presented in a narrative form. The database search returned 10,067 records. Forty-three full text titles were assessed, and of these 40 were excluded, resulting in three studies being included in the review. Two of the studies were quasi experimental designs and the other was considered an uncontrolled before and after experimental study. There were no statistically significant differences observed in any study in the overall job satisfaction of nurses using a team nursing model compared with a total patient care model. Some differences in job satisfaction were however observed within different subgroups of nurses. There were no statistically significant differences in either stress or job tension. Within the selected studies, the specific outcomes of absenteeism and burnout were not addressed. Due to the limited number of quantitative studies identified for inclusion in this systematic review it is not possible to determine whether organizing nursing work in a team nursing or total patient care model is more effective in terms of staff wellbeing in acute care settings. Neither a team nursing or total patient care model had a significant influence on nurses' overall job satisfaction, stress levels or staff turnover. This review could not ascertain if the type of model of care affects absenteeism or burnout as these were not addressed in any of the identified studies.Caution should be taken when evaluating which model of care is appropriate and the decision needs to incorporate staff experience levels and staff skill mix. There needs to be clear definition of nursing roles.This review demonstrates the need for further quantitative studies of these models of care that are well designed with sufficient sample sizes to allow for attrition of participants, and that explore the impact each model has on nurse's wellbeing, in particular, studies that address burnout and absenteeism. There is a need for consistent terminology to allow for future comparison and research to occur at an international level. Future studies on models of care should include economic analysis to fully inform policy and practice.

Validation of oppressed group behaviors in nursing.

PubMed

Matheson, Linda Kay; Bobay, Kathleen

2007-01-01

The possibility that nurses exhibit oppressed group behaviors was first broached by Roberts [Roberts, S. J. (1983). Oppressed group behavior: Implications for nursing. Advances in Nursing Science, 21-30] when Freire's model [Freire, P. (1970). Pedagogy of the oppressed. New York: Herder and Herder] was applied to nursing. Since then, scholarly discussion has focused on aspects of oppression in nursing, but little research toward validation of Freire's model has occurred. An extensive literature search in CINAHL was completed seeking exploration and validation of the oppressed group behavior model and its dimensions. The Educational Testing Services, PsychInfo, Health and Psychosocial Instruments, and Sociological Abstracts databases were searched for measurement tools created within the last 10 years. This literature review identified that a model of oppressed group behavior has not been developed and validated, and that oppressed group behaviors have been studied independent of each other; however, oppressed group behaviors may have implications for the current nursing shortage.

Effects of using the developing nurses' thinking model on nursing students' diagnostic accuracy.

PubMed

Tesoro, Mary Gay

2012-08-01

This quasi-experimental study tested the effectiveness of an educational model, Developing Nurses' Thinking (DNT), on nursing students' clinical reasoning to achieve patient safety. Teaching nursing students to develop effective thinking habits that promote positive patient outcomes and patient safety is a challenging endeavor. Positive patient outcomes and safety are achieved when nurses accurately interpret data and subsequently implement appropriate plans of care. This study's pretest-posttest design determined whether use of the DNT model during 2 weeks of clinical postconferences improved nursing students' (N = 83) diagnostic accuracy. The DNT model helps students to integrate four constructs-patient safety, domain knowledge, critical thinking processes, and repeated practice-to guide their thinking when interpreting patient data and developing effective plans of care. The posttest scores of students from the intervention group showed statistically significant improvement in accuracy. Copyright 2012, SLACK Incorporated.

Innovative Approach to Senior Practicum Students.

PubMed

Golightly, Melissa; Kennett, Natalie; Stout, Jacqueline A

2017-12-01

Traditional senior practicum experiences (SPEs) are microsystem based-they allow senior nursing students the opportunity to build professional nursing competencies as they transition into practice. As health care transformation continues unabated, there is a need to work toward closing the gap between nursing academia and nursing practice. A cardiovascular service line created an innovative SPE to better prepare senior nursing students for working as professional nurses in a service line model. The Senior Practicum Immersion Experience (SPIE) proved to be beneficial to senior practicum students and offered firsthand experience of the role professional nurses play in a service line model. This model increased the number of senior practicum students accepted into the cardiac service line by 50%. The SPIE creates an innovative solution to increasing the number of senior practicum students while allowing students the ability to learn and practice in a service line model. [J Nurs Educ. 2017;56(12):745-747.]. Copyright 2017, SLACK Incorporated.

[Application analysis of Nursing Care Systematization according to Horta's Conceptual Model].

PubMed

da Cunha, Sandra Maria Botelho; Barros, Alba Lúcia Botura Leite

2005-01-01

This study has as purpose to analyse the implementation of the Nursing Care Systematization in a private hospital in medical surgical units. Results evidenced that the Horta's Conceptual Model was present only in part of nursing hystory instrument, that the remaining phases of nursing process were not inter-related and that there was a lack of coherence of the prescribed actions in relation to the patient's health condition. From the results of the study it can be concluded that the model used for Nursing Care Systematization is eclectic, not obeying therefore, only to Horta's conceptual model; the totality of the data had not been collected in some phases of the nursing process; there is no correlation of the phases in the majority of analyzed patient records; diagnostic and planning phases do not comprise the phases of the nursing process as proposed by Horta.

R. Louise Mcmanus and Mildred Montag Create the Associate Degree Model for the Education of Nurses: The Right Leaders, the Right Time, the Right Place: 1947 to 1959

ERIC Educational Resources Information Center

McAllister, Annemarie

2012-01-01

The development of the Associate Degree model for the education of nurses (ADN) in the United States is a significant milestone for the nursing profession. The purpose of this historical study was to examine how nurse leaders developed the model in the 1950s and to explore the contextual factors that fueled the growth of the model. Emphasis was…

Role modeling excellence in clinical nursing practice.

PubMed

Perry, R N Beth

2009-01-01

Role modeling excellence in clinical nursing practice is the focus of this paper. The phenomenological research study reported involved a group of 8 nurses identified by their colleagues as exemplary. The major theme revealed in this study was that these exemplary nurses were also excellent role models in the clinical setting. This paper details approaches used by these nurses that made them excellent role models. Specifically, the themes of attending to the little things, making connections, maintaining a light-hearted attitude, modeling, and affirming others are presented. These themes are discussed within the framework of Watson [Watson, J., 1989. Human caring and suffering: a subjective model for health services. In: Watson, J., Taylor, R. (Eds.), They Shall Not Hurt: Human Suffering and Human Caring. Colorado University, Boulder, CO] "transpersonal caring" and [Bandura, A., 1997. Social Learning Theory. Prentice Hall, Englewood Cliffs, NJ] "Social Learning Theory." Particular emphasis in the discussion is on how positive role modeling by exemplary practitioners can contribute to the education of clinical nurses in the practice setting.

Structural Equation Modeling of Cultural Competence of Nurses Caring for Foreign Patients.

PubMed

Ahn, Jung-Won

2017-03-01

This study aimed to construct and test a hypothetical model including factors related to the cultural competence of nurses caring for foreign patients. The transcultural nursing immersion experience model and anxiety/uncertainty management theory were used to verify the paths between the variables. The exogenous variables were multicultural experience, ethnocentric attitude, and organizational cultural competence support. The endogenous variables were intercultural anxiety, intercultural uncertainty, coping strategy, and cultural competence. Participants were 275 nurses working in general hospitals in Seoul and Kyung-Gi Do, Korea. Each nurse in this study had experience of caring for over 10 foreign patients. Data were collected using a structured questionnaire and analyzed with SPSS statistical software with the added AMOS module. The overall fitness indices of the hypothetical model were a good fit. Multicultural experience, ethnocentric attitude, organizational cultural competence support, and intercultural uncertainty were found to have a direct and indirect effect on the cultural competence of nurses while coping strategy only had a direct effect. Intercultural anxiety did not have a significant effect on cultural competence. This model explained 59.1% of the variance in the nurses' cultural competence when caring for foreign patients. Nurses' cultural competence can be developed by offering multicultural nursing education, increasing direct/indirect multicultural experience, and sharing problem-solving experience to promote the coping ability of nurses. Organizational support can be achieved by preparing relevant personnel and resources. Subsequently, the quality of nursing care for foreign patients' will be ultimately improved. Copyright © 2017. Published by Elsevier B.V.

Development of a clinical pharmacy model within an Australian home nursing service using co-creation and participatory action research: the Visiting Pharmacist (ViP) study

PubMed Central

Lee, Cik Yin; Beanland, Christine; Goeman, Dianne P; Petrie, Neil; Petrie, Barbara; Vise, Felicity; Gray, June

2017-01-01

Objective To develop a collaborative, person-centred model of clinical pharmacy support for community nurses and their medication management clients. Design Co-creation and participatory action research, based on reflection, data collection, interaction and feedback from participants and other stakeholders. Setting A large, non-profit home nursing service in Melbourne, Australia. Participants Older people referred to the home nursing service for medication management, their carers, community nurses, general practitioners (GPs) and pharmacists, a multidisciplinary stakeholder reference group (including consumer representation) and the project team. Data collection and analysis Feedback and reflections from minutes, notes and transcripts from: project team meetings, clinical pharmacists’ reflective diaries and interviews, meetings with community nurses, reference group meetings and interviews and focus groups with 27 older people, 18 carers, 53 nurses, 15 GPs and seven community pharmacists. Results The model was based on best practice medication management standards and designed to address key medication management issues raised by stakeholders. Pharmacist roles included direct client care and indirect care. Direct care included home visits, medication reconciliation, medication review, medication regimen simplification, preparation of medication lists for clients and nurses, liaison and information sharing with prescribers and pharmacies and patient/carer education. Indirect care included providing medicines information and education for nurses and assisting with review and implementation of organisational medication policies and procedures. The model allowed nurses to refer directly to the pharmacist, enabling timely resolution of medication issues. Direct care was provided to 84 older people over a 15-month implementation period. Ongoing feedback and consultation, in line with participatory action research principles, informed the development and refinement of the model and identification of enablers and challenges. Conclusions A collaborative, person-centred clinical pharmacy model that addressed the needs of clients, carers, nurses and other stakeholders was successfully developed. The model is likely to have applicability to home nursing services nationally and internationally. PMID:29102998

Testing an explanatory model of nurses' intention to report adverse drug reactions in hospital settings.

PubMed

Angelis, Alessia De; Pancani, Luca; Steca, Patrizia; Colaceci, Sofia; Giusti, Angela; Tibaldi, Laura; Alvaro, Rosaria; Ausili, Davide; Vellone, Ercole

2017-05-01

To test an explanatory model of nurses' intention to report adverse drug reactions in hospital settings, based on the theory of planned behaviour. Under-reporting of adverse drug reactions is an important problem among nurses. A cross-sectional design was used. Data were collected with the adverse drug reporting nurses' questionnaire. Confirmatory factor analysis was performed to test the factor validity of the adverse drug reporting nurses' questionnaire, and structural equation modelling was used to test the explanatory model. The convenience sample comprised 500 Italian hospital nurses (mean age = 43.52). Confirmatory factor analysis supported the factor validity of the adverse drug reporting nurses' questionnaire. The structural equation modelling showed a good fit with the data. Nurses' intention to report adverse drug reactions was significantly predicted by attitudes, subjective norms and perceived behavioural control (R² = 0.16). The theory of planned behaviour effectively explained the mechanisms behind nurses' intention to report adverse drug reactions, showing how several factors come into play. In a scenario of organisational empowerment towards adverse drug reaction reporting, the major predictors of the intention to report are support for the decision to report adverse drug reactions from other health care practitioners, perceptions about the value of adverse drug reaction reporting and nurses' favourable self-assessment of their adverse drug reaction reporting skills. © 2017 John Wiley & Sons Ltd.

Effects of unit empowerment and perceived support for professional nursing practice on unit effectiveness and individual nurse well-being: a time-lagged study.

PubMed

Spence Laschinger, Heather K; Nosko, Amanda; Wilk, Piotr; Finegan, Joan

2014-12-01

Recruitment and retention strategies have emphasized the importance of positive work environments that support professional nursing practice for sustaining the nursing workforce. Unit leadership that creates empowering workplace conditions plays a key role in establishing supportive practice environments that increase work effectiveness, and, ultimately, improves job satisfaction. To test a multi-level model examining the effect of both contextual and individual factors on individual nurse job satisfaction. At the unit level, structural empowerment and support for professional nursing practice (organizational resources) were hypothesized to be predictors of unit level effectiveness. At the individual level, core self-evaluation, and psychological empowerment (intrapersonal resources) were modeled as predictors of nurse job satisfaction one year later. Cross-level unit effects on individual nurses' job satisfaction were also examined. This study employed a longitudinal survey design with 545 staff nurses from 49 hospital units in Ontario, Canada. Participants completed a survey at two points in time (response rate of 40%) with standardized measures of the major study variables in the hypothesized model. Multilevel structural equation modeling was used to test the model. Nurses shared perceptions of structural empowerment on their units indirectly influenced their shared perceptions of unit effectiveness (Level 2) through perceived unit support for professional nursing practice, which in turn, had a significant positive direct effect on unit effectiveness (Level 2). Unit effectiveness was also strongly related to individual nurse job satisfaction one year later. At Level 1, higher core self-evaluation had a direct and indirect effect on job satisfaction through increased psychological empowerment. The results suggest that nurses' job satisfaction is influenced by a combination of individual and contextual factors demonstrating utility in considering both sources of nurses' satisfaction with their work in creating effective nursing work environments. Copyright © 2014 Elsevier Ltd. All rights reserved.

A model for empowerment of nursing in Iran

PubMed Central

Adib Hajbaghery, Mohsen; Salsali, Mahvash

2005-01-01

Background While the Iranian nursing profession tries to reach to its full capacity for participating in the maintenance of public health, its desire to develop is strongly influenced by cultural, economic, and religious factors. The concept of empowerment is frequently used in nursing and the health services, particularly in relation to the quality of care, since the mission of nursing is to provide safe and quality nursing care thereby enabling patients to achieve their maximum level of wellness. When considering the importance of nursing services in any health system, the 54th World Health Assembly recommended that programs be designed to strengthen and promote the nursing profession. Since empowerment is crucial to the role of nurses, a qualitative study was conducted and aimed at designing a model for empowering nurses in Iran. Methods A grounded theory approach was used for analyzing the participants' experiences, their perceptions and the strategies affecting empowerment. Data collection was done through Semi-structured interviews and participant observation. Forty-four participants were interviewed and 12 sessions of observation were carried out. Results Three main categories emerged from the data collected; these are "personal empowerment", "collective empowerment", and "the culture and structure of the organization." From the participants' perspective, empowerment is a dynamic process that results from mutual interaction between personal and collective traits of nurses as well as the culture and the structure of the organization. Impediments, such as power dynamics within the health care system hinder nurses from demonstrating that they possess the essential ingredients of empowerment. Conclusion A model was designed for empowering the nursing profession in Iran. Implementing this model will not only define nursing roles, identify territories in the national healthcare system, but it will restructure nursing systems, sub-systems, and services. Currently no such model exists; therefore, restructuring of the nursing system, including its services, education and research subsystems is recommended. PMID:15769297

Antecedents and Consequences of Work Engagement Among Nurses

PubMed Central

Sohrabizadeh, Sanaz; Sayfouri, Nasrin

2014-01-01

Background: Engaged nurses have high levels of energy and are enthusiastic about their work which impacts quality of health care services. However, in the context of Iran, due to observed burnout, work engagement among nurses necessitates immediate exploration. Objectives: This investigation aimed to identify a suitable work engagement model in nursing profession in hospitals according to the hypothesized model and to determine antecedents and consequences related to work engagement among nurses. Patients and Methods: In this cross-sectional study, a questionnaire was given to 279 randomly-selected nurses working in two general teaching hospitals of Shiraz University of Medical Sciences (Shiraz, Iran) to measure antecedents and consequences of work engagement using the Saks’s (2005) model. Structural Equation Modeling was used to examine the model fitness. Results: Two paths were added using LISREL software. The resulting model showed good fitness indices (χ2 = 23.62, AGFI = 0.93, CFI = 0.97, RMSEA = 0.07) and all the coefficients of the paths were significant (t ≥ 2, t ≤ -2). A significant correlation was found between work engagement and model variables. Conclusions: Paying adequate attention to the antecedents of work engagement can enhance the quality of performance among nurses. Additionally, rewards, organizational and supervisory supports, and job characteristics should be taken into consideration to establish work engagement among nurses. Further researches are required to identify other probable antecedents and consequences of nursing work engagement, which might be related to specific cultural settings. PMID:25763212

Burnout Study of Clinical Nurses in Vietnam: Development of Job Burnout Model Based on Leiter and Maslach's Theory.

PubMed

Nguyen, Huong Thi Thu; Kitaoka, Kazuyo; Sukigara, Masune; Thai, Anh Lan

2018-03-01

This study aimed to create a Vietnamese version of both the Maslach Burnout Inventory-General Survey (MBI-GS) and Areas of Worklife Scale (AWS) to assess the burnout state of Vietnamese clinical nurses and to develop a causal model of burnout of clinical nurses. We conducted a descriptive design using a cross-sectional survey. The questionnaire was hand divided directly by nursing departments to 500 clinical nurses in three hospitals. Vietnamese MBI-GS and AWS were then examined for reliability and validity. We used the revised exhaustion +1 burnout classification to access burnout state. We performed path analysis to develop a Vietnamese causal model based on the original model by Leiter and Maslach's theory. We found that both scales were reliable and valid for assessing burnout. Among nurse participants, the percentage of severe burnout was 0.7% and burnout was 15.8%, and 17.2% of nurses were exhausted. The best predictor of burnout was "on-duty work schedule" that clinical nurses have to work for 24 hours. In the causal model, we also found similarity and difference pathways in comparison with the original model. Vietnamese MBI-GS and AWS were applicable to research on occupational stress. Nearly one-fifth of Vietnamese clinical nurses were working in burnout state. The causal model suggested a range of factors resulting in burnout, and it is necessary to consider the specific solution to prevent burnout problem. Copyright © 2018. Published by Elsevier B.V.

Specialized nursing practice for chronic disease management in the primary care setting: an evidence-based analysis.

PubMed

2013-01-01

In response to the increasing demand for better chronic disease management and improved health care efficiency in Ontario, nursing roles have expanded in the primary health care setting. To determine the effectiveness of specialized nurses who have a clinical role in patient care in optimizing chronic disease management among adults in the primary health care setting. A literature search was performed using OVID MEDLINE, OVID MEDLINE In-Process and Other Non-Indexed Citations, OVID EMBASE, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), the Wiley Cochrane Library, and the Centre for Reviews and Dissemination database. Results were limited to randomized controlled trials and systematic reviews and were divided into 2 models: Model 1 (nurse alone versus physician alone) and Model 2 (nurse and physician versus physician alone). Effectiveness was determined by comparable outcomes between groups in Model 1, or improved outcomes or efficiency in Model 2. Six studies were included. In Model 1, there were no significant differences in health resource use, disease-specific measures, quality of life, or patient satisfaction. In Model 2, there was a reduction in hospitalizations and improved management of blood pressure and lipids among patients with coronary artery disease. Among patients with diabetes, there was a reduction in hemoglobin A1c but no difference in other disease-specific measures. There was a trend toward improved process measures, including medication prescribing and clinical assessments. Results related to quality of life were inconsistent, but patient satisfaction with the nurse-physician team was improved. Overall, there were more and longer visits to the nurse, and physician workload did not change. There was heterogeneity across patient populations, and in the titles, roles, and scope of practice of the specialized nurses. Specialized nurses with an autonomous role in patient care had comparable outcomes to physicians alone (Model 1) based on moderate quality evidence, with consistent results among a subgroup analysis of patients with diabetes based on low quality evidence. Model 2 showed an overall improvement in appropriate process measures, disease-specific measures, and patient satisfaction based on low to moderate quality evidence. There was low quality evidence that nurses working under Model 2 may reduce hospitalizations for patients with coronary artery disease. The specific role of the nurse in supplementing or substituting physician care was unclear, making it difficult to determine the impact on efficiency. Nurses with additional skills, training, or scope of practice may help improve the primary care of patients with chronic diseases. This review found that specialized nurses working on their own could achieve health outcomes that were similar to those of doctors. It also found that specialized nurses who worked with doctors could reduce hospital visits and improve certain patient outcomes related to diabetes, coronary artery disease, or heart failure. Patients who had nurse-led care were more satisfied and tended to receive more tests and medications. It is unclear whether specialized nurses improve quality of life or doctor workload.

An introduction to the partial credit model for developing nursing assessments.

PubMed

Fox, C

1999-11-01

The partial credit model, which is a special case of the Rasch measurement model, was presented as a useful way to develop and refine complex nursing assessments. The advantages of the Rasch model over the classical psychometric model were presented including the lack of bias in the measurement process, the ability to highlight those items in need of refinement, the provision of information on congruence between the data and the model, and feedback on the usefulness of the response categories. The partial credit model was introduced as a way to develop complex nursing assessments such as performance-based assessments, because of the model's ability to accommodate a variety of scoring procedures. Finally, an application of the partial credit model was illustrated using the Practical Knowledge Inventory for Nurses, a paper-and-pencil instrument that measures on-the-job decision-making for nurses.

Becoming willing to role model. Reciprocity between new graduate nurses and experienced practice nurses in general practice in New Zealand: a constructivist grounded theory.

PubMed

Hoarea, Karen J; Millsc, Jane; Francis, Karen

2013-01-01

Graduate nurses in general practice became a feature of New Zealand's health care system in 2008 following an expansion of the New Entrant to Practice Programme. General practice in New Zealand comprises general practitioner business owners who employ nursing and administration staff. Practice nurses are an ageing workforce in New Zealand, it is imperative therefore to attract younger nurses into general practice. This paper reports a section of the findings from a constructivist grounded theory study which examines the use of information by practice nurses in New Zealand. Initially data were collected using the ethnographic technique of observation and field notations in one general practice. Theoretical sensitivity to the value of role models was heightened by this first phase of data collection. A total of eleven practice nurses were interviewed from six general practices. One practice nurse agreed to a second interview; five of the interviewees were new graduate nurses and the other six were experienced practice nurses. The grounded theory constructed from this research was reciprocal role modelling which comprises the following three categories, becoming willing, realising potential and becoming a better practitioner. Graduate nurses and experienced practice nurses enter into a relationship of reciprocal role modelling. Becoming willing, the first core category of this grounded theory features three sub-categories: building respectful relationships, proving yourself and discerning decision making which are reported in this paper. Findings from this study may address the reported phenomenon of 'transition shock' of newly graduated nurses in the work place.

Causal modeling of self-concept, job satisfaction, and retention of nurses.

PubMed

Cowin, Leanne S; Johnson, Maree; Craven, Rhonda G; Marsh, Herbert W

2008-10-01

The critical shortage of nurses experienced throughout the western world has prompted researchers to examine one major component of this complex problem - the impact of nurses' professional identity and job satisfaction on retention. A descriptive correlational design with a longitudinal element was used to examine a causal model of nurses' self-concept, job satisfaction, and retention plans in 2002. A random sample of 2000 registered nurses was selected from the state registering authority listing. A postal survey assessing multiple dimensions of nurses' self-concept (measured by the nurse self-concept questionnaire), job satisfaction (measured by the index of work satisfaction) was undertaken at Time 1 (n=528) and 8 months later at Time 2 (n=332) (including retention plans (measured by the Nurse Retention Index). Using confirmatory factor analysis, correlation matrices and path analysis, measurement and structural models were examined on matching pairs of data from T1 and T2 (total sample N=332). Nurses' self-concept was found to have a stronger association with nurses' retention plans (B=.45) than job satisfaction (B=.28). Aspects of pay and task were not significantly related to retention plans, however, professional status (r=.51), and to a lesser extent, organizational policies (r=.27) were significant factors. Nurses' general self-concept was strongly related (r=.57) to retention plans. Strategies or interventions requiring implementation and evaluation include: counseling to improve nurse general self-concept, education programs and competencies in health communication between health professionals, reporting of nurse-initiated programs with substantial patient benefit, nurse-friendly organizational policies, common health team learning opportunities, and autonomous practice models.

Efficacy of diabetes nurse expert team program to improve nursing confidence and expertise in caring for hospitalized patients with diabetes mellitus.

PubMed

Corl, Dawn E; McCliment, Sean; Thompson, Rachel E; Suhr, Louise D; Wisse, Brent E

2014-01-01

Nursing care for hospitalized patients with diabetes has become more complex as evidence accumulates that inpatient glycemic control improves outcomes. Previous studies have highlighted challenges for educators in providing inpatient diabetes education to nurses. In this article, the authors show that a unit-based diabetes nurse expert team model, developed and led by a diabetes clinical nurse specialist, effectively increased nurses' confidence and expertise in inpatient diabetes care. Adapting this model in other institutions may be a cost-effective way to improve inpatient diabetes care and safety as well as promote professional growth of staff nurses.

Web-Based Virtual Patients in Nursing Education: Development and Validation of Theory-Anchored Design and Activity Models

PubMed Central

2014-01-01

Background Research has shown that nursing students find it difficult to translate and apply their theoretical knowledge in a clinical context. Virtual patients (VPs) have been proposed as a learning activity that can support nursing students in their learning of scientific knowledge and help them integrate theory and practice. Although VPs are increasingly used in health care education, they still lack a systematic consistency that would allow their reuse outside of their original context. There is therefore a need to develop a model for the development and implementation of VPs in nursing education. Objective The aim of this study was to develop and evaluate a virtual patient model optimized to the learning and assessment needs in nursing education. Methods The process of modeling started by reviewing theoretical frameworks reported in the literature and used by practitioners when designing learning and assessment activities. The Outcome-Present State Test (OPT) model was chosen as the theoretical framework. The model was then, in an iterative manner, developed and optimized to the affordances of virtual patients. Content validation was performed with faculty both in terms of the relevance of the chosen theories but also its applicability in nursing education. The virtual patient nursing model was then instantiated in two VPs. The students’ perceived usefulness of the VPs was investigated using a questionnaire. The result was analyzed using descriptive statistics. Results A virtual patient Nursing Design Model (vpNDM) composed of three layers was developed. Layer 1 contains the patient story and ways of interacting with the data, Layer 2 includes aspects of the iterative process of clinical reasoning, and finally Layer 3 includes measurable outcomes. A virtual patient Nursing Activity Model (vpNAM) was also developed as a guide when creating VP-centric learning activities. The students perceived the global linear VPs as a relevant learning activity for the integration of theory and practice. Conclusions Virtual patients that are adapted to the nursing paradigm can support nursing students’ development of clinical reasoning skills. The proposed virtual patient nursing design and activity models will allow the systematic development of different types of virtual patients from a common model and thereby create opportunities for sharing pedagogical designs across technical solutions. PMID:24727709

Promoting Excellence in Nursing Education (PENE): Pross evaluation model.

PubMed

Pross, Elizabeth A

2010-08-01

The purpose of this article is to examine the Promoting Excellence in Nursing Education (PENE) Pross evaluation model. A conceptual evaluation model, such as the one described here, may be useful to nurse academicians in the ongoing evaluation of educational programs, especially those with goals of excellence. Frameworks for evaluating nursing programs are necessary because they offer a way to systematically assess the educational effectiveness of complex nursing programs. This article describes the conceptual framework and its tenets of excellence. Copyright 2009 Elsevier Ltd. All rights reserved.

The Dual Rounding Model: Forging Therapeutic Alliances 
in Oncology and Palliative Care.

PubMed

Baxley, Carey E

2016-04-01

Inpatients with solid tumors at Duke University Hospital in Durham, NC, are cared for in a dynamic integrated care model that incorporates medical oncology and palliative care. This has profound implications for patients, their loved ones, medical and surgical staff, and oncology nurses. As a nurse with less than three years of experience, my participation in a setting that uses the Dual Rounding Model has accelerated my professional and personal development. During a typical shift, I am an oncology nurse, a palliative care nurse, and a hospice nurse.
.

Exploring Environmental Factors in Nursing Workplaces That Promote Psychological Resilience: Constructing a Unified Theoretical Model.

PubMed

Cusack, Lynette; Smith, Morgan; Hegney, Desley; Rees, Clare S; Breen, Lauren J; Witt, Regina R; Rogers, Cath; Williams, Allison; Cross, Wendy; Cheung, Kin

2016-01-01

Building nurses' resilience to complex and stressful practice environments is necessary to keep skilled nurses in the workplace and ensuring safe patient care. A unified theoretical framework titled Health Services Workplace Environmental Resilience Model (HSWERM), is presented to explain the environmental factors in the workplace that promote nurses' resilience. The framework builds on a previously-published theoretical model of individual resilience, which identified the key constructs of psychological resilience as self-efficacy, coping and mindfulness, but did not examine environmental factors in the workplace that promote nurses' resilience. This unified theoretical framework was developed using a literary synthesis drawing on data from international studies and literature reviews on the nursing workforce in hospitals. The most frequent workplace environmental factors were identified, extracted and clustered in alignment with key constructs for psychological resilience. Six major organizational concepts emerged that related to a positive resilience-building workplace and formed the foundation of the theoretical model. Three concepts related to nursing staff support (professional, practice, personal) and three related to nursing staff development (professional, practice, personal) within the workplace environment. The unified theoretical model incorporates these concepts within the workplace context, linking to the nurse, and then impacting on personal resilience and workplace outcomes, and its use has the potential to increase staff retention and quality of patient care.

The Maternity Care Nurse Workforce in Rural U.S. Hospitals.

PubMed

Henning-Smith, Carrie; Almanza, Jennifer; Kozhimannil, Katy B

To describe the maternity care nurse staffing in rural U.S. hospitals and identify key challenges and opportunities in maintaining an adequate nursing workforce. Cross-sectional survey study. Maternity care units within rural hospitals in nine U.S. states. Maternity care unit managers. We calculated descriptive statistics to characterize the rural maternity care nursing workforce by hospital birth volume and nursing staff model. We used simple content analysis to analyze responses to open-ended questions and identified themes related to challenges and opportunities for maternity care nursing in rural hospitals. Of the 263 hospitals, 51% were low volume (<300 annual births) and 49% were high volume (≥300 annual births). Among low-volume hospitals, 78% used a shared nurse staff model. In contrast, 31% of high-volume hospitals used a shared nurse staff model. Respondents praised the teamwork, dedication, and skill of their maternity care nurses. They did, however, identify significant challenges related to recruiting nurses, maintaining adequate staffing during times of census variability, orienting and training nurses, and retaining experienced nurses. Rural maternity care unit managers recognize the importance of nursing and have varied staffing needs. Policy implementation and programmatic support to ameliorate challenges may help ensure that an adequate nursing staff can be maintained, even in small-volume rural hospitals. Copyright © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

Nursing unit teams matter: Impact of unit-level nurse practice environment, nurse work characteristics, and burnout on nurse reported job outcomes, and quality of care, and patient adverse events--a cross-sectional survey.

PubMed

Van Bogaert, Peter; Timmermans, Olaf; Weeks, Susan Mace; van Heusden, Danny; Wouters, Kristien; Franck, Erik

2014-08-01

To investigate the impact of nurse practice environment factors, nurse work characteristics, and burnout on nurse reported job outcomes, quality of care, and patient adverse events variables at the nursing unit level. Nurse practice environment studies show growing insights and knowledge about determining factors for nurse workforce stability, quality of care, and patient safety. Until now, international studies have primarily focused on variability at the hospital level; however, insights at the nursing unit level can reveal key factors in the nurse practice environment. A cross-sectional design with a survey. In a cross-sectional survey, a sample of 1108 nurses assigned to 96 nursing units completed a structured questionnaire composed of various validated instruments measuring nurse practice environment factors, nurse work characteristics, burnout, nurse reported job outcomes, quality of care, and patient adverse events. Associations between the variables were examined using multilevel modelling techniques. Various unit-level associations (simple models) were identified between nurse practice environment factors, nurse work characteristics, burnout dimensions, and nurse reported outcome variables. Multiple multilevel models showed various independent variables such as nursing management at the unit level, social capital, emotional exhaustion, and depersonalization as important predictors of nurse reported outcome variables such job satisfaction, turnover intentions, quality of care (at the unit, the last shift, and in the hospital within the last year), patient and family complaints, patient and family verbal abuse, patient falls, nosocomial infections, and medications errors. Results suggested a stable nurse work force, with the capability to achieve superior quality and patient safety outcomes, is associated with unit-level favourable perceptions of nurse work environment factors, workload, decision latitude, and social capital, as well low levels of burnout. Nurses, physicians, nursing leaders, and executives share responsibility to create an environment supportive of interdisciplinary team development. Copyright © 2013 Elsevier Ltd. All rights reserved.

From expert generalists to ambiguity masters: using ambiguity tolerance theory to redefine the practice of rural nurses.

PubMed

Knight, Kaye; Kenny, Amanda; Endacott, Ruth

2016-06-01

To redefine the practice of rural nurses and describe a model that conceptualises the capabilities and characteristics required in the rural environment. The way in which the practice of rural nurses has been conceptualised is problematic. Definitions of rural nursing have been identified primarily through the functional context of rural health service delivery. The expert generalist term has provided a foundation theory for rural nurses with understandings informed by the scope of practice needed to meet service delivery requirements. However, authors exploring intrinsic characteristics of rural nurses have challenged this definition, as it does not adequately address the deeper, intangible complexities of practice required in the rural context. Despite this discourse, an alternative way to articulate the distinctive nature of rural nursing practice has eluded authors in Australia and internationally. A theoretical paper based on primary research. The development of the model was informed by the findings of a study that explored the nursing practice of managing telephone presentations in rural health services in Victoria, Australia. The study involved policy review from State and Federal governments, nursing and medical professional bodies, and five rural health services; semi-structured interviews with eight Directors of Nursing, seven registered nurses and focus group interviews with eight registered nurses. An ambiguity tolerance model drawn from corporate global entrepreneurship theory was adapted to explain the findings of the study. The adapted model presents capabilities and characteristics used by nurses to successfully manage the ambiguity of providing care in the rural context. Redefining the practice of rural nurses, through an adapted theory of ambiguity tolerance, highlights nursing characteristics and capabilities required in the rural context. This perspective offers new ways of thinking about the work of rural nurses, rural nurse policy, education, recruitment, retention and clinical governance. A greater understanding of rural nurse practice will assist in achieving positive care outcomes in an environment with competing stakeholder needs, and limited resources and options for care. © 2016 John Wiley & Sons Ltd.

Beliefs Held by Associate Degree Nursing Students about Role Models.

ERIC Educational Resources Information Center

Bellinger, Kathleen; And Others

1985-01-01

Reports on a study of the professional socialization of associate degree nursing (ADN) students. Reviews previous research on the process of nursing socialization. Presents study findings based on responses from 1,877 nursing students in 20 ADN programs, focusing on students' characteristics and ideal and actual role models. (DMM)

Everyday Excellence: A Framework for Professional Nursing Practice in Long-Term Care

PubMed Central

Lyons, Stacie Salsbury; Specht, Janet Pringle; Karlman, Susan E.

2009-01-01

Registered nurses make measurable contributions to the health and wellness of persons living in nursing homes. However, most nursing homes do not employ adequate numbers of professional nurses with specialized training in the nursing care of older adults to positively impact resident outcomes. As a result, many people never receive excellent geriatric nursing while living in a long-term care facility. Nurses have introduced various professional practice models into health care institutions as tools for leading nursing practice, improving client outcomes, and achieving organizational goals. Problematically, few professional practice models have been implemented in nursing homes. This article introduces an evidence-based framework for professional nursing practice in long-term care. The Everyday Excellence framework is based upon eight guiding principles: Valuing, Envisioning, Peopling, Securing, Learning, Empowering, Leading, and Advancing Excellence. Future research will evaluate the usefulness of this framework for professional nursing practice. PMID:20077966

Promoting Bedside Nurse-Led Research Through a Dedicated Neuroscience Nursing Research Fellowship.

PubMed

Stutzman, Sonja; Olson, DaiWai; Supnet, Charlene; Harper, Caryn; Brown-Cleere, Shelley; McCulley, Becky; Goldberg, Mark

2016-12-01

We hypothesized that nurses would benefit from the fellowship model traditionally used to engage physicians in clinical research. The Neuroscience Nursing Research Center (NNRC) fellowship program was created as a model for engaging nurses at all levels of clinical practice to become active in clinical research. The NNRC was established in 2013 as a novel approach to promote bedside nurses as primary investigators in clinical research. The NNRC developed 4 pathways to nursing research success: research fellowship, student-nurse internship, didactic training, and research consultation. Fellows have enrolled more than 900 participants in 14 studies. Nurses have presented more than 20 abstracts at 12 conferences and submitted 11 manuscripts for publication. The NNRC has provided research training to more than 150 nurses. The NNRC program is successful in engaging nurses in research. It shows promise to continue to develop nursing research that is applicable to clinicians and thus improve patient care.

Predictors of home healthcare nurse retention.

PubMed

Ellenbecker, Carol Hall; Porell, Frank W; Samia, Linda; Byleckie, James J; Milburn, Michael

2008-01-01

To examine the level of job satisfaction and test a theoretical model of the direct and indirect effects of job satisfaction, and individual nurse and agency characteristics, on intent to stay and retention for home healthcare nurses. A descriptive correlation study of home healthcare nurses in six New England states. Home healthcare nurse job satisfaction self-report data was collected with the HHNJS survey questionnaire & Retention Survey Questionnaire. Based on a structural equation model, job tenure and job satisfaction were the strongest predictors of nurse retention. Understanding the variables associated with home healthcare nurse retention can help agencies retain nurses in a time of severe nurse shortages and increased patient demand. Predicted nursing shortages and increasing demand have made the retention of experienced, qualified nursing staff essential to assure access to high-quality home healthcare services in the future.

R. Louise McManus and Mildred Montag Create the Associate Degree Model for the Education of Nurses: The Right Leaders, the Right Time, the Right Place--1947 to 1959

ERIC Educational Resources Information Center

McAllister, Annemarie

2012-01-01

The development of the Associate Degree model for the education of nurses (ADN) in the United States is a significant milestone for the nursing profession. The purpose of this historical study was to examine how nurse leaders developed the model in the 1950s and to explore the contextual factors that fueled the growth of the model. Emphasis was…

The Impact of Nursing Leader's Behavioral Integrity and Intragroup Relationship Conflict on Staff Nurses' Intention to Remain.

PubMed

Kang, Seung-Wan; Lee, Soojin; Choi, Suk Bong

2017-05-01

This study tested a multilevel model examining the effect of nursing leader's behavioral integrity and intragroup relationship conflict on staff nurses' intent to remain. In the challenging situation of nursing shortage, nurse executives are required to focus on the retention of nurses. No previous studies have examined the impact of nursing leader's behavioral integrity and intragroup relationship conflict on nurses' intention to remain. A cross-sectional survey of 480 RNs in 34 nursing units of a large public hospital in South Korea was conducted to test the hypothesized multilevel model. Nursing leader's behavioral integrity was positively related to nurses' intention to remain (b = 0.34, P < .001). This relationship was enhanced when the level of intragroup relationship conflict was high (b = 0.21, P < .05). Nursing leaders assigned to units with a high level of intragroup relationship conflict should endeavor to maintain their behavioral integrity to promote nurses' intention to remain.

Top-of-License Nursing Practice: Describing Common Nursing Activities and Nurses' Experiences That Hinder Top-of-License Practice, Part 1.

PubMed

Buck, Jacalyn; Loversidge, Jacqueline; Chipps, Esther; Gallagher-Ford, Lynn; Genter, Lynne; Yen, Po-Yin

2018-05-01

The aims of this study were to describe nurses' perceptions of nursing activities and analyze for consistency with top-of-license (TOL) practice. The Advisory Board Company expert panel proposed 8 TOL core nursing responsibilities representing practice at its potential. Thus far, no empirical work has examined nursing practices relative to TOL, from staff nurses' points of view. This qualitative study used focus groups to explore perceptions of typical nursing activities. We analyzed activities for themes that described nurses' work during typical shifts. Nurses' full scope of work included TOL-consistent categories, as well as categories that did not exemplify TOL practice, such as nonnursing care. A proposed model was developed, which depicts nurses' total scope of work, inclusive of all activity categories. In addition, hindrances to TOL practice were also identified. Findings from this study can inform leadership imperatives and the development of innovative, sustainable nursing practice models that support nursing practice at TOL.

Data envelopment analysis model for the appraisal and relative performance evaluation of nurses at an intensive care unit.

PubMed

Osman, Ibrahim H; Berbary, Lynn N; Sidani, Yusuf; Al-Ayoubi, Baydaa; Emrouznejad, Ali

2011-10-01

The appraisal and relative performance evaluation of nurses are very important and beneficial for both nurses and employers in an era of clinical governance, increased accountability and high standards of health care services. They enhance and consolidate the knowledge and practical skills of nurses by identification of training and career development plans as well as improvement in health care quality services, increase in job satisfaction and use of cost-effective resources. In this paper, a data envelopment analysis (DEA) model is proposed for the appraisal and relative performance evaluation of nurses. The model is validated on thirty-two nurses working at an Intensive Care Unit (ICU) at one of the most recognized hospitals in Lebanon. The DEA was able to classify nurses into efficient and inefficient ones. The set of efficient nurses was used to establish an internal best practice benchmark to project career development plans for improving the performance of other inefficient nurses. The DEA result confirmed the ranking of some nurses and highlighted injustice in other cases that were produced by the currently practiced appraisal system. Further, the DEA model is shown to be an effective talent management and motivational tool as it can provide clear managerial plans related to promoting, training and development activities from the perspective of nurses, hence increasing their satisfaction, motivation and acceptance of appraisal results. Due to such features, the model is currently being considered for implementation at ICU. Finally, the ratio of the number DEA units to the number of input/output measures is revisited with new suggested values on its upper and lower limits depending on the type of DEA models and the desired number of efficient units from a managerial perspective.

Leadership challenges to move nurses toward collaborative individualism within a neo-corporate bureaucratic environment.

PubMed

Hurley, John; Linsley, Paul

2007-10-01

The purpose of this article was to highlight the increasing corporate style pressures being exerted upon the NHS in England and Wales and how the nursing profession needs to fundamentally change in response to this emerging environment. Through examining a range of nursing leadership responses this paper offers a way forward to meet these challenges. Given the accelerating pace of fundamental change within health service delivery the nursing profession is particularly challenged to enact not just new structures but a new, eclectic model of nursing leadership that engages nurses at the clinical interface. Without this, both individual nurses and the wider professions risks being inert within an era of profound change. The palpable incongruence between health organizations and leadership models create ineffectiveness and a paucity of self-determinism within nursing. Apparent is the wide range of leadership styles required to respond to these challenges that overtly exceed a single leadership model alone.

Person-centred communication for emotional support in district nursing: SAGE and THYME model.

PubMed

Griffiths, Jane

2017-12-02

Patients on district nursing caseloads have multiple physical morbidities, and related emotional concerns. District nurses are ideally placed to assess and meet patients' emotional needs but in increasingly stretched workplaces, it is difficult to find time. There is also evidence that district nurses sometimes believe they lack skills to address patients' concerns. Traditional communication skills training is useful for encouraging patients to open up about their concerns, but less helpful at finding workable solutions. District nurses can be afraid to open a 'can of worms' of concerns that they are unable to deal with. SAGE and THYME is a person-centred, evidence-based communication skills model that addresses district nurses' concerns about time and skills. It provides a structure for conversations about concerns, and empowers patients to work with district nurses to find solutions. Research suggests that it is a promising model for district nursing practice.

Nursing Training in the Brazilian Red Cross in the 1940s: a Foucaultian approach.

PubMed

Mecone, Márcia Cristina da Cruz; Freitas, Genival Fernandes de; Bonini, Bárbara Barrionuevo

2015-12-01

Objectives To identify and analyze the discursive statements that characterizes the training of human resources in nursing in the 1940s by the Brazilian Red Cross. Method The approach of the documentary sources was through the assumptions of the Historical Method and they were questioned by using the thought of Michel Foucault. Results Historically, a peculiar model, the military teaching model, influenced the training of human resources in nursing, especially in the 1940s. The Brazilian Red Cross was linked to the Ministry of War and its nursing education had an emphasis on moral conduct, discipline, and respect for hierarchy, culminating in the production of nurses' "docile bodies". The attributes expected of nurses constituted the triad in the professional formation identity at that time: dedication, discipline and obedience. Conclusion The military model still reverberates practices in training of nurses in the present, as in the management, care and education in nursing.

Development of a family nursing model for prevention of cancer and other noncommunicable diseases through an appreciative inquiry.

PubMed

Jongudomkarn, Darunee; Macduff, Colin

2014-01-01

Cancer and non-communicable diseases are a major issue not only for the developed but also developing countries. Public health and primary care nursing offer great potential for primary and secondary prevention of these diseases through community and family-based approaches. Within Thailand there are related established educational curricula but less is known about how graduate practitioners enact ideas in practice and how these can influence policy at local levels. The aim of this inquiry was to develop family nursing practice in primary care settings in the Isaan region or Northeastern Thailand and to distill what worked well into a nursing model to guide practice. An appreciative inquiry approach involving analysis of written reports, focus group discussions and individual interviews was used to synthesize what worked well for fourteen family nurses involved in primary care delivery and to build the related model. Three main strategies were seen to offer a basis for optimal care delivery, namely: enacting a participatory action approach mobilizing families' social capital; using family nursing process; and implementing action strategies within communities. These were distilled into a new conceptual model. The model has some features in common with related community partnership models and the World Health Organization Europe Family Health Nurse model, but highlights practical strategies for family nursing enactment. The model offers a basis not only for planning and implementing family care to help prevent cancer and other diseases but also for education of nurses and health care providers working in communities. This articulation of what works in this culture also offers possible transference to different contexts internationally, with related potential to inform health and social care policies, and international development of care models.

Implementation of a documentation model comprising nursing terminologies--theoretical and methodological issues.

PubMed

von Krogh, Gunn; Nåden, Dagfinn

2008-04-01

To describe and discuss theoretical and methodological issues of implementation of a nursing services documentation model comprising NANDA nursing diagnoses, Nursing Intervention Classification and Nursing Outcome Classification terminologies. The model is developed for electronic patient record and was implemented in a psychiatric hospital on an organizational level and on five test wards in 2001-2005. The theory of Rogers guided the process of innovation, whereas the implementation procedure of McCloskey and Bulecheck combined with adult learning principals guided the test site implementation. The test wards managed in different degrees to adopt the model. Two wards succeeded fully, including a ward with high percentage of staff with interdisciplinary background. Better planning regarding the impact of the organization's innovative aptitude, the innovation strategies and the use of differentiated methods regarding the clinician's individual premises for learning nursing terminologies might have enhanced the adoption to the model. To better understand the nature of barriers and the importance of careful planning regarding the implementation of electronic patient record elements in nursing care services, focusing on nursing terminologies. Further to indicate how a theory and specific procedure can be used to guide the process of implementation throughout the different levels of management.

How nurse-led practices perceive implementation of the patient-centered medical home.

PubMed

Frasso, Rosemary; Golinkoff, A; Klusaritz, Heather; Kellom, Katherine; Kollar-McArthur, Helen; Miller-Day, Michelle; Gabbay, Robert; Cronholm, Peter F

2017-04-01

The Affordable Care Act (ACA) promotes the Patient-Centered Medical Home (PCMH) model as a way to improve healthcare quality, the patient experience, and has identified nurse-led primary care as a mechanism meeting the increasing demand for quality primary care. The purpose of this study was to investigate the implementation of a PCMH model in nurse-led primary care practices and to identify facilitators and barriers to the implementation of this model. Data were collected through in-depth interviews with providers and staff in nurse-led practices. These data suggest two categories of processes that facilitate the integration of PCMH in the nurse-led practice setting: patient-oriented facilitators and organizational facilitators. In addition, a number of barriers were identified to implementing the PCMH model. Overall, these practices creatively engaged in the transformation process by structuring themselves as a complex adaptive system and building upon the core principles of nurse-led care. Since the core principles of nurse-led care map onto many of the same principles of the PCMH model, this study discusses the possibility that nurse-led practices may experience fewer barriers when transitioning into PCMHs. Copyright © 2017 Elsevier Inc. All rights reserved.

Thoughts About Nursing Conceptual Models and the "Medical Model".

PubMed

Fawcett, Jacqueline

2017-01-01

This essay, written to celebrate the 30th anniversary of Nursing Science Quarterly, focuses on the distinctions between the discipline of nursology and the trade of medicine. The distinctions are drawn from content found in nursing conceptual models and from literature about the elusive content of the so-called "medical model."

Chinese Nurses' Acceptance of PDA: A Cross-Sectional Survey Using a Technology Acceptance Model.

PubMed

Wang, Yanling; Xiao, Qian; Sun, Liu; Wu, Ying

2016-01-01

This study explores Chinese nurses' acceptance of PDA, using a questionnaire based on the framework of Technology Acceptance Model (TAM). 357 nurses were involved in the study. The results reveal the scores of the nurses' acceptance of PDA were means 3.18~3.36 in four dimensions. The younger of nurses, the higher nurses' title, the longer previous usage time, the more experienced using PDA, and the more acceptance of PDA. Therefore, the hospital administrators may change strategies to enhance nurses' acceptance of PDA, and promote the wide application of PDA.

New Careers in Nursing: An Effective Model for Increasing Nursing Workforce Diversity.

PubMed

Craft-Blacksheare, Melva

2018-03-01

The Robert Wood Johnson Foundation and the American Association of Colleges of Nursing developed the New Careers in Nursing (NCIN) program to address the nursing shortage, increase workforce diversity, and raise the profession's educational level. The program provided scholarships to second-degree underrepresented or economically disadvantaged (UED) students attending an accelerated nursing program to earn a Bachelor of Science in Nursing degree. A midwestern university received three academic-year cycles of NCIN funding. The program's model, resources, and functioning are described. The NCIN provided exceptional financial and program support that received high marks from participants. During the three award cycles, 20 UED scholars graduated with a Bachelor of Science in Nursing degree. Nineteen of the 20 scholars passed the NCLEX-RN on the first attempt. While the NCIN program has ended, nursing school administrators and faculty wishing to promote UED student success should consider using the program's model and resources as the basis for their own program. [J Nurs Educ. 2018;57(3):178-183.]. Copyright 2018, SLACK Incorporated.

Nursing Education Transformation: Promising Practices in Academic Progression.

PubMed

Gorski, Mary Sue; Farmer, Patricia D; Sroczynski, Maureen; Close, Liz; Wortock, Jean M

2015-09-01

Health care has changed over the past decade; yet, nursing education has not kept pace with social and scientific advances. The Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health, called for a more highly educated nursing work-force and an improved nursing education system. Since the release of that report, the Future of Nursing: Campaign for Action, supported by the Robert Wood Johnson Foundation, AARP, and the AARP Foundation, has worked with nursing education leaders to better understand existing and evolving nursing education structures. Through a consensus-building process, four overarching promising practice models, with an emphasis on seamless academic progression, emerged to advance the goals of education transformation. Key nurse educators and other stakeholders refined those models through a series of meetings, collaborative partnerships, and focused projects that were held across the United States. This article summarizes that process and provides a description of the models, challenges, common themes, recommendations, and progress to date. Copyright 2015, SLACK Incorporated.

A model for mentoring newly-appointed nurse educators in nursing education institutions in South Africa.

PubMed

Seekoe, Eunice

2014-04-24

South Africa transformed higher education through the enactment of the Higher Education Act (No. 101 of 1997). The researcher identified the need to develop a model for the mentoring of newly-appointed nurse educators in nursing education institutions in South Africa.  To develop and describe the model for mentoring newly-appointed nurse educators in nursing education institutions in South Africa.  A qualitative and theory-generating design was used (following empirical findings regarding needs analysis) in order to develop the model. The conceptualisation of the framework focused on the context, content, process and the theoretical domains that influenced the model. Ideas from different theories were borrowed from and integrated with the literature and deductive and inductive strategies were applied.  The structure of the model is multidimensional and complex in nature (macro, mesoand micro) based on the philosophy of reflective practice, competency-based practice andcritical learning theories. The assumptions are in relation to stakeholders, context, mentoring, outcome, process and dynamic. The stakeholders are the mentor and mentee within an interactive participatory relationship. The mentoring takes place within the process with a sequence of activities such as relationship building, development, engagement, reflective process and assessment. Capacity building and empowerment are outcomes of mentoring driven by motivation.  The implication for nurse managers is that the model can be used to develop mentoring programmes for newly-appointed nurse educators.

A review of clinical decision making: models and current research.

PubMed

Banning, Maggi

2008-01-01

The aim of this paper was to review the current literature clinical decision-making models and the educational application of models to clinical practice. This was achieved by exploring the function and related research of the three available models of clinical decision making: information-processing model, the intuitive-humanist model and the clinical decision-making model. Clinical decision making is a unique process that involves the interplay between knowledge of pre-existing pathological conditions, explicit patient information, nursing care and experiential learning. Historically, two models of clinical decision making are recognized from the literature; the information-processing model and the intuitive-humanist model. The usefulness and application of both models has been examined in relation the provision of nursing care and care related outcomes. More recently a third model of clinical decision making has been proposed. This new multidimensional model contains elements of the information-processing model but also examines patient specific elements that are necessary for cue and pattern recognition. Literature review. Evaluation of the literature generated from MEDLINE, CINAHL, OVID, PUBMED and EBESCO systems and the Internet from 1980 to November 2005. The characteristics of the three models of decision making were identified and the related research discussed. Three approaches to clinical decision making were identified, each having its own attributes and uses. The most recent addition to the clinical decision making is a theoretical, multidimensional model which was developed through an evaluation of current literature and the assessment of a limited number of research studies that focused on the clinical decision-making skills of inexperienced nurses in pseudoclinical settings. The components of this model and the relative merits to clinical practice are discussed. It is proposed that clinical decision making improves as the nurse gains experience of nursing patients within a specific speciality and with experience, nurses gain a sense of saliency in relation to decision making. Experienced nurses may use all three forms of clinical decision making both independently and concurrently to solve nursing-related problems. It is suggested that O'Neill's clinical decision-making model could be tested by educators and experienced nurses to assess the efficacy of this hybrid approach to decision making.

Impact of professional nursing practice environment and psychological empowerment on nurses' work engagement: test of structural equation modelling.

PubMed

Wang, Shanshan; Liu, Yanhui

2015-04-01

This study aimed to investigate the influence of professional nursing practice environment and psychological empowerment on nurses' work engagement. Previous researchers have acknowledged the positive influence that nurse work environment and psychological empowerment have on engagement. However, less is known about the mechanisms that explain the links between them. A predictive, non-experimental design was used to test the model in a random sample of 300 clinical nurses from two tertiary first class hospitals of Tianjin, China. The Utrecht Work Engagement Scale, the Practice Environment Scale of the Nursing Work Index and the Psychological Empowerment Scale were used to measure the study variables. Structural equation modelling revealed a good fit of the model to the data based on various fit indices (P = 0.371, χ(2) /df = 1.056, goodness of fit index = 0.967), which indicated that both professional practice environment and psychological empowerment could positively influence work engagement directly, and professional practice environment could also indirectly influence work engagement through the mediation of psychological empowerment. The study hypotheses were supported. Psychological empowerment was found to mediate the relationship between practice environments and work engagement. Administrators should provide a professional nursing practice environment and empower nurses psychologically to increase nurse engagement. © 2013 John Wiley & Sons Ltd.

Nurses and nurse assistants' experiences with using a design thinking approach to innovation in a nursing home.

PubMed

Eines, Trude Fløystad; Vatne, Solfrid

2018-05-01

The aim of this study was to evaluate nurses' and nurse assistants' experiences with a design thinking approach to innovation used in a nursing home in Norway. A design thinking approach to innovation that focuses on users' needs can be employed to address many of the challenges facing health care providers in a field facing a growing ageing population, complex diseases and financial shortfalls. This study is based on a thematic analysis of four focus group interviews with nurses and nurse assistants (n = 23). In the initial phase of developing the new service model, which included defining staff roles and responsibilities, participating nurses and nurse assistants felt engaged and motivated by the designers' inclusive and creative methods. However, during the new model's testing phase, they were critical of management's lack of involvement in the model`s implementation and therefore became less motivated about the project. The findings of the study highlight the importance of the designers cooperating with management and staff for the duration of the innovation process. Challenging innovation processes require strong managers who engage with designers, patients, staff and volunteers throughout all phases of an innovation process using a design thinking approach. © 2017 John Wiley & Sons Ltd.

Undergraduate student nurses' perspectives of an integrated clinical learning model in the mental health environment.

PubMed

Boardman, Gayelene; Lawrence, Karen; Polacsek, Meg

2018-06-13

Providing nursing students with appropriate clinical practice during their undergraduate programme is critical to ensuring that graduates meet the competency requirements to gain registration as a nurse. In response to the predicted nursing workforce shortage, universities have been significantly increasing the enrolment of undergraduate nurses into Bachelor of Nursing courses. This has placed a demand on the availability of clinical placements and often universities struggle to find appropriate places. In this study, a Bachelor of Nursing course incorporated an Integrated Clinical Learning Model (ICLM) for the first time during a mental health placement. The model offered students the flexibility of attending their clinical placement over a 16-week period instead of a traditional block of 4 weeks. The aim of this study was to evaluate the student perspective of this model and whether it prepared them for the nursing workforce. Focus groups were conducted with undergraduate nursing students following their mental health clinical placement at an acute and extended care inpatient unit. Data were analysed using thematic analysis. Main themes included preparedness for practice, maintaining a work-life balance, and perceiving they were part of a team. The ICLM deepened students' knowledge and had a positive impact on their overall clinical learning. © 2018 Australian College of Mental Health Nurses Inc.

Nurse-patient assignment models considering patient acuity metrics and nurses' perceived workload.

PubMed

Sir, Mustafa Y; Dundar, Bayram; Barker Steege, Linsey M; Pasupathy, Kalyan S

2015-06-01

Patient classification systems (PCSs) are commonly used in nursing units to assess how many nursing care hours are needed to care for patients. These systems then provide staffing and nurse-patient assignment recommendations for a given patient census based on these acuity scores. Our hypothesis is that such systems do not accurately capture workload and we conduct an experiment to test this hypothesis. Specifically, we conducted a survey study to capture nurses' perception of workload in an inpatient unit. Forty five nurses from oncology and surgery units completed the survey and rated the impact of patient acuity indicators on their perceived workload using a six-point Likert scale. These ratings were used to calculate a workload score for an individual nurse given a set of patient acuity indicators. The approach offers optimization models (prescriptive analytics), which use patient acuity indicators from a commercial PCS as well as a survey-based nurse workload score. The models assign patients to nurses in a balanced manner by distributing acuity scores from the PCS and survey-based perceived workload. Numerical results suggest that the proposed nurse-patient assignment models achieve a balanced assignment and lower overall survey-based perceived workload compared to the assignment based solely on acuity scores from the PCS. This results in an improvement of perceived workload that is upwards of five percent. Copyright © 2015 Elsevier Inc. All rights reserved.

A conceptual model of nurses' goal orientation, service behavior, and service performance.

PubMed

Chien, Chun-Cheng; Chou, Hsin-Kai; Hung, Shuo-Tsung

2008-01-01

Based on the conceptual framework known as the "service triangle," the authors constructed a model of nurses' goal orientation, service behavior, and service performance to investigate the antecedents and consequences of the medical service behavior provided by nurses. This cross-sectional study collected data from 127 nurses in six hospitals using a mail-in questionnaire. Analysis of the model revealed that the customer-oriented behavior of nurses had a positive influence on organizational citizenship behavior; and both of these behaviors had a significant positive influence on service performance. The results also indicate that a higher learning goal orientation among nurses was associated with the performance of both observable customer-oriented behavior and organizational-citizenship behavior.

Food insecurity: A concept analysis

PubMed Central

Schroeder, Krista; Smaldone, Arlene

2015-01-01

Aim To report an analysis of the concept of food insecurity, in order to 1) propose a theoretical model of food insecurity useful to nursing and 2) discuss its implications for nursing practice, nursing research, and health promotion. Background Forty eight million Americans are food insecure. As food insecurity is associated with multiple negative health effects, nursing intervention is warranted. Design Concept Analysis Data sources A literature search was conducted in May 2014 in Scopus and MEDLINE using the exploded term “food insecur*.” No year limit was placed. Government websites and popular media were searched to ensure a full understanding of the concept. Review Methods Iterative analysis, using the Walker and Avant method Results Food insecurity is defined by uncertain ability or inability to procure food, inability to procure enough food, being unable to live a healthy life, and feeling unsatisfied. A proposed theoretical model of food insecurity, adapted from the Socio-Ecological Model, identifies three layers of food insecurity (individual, community, society), with potential for nursing impact at each level. Conclusion Nurses must work to fight food insecurity. There exists a potential for nursing impact that is currently unrealized. Nursing impact can be guided by a new conceptual model, Food Insecurity within the Nursing Paradigm. PMID:25612146

A model for upscaling global partnerships and building nurse and midwifery capacity.

PubMed

Spies, L A; Garner, S L; Faucher, M A; Hastings-Tolsma, M; Riley, C; Millenbruch, J; Prater, L; Conroy, S F

2017-09-01

To provide a unique model for use in guiding global collaboration and policy to upscale nursing and midwifery partnerships. Nurses and midwives across nations need skills reaching beyond the bedside and unit level in today's complex, global, multifaceted healthcare milieu. Thoughtful consideration, research and concomitant development of models to guide appropriate upscaling of nurse and midwifery capacity within and between nations are needed. This article explores an integrated global approach to upscaling nurse and midwifery capacity using examples of partnerships between nursing and midwifery programmes across multiple continents. Global nurse and midwifery capacity is effectively being developed using a myriad of approaches. A new model is presented to illustrate supports, strategies and activities to achieve intermediate and long-term goals for capacity building through strong and sustainable global partnerships. Development of global skills can focus the nurse and midwife to influence policy-level decisions. Human resource planning that can impact countrywide provision of health care begins in the preservice setting for both nurses and midwives. A global experience can be a value-added component to the well-rounded education of future nurses. Education during preparation for entry into practice is a strategic way to develop a worldview. Incorporating reflective practice can build skills and shape attitudes to prepare the new nurse to be comfortable as a global healthcare provider. An expanded world view is the springboard to more robust and informed involvement and inclusion in policy-level discussions. © 2017 International Council of Nurses.

In Search of a Croatian Model of Nursing Education

PubMed Central

Šimunović, Vladimir J.; Županović, Marija; Mihanović, Frane; Zemunik, Tatijana; Bradarić, Nikola; Janković, Stipan

2010-01-01

Aim To analyze the present status and ongoing reforms of nursing education in Europe, to compare it with the situation in Croatia, and to propose a new educational model that corresponds to the needs of the Croatian health care system. Methods The literature on contemporary nursing education in Europe and North America was reviewed, together with European Commission directives and regulations, as well as pertinent World Health Organization documents. In addition, 20 recent annual reports from 2003-2009, submitted by national nursing associations to the Workgroup of European Nurse Researchers, were studied. Results After appraisal of current trends, the Working Group on Reform of Nursing Education drafted The Croatian Model for Education in Nursing and developed a three-cycle curriculum with syllabus. The proposed curriculum is radically different from traditional ones. Responding to modern demands, it focuses on outcomes (developing competencies) and is evidence-based. Conclusions A new, Croatian concept of nursing education is presented that is concordant with reforms in nursing education in other European countries. It holds promise for making nursing education an integral part of a unified European system of higher education. PMID:20960588

In search of a Croatian model of nursing education.

PubMed

Simunovic, Vladimir J; Zupanovic, Marija; Mihanovic, Frane; Zemunik, Tatijana; Bradaric, Nikola; Jankovic, Stipan

2010-10-01

To analyze the present status and ongoing reforms of nursing education in Europe, to compare it with the situation in Croatia, and to propose a new educational model that corresponds to the needs of the Croatian health care system. The literature on contemporary nursing education in Europe and North America was reviewed, together with European Commission directives and regulations, as well as pertinent World Health Organization documents. In addition, 20 recent annual reports from 2003-2009, submitted by national nursing associations to the Workgroup of European Nurse Researchers (WERN), were studied. After appraisal of current trends, the Working Group on Reform of Nursing Education drafted The Croatian Model for Education in Nursing and developed a three-cycle curriculum with syllabus. The proposed curriculum is radically different from traditional ones. Responding to modern demands, it focuses on outcomes (developing competencies) and is evidence-based. A new, Croatian concept of nursing education is presented that is concordant with reforms in nursing education in other European countries. It holds promise for making nursing education an integral part of a unified European system of higher education.

The role of empathy and emotional intelligence in nurses' communication attitudes using regression models and fuzzy-set qualitative comparative analysis models.

PubMed

Giménez-Espert, María Del Carmen; Prado-Gascó, Vicente Javier

2018-03-01

To analyse link between empathy and emotional intelligence as a predictor of nurses' attitudes towards communication while comparing the contribution of emotional aspects and attitudinal elements on potential behaviour. Nurses' attitudes towards communication, empathy and emotional intelligence are key skills for nurses involved in patient care. There are currently no studies analysing this link, and its investigation is needed because attitudes may influence communication behaviours. Correlational study. To attain this goal, self-reported instruments (attitudes towards communication of nurses, trait emotional intelligence (Trait Emotional Meta-Mood Scale) and Jefferson Scale of Nursing Empathy (Jefferson Scale Nursing Empathy) were collected from 460 nurses between September 2015-February 2016. Two different analytical methodologies were used: traditional regression models and fuzzy-set qualitative comparative analysis models. The results of the regression model suggest that cognitive dimensions of attitude are a significant and positive predictor of the behavioural dimension. The perspective-taking dimension of empathy and the emotional-clarity dimension of emotional intelligence were significant positive predictors of the dimensions of attitudes towards communication, except for the affective dimension (for which the association was negative). The results of the fuzzy-set qualitative comparative analysis models confirm that the combination of high levels of cognitive dimension of attitudes, perspective-taking and emotional clarity explained high levels of the behavioural dimension of attitude. Empathy and emotional intelligence are predictors of nurses' attitudes towards communication, and the cognitive dimension of attitude is a good predictor of the behavioural dimension of attitudes towards communication of nurses in both regression models and fuzzy-set qualitative comparative analysis. In general, the fuzzy-set qualitative comparative analysis models appear to be better predictors than the regression models are. To evaluate current practices, establish intervention strategies and evaluate their effectiveness. The evaluation of these variables and their relationships are important in creating a satisfied and sustainable workforce and improving quality of care and patient health. © 2018 John Wiley & Sons Ltd.

Doctors' and nurses' perceptions of interdisciplinary collaboration in the NICU, and the impact of a neonatal nurse practitioner model of practice.

PubMed

Copnell, Beverley; Johnston, Linda; Harrison, Denise; Wilson, Anita; Robson, Anne; Mulcahy, Caroline; Ramudu, Louisa; McDonnell, Geraldine; Best, Christine

2004-01-01

The importance of interdisciplinary collaboration has been attested to by a number of authors. Some have suggested that Nurse Practitioners (NPs) may be able to improve collaboration between doctors and nurses, but this assertion does not appear to have been researched. To investigate doctors' and nurses' perceptions of interdisciplinary collaboration in two neonatal intensive care units, and to assess the impact of a Neonatal Nurse Practitioner (NNP) practice model on these perceptions. The study was conducted as part of a larger project to develop a NNP model of practice. Survey, pre- and post-intervention. Medical and nursing staff in both units were surveyed before and after introduction of the NP model of practice. The instrument consisted of 25 statements relating to nurse-doctor interactions, with which respondents indicated their level of agreement on a five-point Likert scale. The Mann-Whitney U-test was used to compare scores for individual items and for overall collaboration between various groups of staff, and between the first and second surveys. Significant differences between the responses of nurses and doctors were found on both surveys. Areas of disagreement chiefly concerned doctors' behaviour and their attitudes towards nurses, rather than nurses' behaviour or environmental factors. Doctors consistently reported a higher degree of collaboration than did nurses. Few differences were found between first and second surveys. Results suggest that problems in nurse-physician interactions exist in both units. No impact of the NNP role, as established in this project, on interdisciplinary collaboration could be demonstrated. Further research in this area is warranted.

Incorporating nurse absenteeism into staffing with demand uncertainty.

PubMed

Maass, Kayse Lee; Liu, Boying; Daskin, Mark S; Duck, Mary; Wang, Zhehui; Mwenesi, Rama; Schapiro, Hannah

2017-03-01

Increased nurse-to-patient ratios are associated negatively with increased costs and positively with improved patient care and reduced nurse burnout rates. Thus, it is critical from a cost, patient safety, and nurse satisfaction perspective that nurses be utilized efficiently and effectively. To address this, we propose a stochastic programming formulation for nurse staffing that accounts for variability in the patient census and nurse absenteeism, day-to-day correlations among the patient census levels, and costs associated with three different classes of nursing personnel: unit, pool, and temporary nurses. The decisions to be made include: how many unit nurses to employ, how large a pool of cross-trained nurses to maintain, how to allocate the pool nurses on a daily basis, and how many temporary nurses to utilize daily. A genetic algorithm is developed to solve the resulting model. Preliminary results using data from a large university hospital suggest that the proposed model can save a four-unit pool hundreds of thousands of dollars annually as opposed to the crude heuristics the hospital currently employs.

Barriers to nurse entrepreneurship: a study of the process model of entrepreneurship.

PubMed

Elango, B; Hunter, Gary L; Winchell, Mike

2007-04-01

The potential for nurse entrepreneurship to contribute to the effectiveness of healthcare delivery is well acknowledged, yet it has not been fully realized. Using the process model of entrepreneurship, we attempted to glean information from nursing professionals through focus groups on the barriers to starting a business. Two focus groups were used and expert moderators conducted these exercises. The first focus group included two hospital administrators, a nurse entrepreneur, an ophthalmology entrepreneur, and a dean of the nursing school familiar with nurse entrepreneurship. The second focus group used 20 students in a nurse practitioner program. The study findings indicate nurse practitioners and other nursing professionals do recognize the potential of nurse entrepreneurship. However, several barriers prevent them from exploiting the identified opportunity. While the barriers are significant, we believe they can be overcome with coordinated action by individual nurses, professional associations, and public policy initiatives. Several suggestions are offered to nurses seeking to become nurse entrepreneurs.

Nurse work engagement impacts job outcome and nurse-assessed quality of care: model testing with nurse practice environment and nurse work characteristics as predictors

PubMed Central

Van Bogaert, Peter; van Heusden, Danny; Timmermans, Olaf; Franck, Erik

2014-01-01

Aim: To explore the mechanisms through which nurse practice environment dimensions, such as nurse–physician relationship, nurse management at the unit level and hospital management and organizational support, are associated with job outcomes and nurse-assessed quality of care. Mediating variables included nurse work characteristics of workload, social capital, decision latitude, as well as work engagement dimensions of vigor, dedication and absorption. Background: Understanding how to support and guide nurse practice communities in their daily effort to answer complex care most accurate, alongside with the demand of a stable and healthy nurse workforce, is challenging. Design: Cross-sectional survey. Method: Based on earlier empirical findings, a structural equation model, designed with valid measurement instruments, was tested. The study population included registered acute care hospital nurses (N = 1201) in eight hospitals across Belgium. Results: Nurse practice environment dimensions predicted nurses’ ratings of job outcome variables as well as quality of care. Features of nurses’ work characteristics, e.g., perceived workload, decision latitude, social capital, and the three dimension of work engagement, played mediating roles between nurse practice environment and outcomes. A revised model, using various fit measures, explained 60% of job outcomes and 47% of nurse-assessed quality of care. Conclusion: The findings in this study show that nurse work characteristics as workload, decision latitude, and social capital, alongside with nurse work engagement (e.g., vigor, dedication, and absorption) influence nurses’ perspective of their nurse practice environment, job outcomes, and quality of care. The results underline aspects to considerate for various stakeholders, such as executives, nurse managers, physicians, and staff nurses, in setting up and organizing health care services. PMID:25431563

Testing the social cognitive career theory in Thai nurses' interest to become nurse educators: A structural equation modeling analysis.

PubMed

Thungjaroenkul, Petsunee; G Cummings, Greta; Tate, Kaitlyn

2016-09-01

A shortage of nurse educators generates a systemic problem in nursing education. A model to develop interventions directed at enhancing graduate nursing student interest in assuming a future faculty role is needed. This study used a social cognitive career theory perspective to examine the effects of past performance in teaching and supervision, social influence, observing others teaching, perceived task demands for nurse educators, self-efficacy, and outcome expectations on Thai graduate nursing students' (n=236) interest to become a nurse educator. Results of structural equation modeling analyses revealed that social influence and past performance in teaching and supervision had significant effects on interest to become a nurse educator when mediated by self-efficacy and outcome expectations. Observing others teaching and perceived task demands for nurse educators did not significantly predict interest in faculty roles. These findings provide new knowledge about factors and their influence on the development of interest to assume faculty roles. Implications for nursing education include the design of feasible graduate curricula that enhance students' abilities in faculty role and increases valuation of teaching careers. Copyright © 2016 Elsevier Ltd. All rights reserved.

Shared Curriculum Model: A Promising Practice for Education Transformation.

PubMed

Close, Liz; Gorski, Mary Sue; Sroczynski, Maureen; Farmer, Pat; Wortock, Jean

2015-12-01

The shared curriculum model is one of four successful models of academic progression identified through a consensus-building process facilitated by The Future of Nursing: Campaign for Action, with support from the Robert Wood Johnson Foundation, AARP, and the AARP Foundation. Seamless academic progression from the associate degree in nursing (ADN) to the baccalaureate degree in nursing (BSN) is achieved either by simultaneously revising both ADN and BSN curricula or by making targeted adjustments in ADN or BSN curricula to create a unified academic progression. Systematic vetting and definitive agreement on nursing prerequisites and corequisites, general education courses, nursing major content, and general degree requirements are necessary to ensure coordinated degree progression. A standardized set of expectations for beginning professional practice and for unique baccalaureate nursing knowledge ensures vital nursing content across the ADN-to-BSN continuum. Examples of state and regional ADN-to-BSN progression programs using the shared curriculum model are highlighted. The shared curriculum model is a promising practical and sustainable approach to seamless ADN-to-BSN academic progression. Copyright 2015, SLACK Incorporated.

What predicts nurse faculty members' intent to stay in the academic organization? A structural equation model of a national survey of nursing faculty.

PubMed

Candela, Lori; Gutierrez, Antonio P; Keating, Sarah

2015-04-01

To investigate the relations among several factors regarding the academic context within a nationally representative sample of U.S. nursing faculty. Correlational design using structural equation modeling to explore the predictive nature of several factors related to the academic organization and the work life of nursing faculty. A survey was used to evaluate several aspects of the work life of U.S. nursing faculty members. Nursing faculty members in academic organizations across the U.S. serving at either CCNE- or NLNAC-accredited institutions of higher education. Standard confirmatory factor analysis was used to assess the validity of a proposed measurement model, and structural equation modeling was used to evaluate the validity of a structural/latent variable model. Several direct and indirect effects were observed among the factors under investigation. Of special importance, perceptions of nurse administration's support and perceived teaching expertise positively predicted U.S. nursing faculty members' intent to stay in the academic organization. Understanding the way that nursing faculty members' perceptions of the various factors common to the academic context interact with intent to stay in the academic organization is essential for faculty and nursing administrators. This information can assist administrators in obtaining more resources for faculty development to lobby for additional faculty in order to meet the teaching, research, and service missions of the organization; and to personalize relationships with individual faculty members to understand their needs and acknowledge their efforts. Published by Elsevier Ltd.

Perspectives on specialist nursing in Saudi Arabia: a national model for success.

PubMed

Hibbert, Denise; Al-Sanea, Nasser A; Balens, Julie A

2012-01-01

In many parts of the world, vulnerable patient populations may be cared for by a clinical nurse specialist (CNS). Nurses desiring to develop themselves professionally in the clinical arena, within the specialty of their choice, have the opportunity to obtain the knowledge, skills, experience and qualifications necessary to attain advanced practice positions such as CNS or nurse consultant (NC). Although studies have demonstrated the benefits of such roles and while the World Health Organization (WHO) recommends it, advanced nursing practice is not yet integrated into the health care culture in Saudi Arabia. The reasons for this are multiple, but the most important is the poor image of clinical nursing throughout the country. This article aims to share a perspective on CNS practice, while casting light on some of the obstacles encountered within Saudi Arabia. A model is proposed representing specialist nurse-physician collaborative practice for implementation nationally. The model has been implemented in the care of the colorectal and stoma patient populations while taking into consideration patient population needs and local health care culture. This model is based on the concepts of holistic "patient-centered care", specialist nurse-physician collaborative practice, and the four practice domains for NCs (expert practice, leadership, research and education) as indicated by the Department of Health in the United Kingdom. We suggest this model will enable the introduction of advanced specialist nursing and collaborative partnerships in Saudi Arabia with benefits for patients, physicians, health care organizations and the nursing profession as a whole.

Context and the leadership experiences and perceptions of professionals: a review of the nursing profession.

PubMed

Jefferson, Therese; Klass, Des; Lord, Linley; Nowak, Margaret; Thomas, Gail

2014-01-01

Leadership studies which focus on categorising leadership styles have been critiqued for failure to consider the lived experience of leadership. The purpose of this paper is to use the framework of Jepson's model of contextual dynamics to explore whether this framework assists understanding of the "how and why" of lived leadership experience within the nursing profession. Themes for a purposeful literature search and review, having regard to the Jepson model, are drawn from the contemporary and dynamic context of nursing. Government reports, coupled with preliminary interviews with a nurseleadership team, guided selection of contextual issues. The contextual interactions arising from managerialism, existing hierarchical models of leadership and increasing knowledge work provided insights into leadership experience in nursing, in the contexts of professional identity and changing educational and generational profiles of nurses. The authors conclude that employing a contextual frame provides insights in studying leadership experience. The author propose additions to the cultural and institutional dimensions of Jepson's model. The findings have implications for structuring and communicating key roles and policies relevant to nursing leadership. These include the need to: address perceptions around the legitimacy of current nursing leaders to provide clinical leadership; modify hierarchical models of nursing leadership; address implications of the role of the knowledge workers. Observing nursing leadership through the lens of Jepson's model of contextual dynamics confirms that this is an important way of exploring how leadership is enacted. The authors found, however, the model also provided a useful frame for considering the experience and understanding of leadership by those to be led.

Understanding Influence within the Context of Nursing: Development of the Adams Influence Model Using Practice, Research, and Theory.

PubMed

Adams, Jeffrey M; Natarajan, Sudha

2016-01-01

Acquiring influence, and knowing how to use it, is a required competency for nurse leaders, yet the concept of influence and how it works is not well described in the nursing literature. In this article, the authors examine what is known about influence and present an influence model specific to nurse leaders. The Adams Influence Model was developed through an iterative process and is based on a comprehensive review of the influence literature, expert commentary, multiple pilot studies, evaluation of nursing theories, and validation by an external data source. Rather than defining "how to" influence, the model serves as a guide for personal reflection, helping nurse leaders understand and reflect on the influence process and factors, tactics, and strategies they can use when seeking to influence others.

The Evolution of Data-Information-Knowledge-Wisdom in Nursing Informatics.

PubMed

Ronquillo, Charlene; Currie, Leanne M; Rodney, Paddy

2016-01-01

The data-information-knowledge-wisdom (DIKW) model has been widely adopted in nursing informatics. In this article, we examine the evolution of DIKW in nursing informatics while incorporating critiques from other disciplines. This includes examination of assumptions of linearity and hierarchy and an exploration of the implicit philosophical grounding of the model. Two guiding questions are considered: (1) Does DIKW serve clinical information systems, nurses, or both? and (2) What level of theory does DIKW occupy? The DIKW model has been valuable in advancing the independent field of nursing informatics. We offer that if the model is to continue to move forward, its role and functions must be explicitly addressed.

Automatic generation of nursing narratives from entity-attribute-value triplet for electronic nursing records system.

PubMed

Min, Yul Ha; Park, Hyeoun-Ae; Lee, Joo Yun; Jo, Soo Jung; Jeon, Eunjoo; Byeon, Namsoo; Choi, Seung Yong; Chung, Eunja

2014-01-01

The aim of this study is to develop and evaluate a natural language generation system to populate nursing narratives using detailed clinical models. Semantic, contextual, and syntactical knowledges were extracted. A natural language generation system linking these knowledges was developed. The quality of generated nursing narratives was evaluated by the three nurse experts using a five-point rating scale. With 82 detailed clinical models, in total 66,888 nursing narratives in four different types of statement were generated. The mean scores for overall quality was 4.66, for content 4.60, for grammaticality 4.40, for writing style 4.13, and for correctness 4.60. The system developed in this study generated nursing narratives with different levels of granularity. The generated nursing narratives can improve semantic interoperability of nursing data documented in nursing records.

The Roy Adaptation Model: A Theoretical Framework for Nurses Providing Care to Individuals With Anorexia Nervosa.

PubMed

Jennings, Karen M

Using a nursing theoretical framework to understand, elucidate, and propose nursing research is fundamental to knowledge development. This article presents the Roy Adaptation Model as a theoretical framework to better understand individuals with anorexia nervosa during acute treatment, and the role of nursing assessments and interventions in the promotion of weight restoration. Nursing assessments and interventions situated within the Roy Adaptation Model take into consideration how weight restoration does not occur in isolation but rather reflects an adaptive process within external and internal environments, and has the potential for more holistic care.

Development of an Instructional Quality Assurance Model in Nursing Science

ERIC Educational Resources Information Center

Ajpru, Haruthai; Pasiphol, Shotiga; Wongwanich, Suwimon

2011-01-01

The purpose of this study was to develop an instructional quality assurance model in nursing science. The study was divided into 3 phases; (1) to study the information for instructional quality assurance model development (2) to develop an instructional quality assurance model in nursing science and (3) to audit and the assessment of the developed…

Nursing Models: Application to practice Alan Pearson , Barbara Vaughan and Mary Fitzgerald Nursing Models: Application to Practice Quay Books £24.99 280pp [Formula: see text].

PubMed

2010-10-07

AT A time when evidence-based practice is the predominant nursing model, the authors of this book want to interest academics and practitioners in models that were in vogue in the Uk in the 1980s and 1990s.

Nursing Models - Application to Practice Cutliffe John et al Nursing Models - Application to Practice 280pp Quay Books 9781856423793 1856423794 [Formula: see text].

PubMed

2010-09-22

The authors set themselves the interesting challenge of reviving the interest of academics and practitioners in nursing models. Such models were in vogue in the UK in the 1980s and 1990s, at a time dominated by the evidence-based practice movement.

Educating Nurses for Public Health Leadership. Project Report of the Interdisciplinary Graduate Program Models To Prepare Public Health Nurses for Leadership in a Changing Health Care System.

ERIC Educational Resources Information Center

Josten, LaVohn; And Others

This report discusses the role of graduate nurses in public health leadership and the development of new models of graduate education to prepare nurses for public health leadership. It reviews the need for graduate nurses in public health leadership positions, the health needs of the population, the role of public health in a changing health care…

Modeling the outcomes of nursing home care.

PubMed

Rohrer, J E; Hogan, A J

1987-01-01

In this exploratory analysis using data on 290 patients, we use regression analysis to model patient outcomes in two Veterans Administration nursing homes. We find resource use, as measured with minutes of nursing time, to be associated with outcomes when case mix is controlled. Our results suggest that, under case-based reimbursement systems, nursing homes could increase their revenues by withholding unskilled and psychosocial care and discouraging physicians' visits. Implications for nursing home policy are discussed.

Specialized Nursing Practice for Chronic Disease Management in the Primary Care Setting

PubMed Central

2013-01-01

Background In response to the increasing demand for better chronic disease management and improved health care efficiency in Ontario, nursing roles have expanded in the primary health care setting. Objectives To determine the effectiveness of specialized nurses who have a clinical role in patient care in optimizing chronic disease management among adults in the primary health care setting. Data Sources and Review Methods A literature search was performed using OVID MEDLINE, OVID MEDLINE In-Process and Other Non-Indexed Citations, OVID EMBASE, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), the Wiley Cochrane Library, and the Centre for Reviews and Dissemination database. Results were limited to randomized controlled trials and systematic reviews and were divided into 2 models: Model 1 (nurse alone versus physician alone) and Model 2 (nurse and physician versus physician alone). Effectiveness was determined by comparable outcomes between groups in Model 1, or improved outcomes or efficiency in Model 2. Results Six studies were included. In Model 1, there were no significant differences in health resource use, disease-specific measures, quality of life, or patient satisfaction. In Model 2, there was a reduction in hospitalizations and improved management of blood pressure and lipids among patients with coronary artery disease. Among patients with diabetes, there was a reduction in hemoglobin A1c but no difference in other disease-specific measures. There was a trend toward improved process measures, including medication prescribing and clinical assessments. Results related to quality of life were inconsistent, but patient satisfaction with the nurse-physician team was improved. Overall, there were more and longer visits to the nurse, and physician workload did not change. Limitations There was heterogeneity across patient populations, and in the titles, roles, and scope of practice of the specialized nurses. Conclusions Specialized nurses with an autonomous role in patient care had comparable outcomes to physicians alone (Model 1) based on moderate quality evidence, with consistent results among a subgroup analysis of patients with diabetes based on low quality evidence. Model 2 showed an overall improvement in appropriate process measures, disease-specific measures, and patient satisfaction based on low to moderate quality evidence. There was low quality evidence that nurses working under Model 2 may reduce hospitalizations for patients with coronary artery disease. The specific role of the nurse in supplementing or substituting physician care was unclear, making it difficult to determine the impact on efficiency. Plain Language Summary Nurses with additional skills, training, or scope of practice may help improve the primary care of patients with chronic diseases. This review found that specialized nurses working on their own could achieve health outcomes that were similar to those of doctors. It also found that specialized nurses who worked with doctors could reduce hospital visits and improve certain patient outcomes related to diabetes, coronary artery disease, or heart failure. Patients who had nurse-led care were more satisfied and tended to receive more tests and medications. It is unclear whether specialized nurses improve quality of life or doctor workload. PMID:24194798

Teaching qualitative research as a means of socialization to nursing.

PubMed

Arieli, Daniella; Tamir, Batya; Man, Michal

2015-06-01

The aim of the present article is to present a model for teaching qualitative research as part of nursing education. The uniqueness of the course model is that it seeks to combine two objectives: (1) initial familiarization of the students with the clinical-nursing environment and the role of the nurse; and (2) understanding the qualitative research approach and inculcation of basic qualitative research skills. The article describes how teaching two central genres in qualitative research - ethnographic and narrative research - constitutes a way of teaching the important skills, concepts, and values of the nursing profession. The article presents the model's structure, details its principal stages, and explains the rationale of each stage. It also presents the central findings of an evaluation of the model's implementation in eight groups over a two-year period. In this way the article seeks to contribute to nursing education literature in general, and to those engaged in clinical training and teaching qualitative research in nursing education in particular. Copyright © 2015 Elsevier Ltd. All rights reserved.

Exploring Environmental Factors in Nursing Workplaces That Promote Psychological Resilience: Constructing a Unified Theoretical Model

PubMed Central

Cusack, Lynette; Smith, Morgan; Hegney, Desley; Rees, Clare S.; Breen, Lauren J.; Witt, Regina R.; Rogers, Cath; Williams, Allison; Cross, Wendy; Cheung, Kin

2016-01-01

Building nurses' resilience to complex and stressful practice environments is necessary to keep skilled nurses in the workplace and ensuring safe patient care. A unified theoretical framework titled Health Services Workplace Environmental Resilience Model (HSWERM), is presented to explain the environmental factors in the workplace that promote nurses' resilience. The framework builds on a previously-published theoretical model of individual resilience, which identified the key constructs of psychological resilience as self-efficacy, coping and mindfulness, but did not examine environmental factors in the workplace that promote nurses' resilience. This unified theoretical framework was developed using a literary synthesis drawing on data from international studies and literature reviews on the nursing workforce in hospitals. The most frequent workplace environmental factors were identified, extracted and clustered in alignment with key constructs for psychological resilience. Six major organizational concepts emerged that related to a positive resilience-building workplace and formed the foundation of the theoretical model. Three concepts related to nursing staff support (professional, practice, personal) and three related to nursing staff development (professional, practice, personal) within the workplace environment. The unified theoretical model incorporates these concepts within the workplace context, linking to the nurse, and then impacting on personal resilience and workplace outcomes, and its use has the potential to increase staff retention and quality of patient care. PMID:27242567

Comparison of Nurse Staffing Measurements in Staffing-Outcomes Research.

PubMed

Park, Shin Hye; Blegen, Mary A; Spetz, Joanne; Chapman, Susan A; De Groot, Holly A

2015-01-01

Investigators have used a variety of operational definitions of nursing hours of care in measuring nurse staffing for health services research. However, little is known about which approach is best for nurse staffing measurement. To examine whether various nursing hours measures yield different model estimations when predicting patient outcomes and to determine the best method to measure nurse staffing based on the model estimations. We analyzed data from the University HealthSystem Consortium for 2005. The sample comprised 208 hospital-quarter observations from 54 hospitals, representing information on 971 adult-care units and about 1 million inpatient discharges. We compared regression models using different combinations of staffing measures based on productive/nonproductive and direct-care/indirect-care hours. Akaike Information Criterion and Bayesian Information Criterion were used in the assessment of staffing measure performance. The models that included the staffing measure calculated from productive hours by direct-care providers were best, in general. However, the Akaike Information Criterion and Bayesian Information Criterion differences between models were small, indicating that distinguishing nonproductive and indirect-care hours from productive direct-care hours does not substantially affect the approximation of the relationship between nurse staffing and patient outcomes. This study is the first to explicitly evaluate various measures of nurse staffing. Productive hours by direct-care providers are the strongest measure related to patient outcomes and thus should be preferred in research on nurse staffing and patient outcomes.

Correlates and predictors of missed nursing care in hospitals.

PubMed

Bragadóttir, Helga; Kalisch, Beatrice J; Tryggvadóttir, Gudný Bergthora

2017-06-01

To identify the contribution of hospital, unit, staff characteristics, staffing adequacy and teamwork to missed nursing care in Iceland hospitals. A recently identified quality indicator for nursing care and patient safety is missed nursing care defined as any standard, required nursing care omitted or significantly delayed, indicating an error of omission. Former studies point to contributing factors to missed nursing care regarding hospital, unit and staff characteristics, perceptions of staffing adequacy as well as nursing teamwork, displayed in the Missed Nursing Care Model. This was a quantitative cross-sectional survey study. The samples were all registered nurses and practical nurses (n = 864) working on 27 medical, surgical and intensive care inpatient units in eight hospitals throughout Iceland. Response rate was 69·3%. Data were collected in March-April 2012 using the combined MISSCARE Survey-Icelandic and the Nursing Teamwork Survey-Icelandic. Descriptive, correlational and regression statistics were used for data analysis. Missed nursing care was significantly related to hospital and unit type, participants' age and role and their perception of adequate staffing and level of teamwork. The multiple regression testing of Model 1 indicated unit type, role, age and staffing adequacy to predict 16% of the variance in missed nursing care. Controlling for unit type, role, age and perceptions of staffing adequacy, the multiple regression testing of Model 2 showed that nursing teamwork predicted an additional 14% of the variance in missed nursing care. The results shed light on the correlates and predictors of missed nursing care in hospitals. This study gives direction as to the development of strategies for decreasing missed nursing care, including ensuring appropriate staffing levels and enhanced teamwork. By identifying contributing factors to missed nursing care, appropriate interventions can be developed and tested. © 2016 John Wiley & Sons Ltd.

A salaried compensation model for postanesthesia nurses.

PubMed

Mushala, M E; Henderson, M A

1995-08-01

Health care organizations involved in innovative and creative work redesign projects may find traditional pay structures inadequate to meet the needs of the changing environment. The idea of salaried compensation for registered nurses is not unprecedented. However, few salaried compensation models for nurses are described in the literature. This article presents a model that we believe will be of particular interest to nurses in PACUs, because its design allows for adequate call coverage plus flexibility in scheduling. In addition, this compensation model eliminates incidental overtime, thus allowing for a more predictable salary budget.

Ward leadership styles.

PubMed

Bowman, G

1989-01-01

The purpose of this study was to devise a leadership style scale based in the authoritarian/democratic concept of leadership and to test it with a group of nurses. The working hypothesis was that nurses, working by primary nursing methods, would have a more democratic attitude to leadership than those nurses working in a traditional task allocation system. Recent papers such as that of Henry & Tuxill (1) plead for the caring professions to take on board the concept of the 'person'. Not only is the traditional model of nursing care seen as bad for the patient; it is seen also as harmful to the nurses. Fretwell (2) describes the task system as essentially an industrial model rather than a professional one which tends to satisfy the needs of the doctor rather than the patient or nurse. Kinston (3) describes nursing decision-making and work as Level I work (tradesmen). Current models of care that individualize the nurse's response to work and decision-making become Level II type (professional). Primary nursing fulfils the need for professionalizing nursing and meeting the need for more independence as well as respecting the patient as a 'person' with the organisation there to facilitate interaction between qualified nurse and patient. Changes in attitude and relationships are essential if work is to change from task to person-centred. Styles of leadership in nurses need to alter as our orientation to care issues change (4).(ABSTRACT TRUNCATED AT 250 WORDS)

Testing the Electronic Personal Health Record Acceptance Model by Nurses for Managing Their Own Health: A Cross-sectional Survey.

PubMed

Gartrell, K; Trinkoff, A M; Storr, C L; Wilson, M L; Gurses, A P

2015-01-01

To our knowledge, no evidence is available on health care professionals' use of electronic personal health records (ePHRs) for their health management. We therefore focused on nurses' personal use of ePHRs using a modified technology acceptance model. To examine (1) the psychometric properties of the ePHR acceptance model, (2) the associations of perceived usefulness, ease of use, data privacy and security protection, and perception of self as health-promoting role models to nurses' own ePHR use, and (3) the moderating influences of age, chronic illness and medication use, and providers' use of electronic health record (EHRs) on the associations between the ePHR acceptance constructs and ePHR use. A convenience sample of registered nurses, those working in one of 12 hospitals in the Maryland and Washington, DC areas and members of the nursing informatics community (AMIA and HIMSS), were invited to respond to an anonymous online survey; 847 responded. Multiple logistic regression identified associations between the model constructs and ePHR use, and the moderating effect. Overall, ePHRs were used by 47%. Sufficient reliability for all scales was found. Three constructs were significantly related to nurses' own ePHR use after adjusting for covariates: usefulness, data privacy and security protection, and health-promoting role model. Nurses with providers that used EHRs who perceived a higher level of data privacy and security protection had greater odds of ePHR use than those whose providers did not use EHRs. Older nurses with a higher self-perception as health-promoting role models had greater odds of ePHR use than younger nurses. Nurses who use ePHRs for their personal health might promote adoption by the general public by serving as health-promoting role models. They can contribute to improvements in patient education and ePHR design, and serve as crucial resources when working with their individual patients.

Nurses and opioids: results of a bi-national survey on mental models regarding opioid administration in hospitals.

PubMed

Guest, Charlotte; Sobotka, Fabian; Karavasopoulou, Athina; Ward, Stephen; Bantel, Carsten

2017-01-01

Pain remains insufficiently treated in hospitals. Increasing evidence suggests human factors contribute to this, due to nurses failing to administer opioids. This behavior might be the consequence of nurses' mental models about opioids. As personal experience and conceptions shape these models, the aim of this prospective survey was to identify model-influencing factors. A questionnaire was developed comprising of 14 statements concerning ideations about opioids and seven questions concerning demographics, indicators of adult learning, and strength of religious beliefs. Latent variables that may underlie nurses' mental models were identified using undirected graphical dependence models. Representative items of latent variables were employed for ordinal regression analysis. Questionnaires were distributed to 1,379 nurses in two London, UK, hospitals (n=580) and one German (n=799) hospital between September 2014 and February 2015. A total of 511 (37.1%) questionnaires were returned. Mean (standard deviation) age of participants were 37 (11) years; 83.5% participants were female; 45.2% worked in critical care; and 51.5% had more than 10 years experience. Of the nurses, 84% were not scared of opioids, 87% did not regard opioids as drugs to help patients die, and 72% did not view them as drugs of abuse. More English (41%) than German (28%) nurses were afraid of criminal investigations and were constantly aware of side effects (UK, 94%; Germany, 38%) when using opioids. Four latent variables were identified which likely influence nurses' mental models: "conscious decision-making"; "medication-related fears"; "practice-based observations"; and "risk assessment". They were predicted by strength of religious beliefs and indicators of informal learning such as experience but not by indicators of formal learning such as conference attendance. Nurses in both countries employ analytical and affective mental models when administering the opioids and seem to learn from experience rather than from formal teaching. Additionally, some attitudes and emotions towards opioids are likely the result of nurses' cultural background.

Nursing 2000: Collaboration to Promote Careers in Registered Nursing.

ERIC Educational Resources Information Center

Wilson, Connie S.; Mitchell, Barbara S.

1999-01-01

The effectiveness of the collaborative Nursing 2000 model in promoting nursing careers was evaluated through a survey of 1,598 nursing students (637 responses). Most effective techniques were the "shadow a nurse" program, publications, classroom and community presentations, and career-counseling telephone calls. (SK)

Development of user-centered interfaces to search the knowledge resources of the Virginia Henderson International Nursing Library.

PubMed

Jones, Josette; Harris, Marcelline; Bagley-Thompson, Cheryl; Root, Jane

2003-01-01

This poster describes the development of user-centered interfaces in order to extend the functionality of the Virginia Henderson International Nursing Library (VHINL) from library to web based portal to nursing knowledge resources. The existing knowledge structure and computational models are revised and made complementary. Nurses' search behavior is captured and analyzed, and the resulting search models are mapped to the revised knowledge structure and computational model.

Measuring Nursing Value from the Electronic Health Record.

PubMed

Welton, John M; Harper, Ellen M

2016-01-01

We report the findings of a big data nursing value expert group made up of 14 members of the nursing informatics, leadership, academic and research communities within the United States tasked with 1. Defining nursing value, 2. Developing a common data model and metrics for nursing care value, and 3. Developing nursing business intelligence tools using the nursing value data set. This work is a component of the Big Data and Nursing Knowledge Development conference series sponsored by the University Of Minnesota School Of Nursing. The panel met by conference calls for fourteen 1.5 hour sessions for a total of 21 total hours of interaction from August 2014 through May 2015. Primary deliverables from the bit data expert group were: development and publication of definitions and metrics for nursing value; construction of a common data model to extract key data from electronic health records; and measures of nursing costs and finance to provide a basis for developing nursing business intelligence and analysis systems.

A model of adaptation of overseas nurses: exploring the experiences of Japanese nurses working in Australia.

PubMed

Kishi, Yuka; Inoue, Kumiyo; Crookes, Patrick; Shorten, Allison

2014-04-01

The purpose of the study was to investigate the experiences of Japanese nurses and their adaptation to their work environment in Australia. Using a qualitative research method and semistructured interviews, the study aimed to discover, describe, and analyze the experiences of 14 Japanese nurses participating in the study. A qualitative study. Fourteen Japanese registered nurses working in Australian hospitals participated in the study. Individual semistructured interviews were conducted from April to June in 2008. Thematic analysis was used to identify themes within the data. Analysis of qualitative open-ended questions revealed the participants' adaptation process. It consists of three themes or phases: seeking (S), acclimatizing (A), and settling (S), subsequently named the S.A.S. model. The conceptual model of the adaptation processes of 14 Japanese nurses working in Australia includes the seeking, acclimatizing, and settling phases. Although these phases are not mutually exclusive and the process is not necessarily uniformly linear, all participants in this study passed through this S.A.S. model in order to adapt to their new environment. The S.A.S. model of adaptation helps to describe the experiences of Japanese overseas qualified nurses working in Australian hospitals. Future research is needed to examine whether this model can be applied to nurses from other countries and in other settings outside Australia.

Development of a clinical pharmacy model within an Australian home nursing service using co-creation and participatory action research: the Visiting Pharmacist (ViP) study.

PubMed

Elliott, Rohan A; Lee, Cik Yin; Beanland, Christine; Goeman, Dianne P; Petrie, Neil; Petrie, Barbara; Vise, Felicity; Gray, June

2017-11-03

To develop a collaborative, person-centred model of clinical pharmacy support for community nurses and their medication management clients. Co-creation and participatory action research, based on reflection, data collection, interaction and feedback from participants and other stakeholders. A large, non-profit home nursing service in Melbourne, Australia. Older people referred to the home nursing service for medication management, their carers, community nurses, general practitioners (GPs) and pharmacists, a multidisciplinary stakeholder reference group (including consumer representation) and the project team. Feedback and reflections from minutes, notes and transcripts from: project team meetings, clinical pharmacists' reflective diaries and interviews, meetings with community nurses, reference group meetings and interviews and focus groups with 27 older people, 18 carers, 53 nurses, 15 GPs and seven community pharmacists. The model was based on best practice medication management standards and designed to address key medication management issues raised by stakeholders. Pharmacist roles included direct client care and indirect care. Direct care included home visits, medication reconciliation, medication review, medication regimen simplification, preparation of medication lists for clients and nurses, liaison and information sharing with prescribers and pharmacies and patient/carer education. Indirect care included providing medicines information and education for nurses and assisting with review and implementation of organisational medication policies and procedures. The model allowed nurses to refer directly to the pharmacist, enabling timely resolution of medication issues. Direct care was provided to 84 older people over a 15-month implementation period. Ongoing feedback and consultation, in line with participatory action research principles, informed the development and refinement of the model and identification of enablers and challenges. A collaborative, person-centred clinical pharmacy model that addressed the needs of clients, carers, nurses and other stakeholders was successfully developed. The model is likely to have applicability to home nursing services nationally and internationally. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Promoting the self-regulation of clinical reasoning skills in nursing students.

PubMed

Kuiper, R; Pesut, D; Kautz, D

2009-10-02

The purpose of this paper is to describe the research surrounding the theories and models the authors united to describe the essential components of clinical reasoning in nursing practice education. The research was conducted with nursing students in health care settings through the application of teaching and learning strategies with the Self-Regulated Learning Model (SRL) and the Outcome-Present-State-Test (OPT) Model of Reflective Clinical Reasoning. Standardized nursing languages provided the content and clinical vocabulary for the clinical reasoning task. This descriptive study described the application of the OPT model of clinical reasoning, use of nursing language content, and reflective journals based on the SRL model with 66 undergraduate nursing students over an 8 month period of time. The study tested the idea that self-regulation of clinical reasoning skills can be developed using self-regulation theory and the OPT model. This research supports a framework for effective teaching and learning methods to promote and document learner progress in mastering clinical reasoning skills. Self-regulated Learning strategies coupled with the OPT model suggest benefits of self-observation and self-monitoring during clinical reasoning activities, and pinpoints where guidance is needed for the development of cognitive and metacognitive awareness. Thinking and reasoning about the complexities of patient care needs requires attention to the content, processes and outcomes that make a nursing care difference. These principles and concepts are valuable to clinical decision making for nurses globally as they deal with local, regional, national and international health care issues.

[Methods and Applications to estimate the conversion factor of Resource-Based Relative Value Scale for nurse-midwife's delivery service in the national health insurance].

PubMed

Kim, Jinhyun; Jung, Yoomi

2009-08-01

This paper analyzed alternative methods of calculating the conversion factor for nurse-midwife's delivery services in the national health insurance and estimated the optimal reimbursement level for the services. A cost accounting model and Sustainable Growth Rate (SGR) model were developed to estimate the conversion factor of Resource-Based Relative Value Scale (RBRVS) for nurse-midwife's services, depending on the scope of revenue considered in financial analysis. The data and sources from the government and the financial statements from nurse-midwife clinics were used in analysis. The cost accounting model and SGR model showed a 17.6-37.9% increase and 19.0-23.6% increase, respectively, in nurse-midwife fee for delivery services in the national health insurance. The SGR model measured an overall trend of medical expenditures rather than an individual financial status of nurse-midwife clinics, and the cost analysis properly estimated the level of reimbursement for nurse-midwife's services. Normal vaginal delivery in nurse-midwife clinics is considered cost-effective in terms of insurance financing. Upon a declining share of health expenditures on midwife clinics, designing a reimbursement strategy for midwife's services could be an opportunity as well as a challenge when it comes to efficient resource allocation.

Factorial Validity of the Decisional Involvement Scale as a Measure of Content and Context of Nursing Practice.

PubMed

Yurek, Leo A; Havens, Donna S; Hays, Spencer; Hughes, Linda C

2015-10-01

Decisional involvement is widely recognized as an essential component of a professional nursing practice environment. In recent years, researchers have added to the conceptualization of nurses' role in decision-making to differentiate between the content and context of nursing practice. Yet, instruments that clearly distinguish between these two dimensions of practice are lacking. The purpose of this study was to examine the factorial validity of the Decisional Involvement Scale (DIS) as a measure of both the content and context of nursing practice. This secondary analysis was conducted using data from a longitudinal action research project to improve the quality of nursing practice and patient care in six hospitals (N = 1,034) in medically underserved counties of Pennsylvania. A cross-sectional analysis of baseline data from the parent study was used to compare the factor structure of two models (one nested within the other) using confirmatory factor analysis. Although a comparison of the two models indicated that the addition of second-order factors for the content and context of nursing practice improved model fit, neither model provided optimal fit to the data. Additional model-generating research is needed to develop the DIS as a valid measure of decisional involvement for both the content and context of nursing practice. © 2015 Wiley Periodicals, Inc.

Revisiting the impact of job satisfaction and organizational commitment on nurse turnover intention: an individual differences analysis.

PubMed

De Gieter, Sara; Hofmans, Joeri; Pepermans, Roland

2011-12-01

Nurse turnover is an important contributing factor to the worldwide nursing shortage. Many studies have examined the antecedents of nurse turnover to gain a better understanding of the problem and help hospitals reduce their turnover rates. However, an important shortcoming of this research stream is its exclusive focus on explaining turnover behavior of the "average nurse", thereby disregarding individual differences between nurses and groups of nurses. To examine individual differences in the relationships between two crucial turnover antecedents - job satisfaction and organizational commitment - and nurse turnover intention. A sample of 287 nurses working for a variety of Belgian hospitals participated in the study. A survey method was used to collect quantitative data, which were analyzed through standard multiple linear regression, mixture regression models and t-tests. In the total sample of hospital nurses, both job satisfaction and organizational commitment significantly predicted nurse turnover intention. However, subsequent individual differences analyses revealed the existence of two subgroups of nurses. In the satisfaction focused group, only job satisfaction was found to predict nurse turnover intention, whereas in the satisfaction and commitment focused group both job satisfaction and organizational commitment were related to turnover intention. Furthermore, nurses in the latter group displayed stronger turnover intention, were significantly younger and had less job tenure and organizational tenure than nurses in the satisfaction focused group. The debate on the antecedents of nurse turnover still continues, as the existing models fail to fully grasp nurse turnover. The present study identifies individual differences in nurse turnover antecedents among groups of nurses as a possible reason for the absence of one comprehensive turnover model that holds for the general nursing population. Further studies are needed in order to capture the total impact of the underlying individual differences in nurse turnover antecedents. 2011 Elsevier Ltd. All rights reserved.

"We definitely are role models": Exploring how clinical instructors' influence nursing students' attitudes towards older adults.

PubMed

Gibbs, Sheena Simpkins; Kulig, Judith C

2017-09-01

The world's population is getting older, which will inevitably cause increased demands for nurses to provide high quality care to this demographic. Attitudes have been shown to influence the quality of care that older adults receive. It is therefore important to gain a better understanding of what influences nursing students' attitudes towards older adults. This article reports on one of three inter-connected research questions of a mixed methods study that explored the relationship between clinical instructors' attitudes and nursing students' attitudes towards older adults. Semi-structured interviews were conducted with 6 clinical instructors and 13 nursing students. Interview data was analyzed using thematic analysis. A conceptual model was developed from the research findings, which revealed that nursing instructors are seen as strong role models for their students, and as role models, they influence students through demonstrations, expectations and support. As a result, nursing students mirror the attitudes of their instructors towards older adults. Findings from this study highlight the strong connection between nursing instructors' and students' attitudes. This has important implications for nursing education including strategies that instructors can employ to enhance students' attitudes towards older adults. Insights from this study also have the potential to improve the quality of care that future nurses provide to older adults. Copyright © 2017 Elsevier Ltd. All rights reserved.

Missed nursing care: a concept analysis.

PubMed

Kalisch, Beatrice J; Landstrom, Gay L; Hinshaw, Ada Sue

2009-07-01

This paper is a report of the analysis of the concept of missed nursing care. According to patient safety literature, missed nursing care is an error of omission. This concept has been conspicuously absent in quality and patient safety literature, with individual aspects of nursing care left undone given only occasional mention. An 8-step method of concept analysis - select concept, determine purpose, identify uses, define attributes, identify model case, describe related and contrary cases, identify antecedents and consequences and define empirical referents - was used to examine the concept of missed nursing care. The sources for the analysis were identified by systematic searches of the World Wide Web, MEDLINE, CINAHL and reference lists of related journal articles with a timeline of 1970 to April 2008. Missed nursing care, conceptualized within the Missed Nursing Care Model, is defined as any aspect of required patient care that is omitted (either in part or in whole) or delayed. Various attribute categories reported by nurses in acute care settings contribute to missed nursing care: (1) antecedents that catalyse the need for a decision about priorities; (2) elements of the nursing process and (3) internal perceptions and values of the nurse. Multiple elements in the nursing environment and internal to nurses influence whether needed nursing care is provided. Missed care as conceptualized within the Missed Care Model is a universal phenomenon. The concept is expected to occur across all cultures and countries, thus being international in scope.

Dedicated education unit: nurse perspectives on their clinical teaching role.

PubMed

Nishioka, Vicki M; Coe, Michael T; Hanita, Makoto; Moscato, Susan R

2014-01-01

The study compared the perceptions of nurses who participated in the clinical education of students using traditional and dedicated education unit (DEU) models. In the traditional model, faculty are the primary clinical instructors for students. In a DEU, nurses provide clinical instruction with faculty support. This mixed-methods study used surveys and interviews. Compared to nurses on traditional units, DEU nurses were more likely to agree that their unit welcomed students, had a strong commitment to teaching, and received professional development from clinical faculty. The nurses rated the learning gains of students as greater on DEUs than traditional units and viewed the leadership of the nurse manager and the quality of patient care as similar. The study provides evidence that, from the nurses' perspective, the DEU faculty-nurse partnership provides students with superior clinical education experiences and may improve nurse work satisfaction.

Parting at the crossroads: the emergence of education for psychiatric nursing in three Canadian provinces, 1909-1955.

PubMed

Tipliski, Veryl Margaret

2004-01-01

Early in the 20th century, nursing emerged as an essential part of psychiatry's attempt to provide scientific care for insanity. Throughout Canada psychiatric nursing is a specialty of general or registered nursing. In Western Canada, however, it is also a separate and distinct profession known as registered psychiatric nursing (RPN). To further the study of nursing history, this paper examines the emergence and early development of mental hospital nursing in Canada, tracing the changing patterns of nurse training from 1909, when Ontario's asylum training school movement was established, to 1955, when education for psychiatric nursing split along the Manitoba-Ontario border into two models. Through case studies in three provinces (Ontario, Manitoba and Saskatchewan), this study examines the question of how Canadian psychiatric nursing developed into two entirely different models. During the 20th century, and interplay of social, political and economic factors emerged which shaped the development of psychiatric nursing and influenced the evolution of the two models. In addition, there were forces within nursing itself, including the effects of specific strategic decisions taken by nursing's leaders and the continuing role of nurses' resistance to the authority expressed by those within the medical profession. The development of psychiatric nursing is best understood by focusing on the point where psychiatry's authority intersected with the gendered limitations of nursing's leaders. This struggle represented a contest for control over education for mental hospital nursing. This paper argues that the turning point in the battle for control of Canadian education for psychiatric nursing occurred when nurse leaders refused to allow the specialty of psychiatric nursing to be taken over by an expanding psychiatric monopoly. The distinct psychiatric-controlled Western Canadian-style apprenticeship training was halted at the Manitoba-Ontario border. That nursing leaders persevered in the struggle to gain authority for psychiatric nursing education was a significant contribution to the development of Canadian nursing education and the psychiatric nursing specialty. Remnants of the themes found in the study endure to the present as organized nursing continues to struggle with issues around autonomy and authority over education and practice.

"I know exactly what I'm going into": recommendations for pre-nursing experience from an evaluation of a pre-nursing scholarship in rural Scotland.

PubMed

Smith, Annetta; Beattie, Michelle; Kyle, Richard G

2015-11-01

To develop a model of pre-nursing experience from evaluation of a pre-nursing scholarship for school pupils in Scotland. Action research study. School pupils ( n  = 42) completed questionnaire surveys and participated in anecdote circles. Student nurses acting as pupil 'buddies' ( n  = 33) participated in focus groups. Descriptive quantitative data and thematic analyses of qualitative data were integrated across cohorts and campuses. Ten recommended components of a model of pre-nursing experience were identified: educational experience of: (1) face-to-face on-campus teaching; (2) hands-on clinical skills sessions; and (3) andragogy, practice exposure to (4) nursing language; (5) nurses' emotional labour; (6) patients' stories; (7) pupils socializing with buddies; (8) buddies planning placement activities; and (9) supporting pupils during placements. Academic attainment was not a central component of the model due to pupils' need to (10) prioritize examined work for further/higher education entry.

The protective role of self-efficacy against workplace incivility and burnout in nursing: A time-lagged study.

PubMed

Fida, Roberta; Laschinger, Heather K Spence; Leiter, Michael P

Incivility has negative consequences in the workplace and remains a prevalent issue in nursing. Research has consistently linked incivility to nurse burnout and, in turn, to poor mental health and turnover intentions. To retain high-quality nurses, it is important to understand what factors might protect nurses from the negative effects of workplace mistreatment. The aim of the study was to investigate the role of relational occupational coping self-efficacy in protecting nurses from workplace incivility and related burnout and turnover intentions. A two-wave national sample of 596 Canadian nurses completed mail surveys both at Time 1 and one year later at Time 2. Structural equation modeling was used to test the hypothesized model. The model showed a good fit, and most of the hypothesized paths were significant. Overall, the results supported the hypothesized protective effect of relational occupational coping self-efficacy against incivility and later burnout, mental health, and turnover intentions. Relational occupational coping self-efficacy is an important protective factor against negative work behavior. Organizations should provide nurses with opportunities to build their coping strategies for managing job demands and difficult interpersonal interactions. Similarly, providing exposure to effective role models and providing meaningful verbal encouragement are other sources of efficacy information for building nurses' relational coping self-efficacy.

Testing a Nursing-Specific Model of Electronic Patient Record documentation with regard to information completeness, comprehensiveness and consistency.

PubMed

von Krogh, Gunn; Nåden, Dagfinn; Aasland, Olaf Gjerløw

2012-10-01

To present the results from the test site application of the documentation model KPO (quality assurance, problem solving and caring) designed to impact the quality of nursing information in electronic patient record (EPR). The KPO model was developed by means of consensus group and clinical testing. Four documentation arenas and eight content categories, nursing terminologies and a decision-support system were designed to impact the completeness, comprehensiveness and consistency of nursing information. The testing was performed in a pre-test/post-test time series design, three times at a one-year interval. Content analysis of nursing documentation was accomplished through the identification, interpretation and coding of information units. Data from the pre-test and post-test 2 were subjected to statistical analyses. To estimate the differences, paired t-tests were used. At post-test 2, the information is found to be more complete, comprehensive and consistent than at pre-test. The findings indicate that documentation arenas combining work flow and content categories deduced from theories on nursing practice can influence the quality of nursing information. The KPO model can be used as guide when shifting from paper-based to electronic-based nursing documentation with the aim of obtaining complete, comprehensive and consistent nursing information. © 2012 Blackwell Publishing Ltd.

Exploring nursing e-learning systems success based on information system success model.

PubMed

Chang, Hui-Chuan; Liu, Chung-Feng; Hwang, Hsin-Ginn

2011-12-01

E-learning is thought of as an innovative approach to enhance nurses' care service knowledge. Extensive research has provided rich information toward system development, courses design, and nurses' satisfaction with an e-learning system. However, a comprehensive view in understanding nursing e-learning system success is an important but less focused-on topic. The purpose of this research was to explore net benefits of nursing e-learning systems based on the updated DeLone and McLean's Information System Success Model. The study used a self-administered questionnaire to collected 208 valid nurses' responses from 21 of Taiwan's medium- and large-scale hospitals that have implemented nursing e-learning systems. The result confirms that the model is sufficient to explore the nurses' use of e-learning systems in terms of intention to use, user satisfaction, and net benefits. However, while the three exogenous quality factors (system quality, information quality, and service quality) were all found to be critical factors affecting user satisfaction, only information quality showed a direct effect on the intention to use. This study provides useful insights for evaluating nursing e-learning system qualities as well as an understanding of nurses' intentions and satisfaction related to performance benefits.

A synthesis of Vroom's model with other social theories: an application to nursing education.

PubMed

Gyurko, Charlene C

2011-07-01

In 2009, the National League for Nursing reported that there are over 3.4 million persons in the United States employed in nursing in the roles of Registered Nurses (RNs) and Advanced Practice Nurses (APRNs). In 2007, the Bureau of Labor Statistics also reported that in 2006, there were over 749,000 Licensed Practical Nurses (LPNs) working in the United States with a projected increase of 14% by 2016. Buerhaus et al, in 2009, stated that between 2016 and 2025, it is estimated that the U.S. will need over 260,000 registered nurses (RNs) Using the conceptual framework of Vroom's expectancy theory on motivation as well as theories addressing student and career development, this paper demonstrates a synthesis of Vroom's model with other educational theories and its application to nursing education, specifically the prediction of motivation to advance one's nursing education. By putting Vroom's theory into a context, Vroom's fairly simple model could help nurse educators predict the factors that make for success in midcareer educational advancement--and even possibly manipulate those factors to increase that success. In today's economy, that practical part seems too good to lose. Copyright © 2010 Elsevier Ltd. All rights reserved.

[New ways of higher education in nursing: globalisation of nursing leadership and its teaching--dual degree in nursing].

PubMed

Pop, Marcel; Hollós, Sándor; Vingender, István; Mészáros, Judit

2009-03-08

Our paper is presenting a new initiative regarding an international cooperation willing to develop a dual degree program in nursing, the so-called Transatlantic Curriculum in Nursing. The candidates--after successful completion of their studies--will get a European and an American partner diploma in nursing. The objective is to prepare an internationally and culturally competent workforce; develop the practice of nursing students' exchange programs; process the model of dual degree independent of geographical, political or cultural borders; spread the evidence-based nursing standards in the daily practice. The partners in this initiative are Semmelweis University in Budapest, Hungary, Nazareth College of Rochester, NY, USA and Laurea University in Tikkurila, Finland. The planned activities in the framework of the program: mutual student and staff mobility, joint curriculum development and teaching process, determining joint standards. The expected outcomes are: to develop a standardised model for the enhancement and implementation of international educational programs in nursing; to improve institutional work culture; to improve professional terminology and cultural abilities; to create the model of a new type of nursing professional having a high level of cultural and language competence which are indispensable for participating in global programs.

Strategic directions for developing the Australian general practice nurse role in cardiovascular disease management.

PubMed

Halcomb, Elizabeth J; Davidson, Patricia M; Yallop, Julie; Griffiths, Rhonda; Daly, John

2007-08-01

Practice nursing is an integral component of British and New Zealand primary care, but in Australia it remains an emerging specialty. Despite an increased focus on the Australian practice nurse role, there has been limited strategic role development, particularly relating to national health priority areas. This paper reports the third stage of a Project exploring the Australian practice nurse role in the management of cardiovascular disease (CVD). This stage involved a consensus development conference, undertaken to identify strategic, priority recommendations for practice nurse role development. 1. Practice nurses have an important role in developing systems and processes for CVD management; 2. A change in the culture of general practice is necessary to promote acceptance of nurse-led CVD management; 3. Future research needs to evaluate specific models of care, incorporating outcome measures sensitive to nursing interventions; 4. Considerable challenges exist in conducting research in general practice; and 5. Changes in funding models are necessary for widespread practice nurse role development. The shifting of funding models provides evidence to support interdisciplinary practice in Australian general practice. The time is ripe, therefore, to engage in prospective and strategic planning to inform development of the practice nurse role.

Implementing two nurse practitioner models of service at an Australian male prison: A quality assurance study.

PubMed

Wong, Ides; Wright, Eryn; Santomauro, Damian; How, Raquel; Leary, Christopher; Harris, Meredith

2018-01-01

To examine the quality and safety of nurse practitioner services of two newly implemented nurse practitioner models of care at a correctional facility. Nurse practitioners could help to meet the physical and mental health needs of Australia's growing prison population; however, the nurse practitioner role has not previously been evaluated in this context. A quality assurance study conducted in an Australian prison where a primary health nurse practitioner and a mental health nurse practitioner were incorporated into an existing primary healthcare service. The study was guided by Donabedian's structure, processes and outcomes framework. Routinely collected information included surveys of staff attitudes to the implementation of the nurse practitioner models (n = 21 staff), consultation records describing clinical processes and time use (n = 289 consultations), and a patient satisfaction survey (n = 29 patients). Data were analysed descriptively and compared to external benchmarks where available. Over the two-month period, the nurse practitioners provided 289 consultations to 208 prisoners. The presenting problems treated indicated that most referrals were appropriate. A significant proportion of consultations involved medication review and management. Both nurse practitioners spent more than half of their time on individual patient-related care. Overall, multidisciplinary team staff agreed that the nurse practitioner services were necessary, safe, met patient need and reduced treatment delays. Findings suggest that the implementation of nurse practitioners into Australian correctional facilities is acceptable and feasible and has the potential to improve prisoners' access to health services. Structural factors (e.g., room availability and limited access to prisoners) may have reduced the efficiency of the nurse practitioners' clinical processes and service implementation. Results suggest that nurse practitioner models can be successfully integrated into a prison setting and could provide a nursing career pathway. © 2017 John Wiley & Sons Ltd.

[New model of doctor-nurse communication based on electronic medical advice platform].

PubMed

Cao, Yang; Ding, Aimin; Wang, Yan

2012-01-01

This article introduces a new model of the communication between doctors and nurses, with the aid of the electronic medical advice platform. This model has achieved good results in improving doctor and nurse's co-working efficiency, treating patients safely, preventing medical accidents, reducing medical errors and so on.

Predictors of nursing home residents' time to hospitalization.

PubMed

O'Malley, A James; Caudry, Daryl J; Grabowski, David C

2011-02-01

To model the predictors of the time to first acute hospitalization for nursing home residents, and accounting for previous hospitalizations, model the predictors of time between subsequent hospitalizations. Merged file from New York State for the period 1998-2004 consisting of nursing home information from the minimum dataset and hospitalization information from the Statewide Planning and Research Cooperative System. Accelerated failure time models were used to estimate the model parameters and predict survival times. The models were fit to observations from 50 percent of the nursing homes and validated on the remaining observations. Pressure ulcers and facility-level deficiencies were associated with a decreased time to first hospitalization, while the presence of advance directives and facility staffing was associated with an increased time. These predictors of the time to first hospitalization model had effects of similar magnitude in predicting the time between subsequent hospitalizations. This study provides novel evidence suggesting modifiable patient and nursing home characteristics are associated with the time to first hospitalization and time to subsequent hospitalizations for nursing home residents. © Health Research and Educational Trust.

A scoping review of nursing workforce planning and forecasting research.

PubMed

Squires, Allison; Jylhä, Virpi; Jun, Jin; Ensio, Anneli; Kinnunen, Juha

2017-11-01

This study will critically evaluate forecasting models and their content in workforce planning policies for nursing professionals and to highlight the strengths and the weaknesses of existing approaches. Although macro-level nursing workforce issues may not be the first thing that many nurse managers consider in daily operations, the current and impending nursing shortage in many countries makes nursing specific models for workforce forecasting important. A scoping review was conducted using a directed and summative content analysis approach to capture supply and demand analytic methods of nurse workforce planning and forecasting. The literature on nurse workforce forecasting studies published in peer-reviewed journals as well as in grey literature was included in the scoping review. Thirty six studies met the inclusion criteria, with the majority coming from the USA. Forecasting methods were biased towards service utilization analyses and were not consistent across studies. Current methods for nurse workforce forecasting are inconsistent and have not accounted sufficiently for socioeconomic and political factors that can influence workforce projections. Additional studies examining past trends are needed to improve future modelling. Accurate nursing workforce forecasting can help nurse managers, administrators and policy makers to understand the supply and demand of the workforce to prepare and maintain an adequate and competent current and future workforce. © 2017 John Wiley & Sons Ltd.

Optimizing nursing human resource planning in British Columbia.

PubMed

Lavieri, Mariel S; Puterman, Martin L

2009-06-01

This paper describes a linear programming hierarchical planning model that determines the optimal number of nurses to train, promote to management and recruit over a 20 year planning horizon to achieve specified workforce levels. Age dynamics and attrition rates of the nursing workforce are key model components. The model was developed to help policy makers plan a sustainable nursing workforce for British Columbia, Canada. An easy to use interface and considerable flexibility makes it ideal for scenario and "What-If?" analyses.

A beginner's guide to writing the nursing conceptual model-based theoretical rationale.

PubMed

Gigliotti, Eileen; Manister, Nancy N

2012-10-01

Writing the theoretical rationale for a study can be a daunting prospect for novice researchers. Nursing's conceptual models provide excellent frameworks for placement of study variables, but moving from the very abstract concepts of the nursing model to the less abstract concepts of the study variables is difficult. Similar to the five-paragraph essay used by writing teachers to assist beginning writers to construct a logical thesis, the authors of this column present guidelines that beginners can follow to construct their theoretical rationale. This guide can be used with any nursing conceptual model but Neuman's model was chosen here as the exemplar.

The emerging role of faith community nurses in prevention and management of chronic disease.

PubMed

McGinnis, Sandra L; Zoske, Frances M

2008-08-01

Faith community nursing, formerly known as parish nursing, is one model of care that relies heavily on older registered nurses (RNs) to provide population-based and other nonclinical services in community settings. Faith community nursing provides services not commonly available in the traditional health care system (e.g., community case management, community advocacy, community health education). With appropriate support, this model of nursing could be expanded into other settings within the community and has the potential to draw on the skills of experienced RNs to provide communities with services that address unmet health care needs.

Teaching Culture within the Nursing Curriculum Using the Giger-Davidhizar Model of Transcultural Nursing Assessment.

ERIC Educational Resources Information Center

Davidhizar, Ruth; Giger, Joyce Newman

2001-01-01

Presents a method for integrating cultural competence throughout the nursing curriculum. The model contains six cultural phenomena: communication, space, social organization, time, environmental control, and biological variation. Contains 17 references. (SK)

Predictors of burnout, work engagement and nurse reported job outcomes and quality of care: a mixed method study.

PubMed

Van Bogaert, Peter; Peremans, Lieve; Van Heusden, Danny; Verspuy, Martijn; Kureckova, Veronika; Van de Cruys, Zoë; Franck, Erik

2017-01-01

High levels of work-related stress, burnout, job dissatisfaction, and poor health are common within the nursing profession. A comprehensive understanding of nurses' psychosocial work environment is necessary to respond to complex patients' needs. The aims of this study were threefold: (1) To retest and confirm two structural equation models exploring associations between practice environment and work characteristics as predictors of burnout (model 1) and engagement (model 2) as well as nurse-reported job outcome and quality of care; (2) To study staff nurses' and nurse managers' perceptions and experiences of staff nurses' workload; (3) To explain and interpret the two models by using the qualitative study findings. This mixed method study is based on an explanatory sequential study design. We first performed a cross-sectional survey design in two large acute care university hospitals. Secondly, we conducted individual semi-structured interviews with staff nurses and nurse managers assigned to medical or surgical units in one of the study hospitals. Study data was collected between September 2014 and June 2015. Finally, qualitative study results assisted in explaining and interpreting the findings of the two models. The two models with burnout and engagement as mediating outcome variables fitted sufficiently to the data. Nurse-reported job outcomes and quality of care explained variances between 52 and 62%. Nurse management at the unit level and workload had a direct impact on outcome variables with explained variances between 23 and 36% and between 12 and 17%, respectively. Personal accomplishment and depersonalization had an explained variance on job outcomes of 23% and vigor of 20%. Burnout and engagement had a less relevant direct impact on quality of care (≤5%). The qualitative study revealed various themes such as organisation of daily practice and work conditions; interdisciplinary collaboration, communication and teamwork; staff nurse personal characteristics and competencies; patient centeredness, quality and patient safety. Respondents' statements corresponded closely to the models' associations. A deep understanding of various associations and impacts on studied outcome variables such as risk factors and protective factors was gained through the retested models and the interviews with the study participants. Besides the softer work characteristics - such as decision latitude, social capital and team cohesion - more insight and knowledge of the hard work characteristic workload is essential.

Examining Variation in Mental Models of Influence and Leadership Among Nursing Leaders and Direct Care Nurses.

PubMed

Weaver, Sallie J; Mossburg, Sarah E; Pillari, MarieSarah; Kent, Paula S; Daugherty Biddison, Elizabeth Lee

This study explored similarities and differences in the views on team membership and leadership held by nurses in formal unit leadership positions and direct care nurses. We used a mixed-methods approach and a maximum variance sampling strategy, sampling from units with both high and low safety behaviors and safety culture scores. We identified several key differences in mental models of care team membership and leadership between formal leaders and direct care nurses that warrant further exploration.

[Clinical faculty in nursing care: weaving together the competences of nurse and teacher for a role change].

PubMed

Perrenoud, Béatrice; Marquis, Anne-Marie

2007-09-01

The nurse preceptor holds a specific role in the healthcare staff linked with both educational and nursing cultures. This article presents the analysis of the training program developed at the CHUV (Switzerland). The analysis indicates tra- how the training model centered on thefields of nursing and education, improves the development of a bi cultural identity, and the implementation of the preceptorship role. This training model effectively enables nurse preceptors to support students learning in a care perspective and allow them to cope with the potential conflicts between educational and nursing approaches. An evaluation of the training experience and some potential directions for the program are discussed.

Using a didactic model to improve patient observation skills in neonatal intensive care nurse trainees - a pilot study.

PubMed

Solberg, Marianne Trygg; Tandberg, Bente Silnes; Lerdal, Anners

2012-08-01

To implement a didactic model for students specialising in intensive care nursing (n=12) and nurses working in neonatal intensive care units (NICU) (n=17). To evaluate nurse self-assessments following observation of children with congenital heart disease (CHD), before and after participation in the programme, as well as the usefulness of the programme. A pilot study with a pre- and post-test design, using self-administered questionnaires. The didactic model increased the number of clinical observations and assessments of physiological factors made by both students and NICU nurses during evaluation of children with suspected CHD. The majority of nurses reported that both participation in the programme and the didactic model were useful and they demonstrated high-level knowledge, according to Bloom's taxonomy for cognitive learning. In particular, subjects found that the literature provided and structured bedside guidance in the clinical setting assisted learning. Intensive care students and NICU nurses performed clinical observations and physical factor assessments more frequently after completing the programme, compared with baseline. We speculate that this didactic model may also be useful in other clinical settings. Copyright © 2011 Elsevier Ltd. All rights reserved.

Impact of resilience and job involvement on turnover intention of new graduate nurses using structural equation modeling.

PubMed

Yu, Mi; Lee, Haeyoung

2018-03-06

Nurses' turnover intention is not just a result of their maladjustment to the field; it is an organizational issue. This study aimed to construct a structural model to verify the effects of new graduate nurses' work environment satisfaction, emotional labor, and burnout on their turnover intention, with consideration of resilience and job involvement, and to test the adequacy of the developed model. A cross-sectional study and a structural equation modelling approach were used. A nationwide survey was conducted of 371 new nurses who were working in hospitals for ≤18 months between July and October, 2014. The final model accounted for 40% of the variance in turnover intention. Emotional labor and burnout had a significant positive direct effect and an indirect effect on nurses' turnover intention. Resilience had a positive direct effect on job involvement. Job involvement had a negative direct effect on turnover intention. Resilience and job involvement mediated the effect of work environment satisfaction, emotional labor, and burnout on turnover intention. It is important to strengthen new graduate nurses' resilience in order to increase their job involvement and to reduce their turnover intention. © 2018 Japan Academy of Nursing Science.

Using trauma informed care as a nursing model of care in an acute inpatient mental health unit: A practice development process.

PubMed

Isobel, Sophie; Edwards, Clair

2017-02-01

Without agreeing on an explicit approach to care, mental health nurses may resort to problem focused, task oriented practice. Defining a model of care is important but there is also a need to consider the philosophical basis of any model. The use of Trauma Informed Care as a guiding philosophy provides a robust framework from which to review nursing practice. This paper describes a nursing workforce practice development process to implement Trauma Informed Care as an inpatient model of mental health nursing care. Trauma Informed Care is an evidence-based approach to care delivery that is applicable to mental health inpatient units; while there are differing strategies for implementation, there is scope for mental health nurses to take on Trauma Informed Care as a guiding philosophy, a model of care or a practice development project within all of their roles and settings in order to ensure that it has considered, relevant and meaningful implementation. The principles of Trauma Informed Care may also offer guidance for managing workforce stress and distress associated with practice change. © 2016 Australian College of Mental Health Nurses Inc.

Instructional Storytelling: Application of the Clinical Judgment Model in Nursing.

PubMed

Timbrell, Jessica

2017-05-01

Little is known about the teaching and learning implications of instructional storytelling (IST) in nursing education or its potential connection to nursing theory. The literature establishes storytelling as a powerful teaching-learning method in the educational, business, humanities, and health sectors, but little exploration exists that is specific to nursing. An example of a story demonstrating application of the domains of Tanner's clinical judgment model links storytelling with learning outcomes appropriate for the novice nursing student. Application of Tanner's clinical judgment model offers consistency of learning experience while preserving the creativity inherent in IST. Further research into student learning outcomes achievement using IST is warranted as a step toward establishing best practices with IST in nursing education. [J Nurs Educ. 2017;56(5):305-308.]. Copyright 2017, SLACK Incorporated.

The incommensurability of nursing as a practice and the customer service model: an evolutionary threat to the discipline.

PubMed

Austin, Wendy J

2011-07-01

Corporate and commercial values are inducing some healthcare organizations to prescribe a customer service model that reframes the provision of nursing care. In this paper it is argued that such a model is incommensurable with nursing conceived as a moral practice and ultimately places nurses at risk. Based upon understanding from ongoing research on compassion fatigue, it is proposed that compassion fatigue as currently experienced by nurses may not arise predominantly from too great a demand for compassion, but rather from barriers to enacting compassionate care. These barriers are often systemic. The paradigm shift in which healthcare environments are viewed as marketplaces rather than moral communities has the potential to radically affect the evolution of nursing as a discipline. © 2011 Blackwell Publishing Ltd.

Tackling the workforce crisis in district nursing: can the Dutch Buurtzorg model offer a solution and a better patient experience? A mixed methods case study.

PubMed

Drennan, Vari M; Calestani, Melania; Ross, Fiona; Saunders, Mary; West, Peter

2018-06-06

Despite policy intentions for more healthcare out of hospital, district nursing services face multiple funding and staffing challenges, which compromise the care delivered and policy objectives. What is the impact of the adapted Buurtzorg model on feasibility, acceptability and effective outcomes in an English district nursing service? Mixed methods case study. Primary care. Neighbourhood nursing team (Buurtzorg model), patients and carers, general practitioners (GPs), other health professionals, managers and conventional district nurses. The adapted Buurtzorg model of community nursing demonstrated feasibility and acceptability to patients, carers, GPs and other health professionals. For many patients, it was preferable to previous experiences of district nursing in terms of continuity in care, improved support of multiple long-term conditions (encompassing physical, mental and social factors) and proactive care. For the neighbourhood nurses, the ability to make operational and clinical decisions at team level meant adopting practices that made the service more responsive, accessible and efficient and offered a more attractive working environment. Challenges were reported by nurses and managers in relation to the recognition and support of the concept of self-managing teams within a large bureaucratic healthcare organisation. While there were some reports of clinical effectiveness and efficiency, this was not possible to quantify, cost or compare with the standard district nursing service. The adapted Buurtzorg model of neighbourhood nursing holds potential for addressing issues of concern to patients, carers and staff in the community. The two interacting innovations, that is, a renewed focus on patient and carer-centred care and the self-managing team, were implemented in ways that patients, carers, other health professionals and nurses could identify difference for both the nursing care and also the nurses' working lives. It now requires longer term investigation to understand both the mechanism for change and also the sustainability. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

New graduate nurses as knowledge brokers in general practice in New Zealand: a constructivist grounded theory.

PubMed

Hoare, Karen J; Mills, Jane; Francis, Karen

2013-07-01

Practice nursing in New Zealand is not well described in the literature. One survey illustrated that most of the New Zealand practice nurses sampled did not know of the country's two premier evidence-based health websites. A recent review compared general practice in the UK, New Zealand and Australia and found that whereas there had been significant developments in empowering the practice nurse workforce to run nurse-led clinics in the UK, New Zealand and Australia lagged behind. The aim of this reported constructivist grounded theory study was to investigate practice nurses' use of information. Conducted in Auckland, New Zealand, data were collected through ethnographic techniques in one general practice between September 2009 and January 2010 to enhance theoretical sensitivity to the area of information use. Subsequently, six experienced practice nurses (one twice after moving jobs) and five new graduate nurses from five different general practices were interviewed, using open-ended questions, between January 2010 and August 2011. Concurrent data collection and analysis occurred throughout the study period. The use of memos, the constant comparative method, data categorisation and finally, data abstraction resulted in the final theory of reciprocal role modelling. Experienced practice nurses role modelled clinical skills to new graduate nurses. Unexpectedly, new graduate nurses were unconscious experts at sourcing information and role modelled this skill to experienced practice nurses. Once this attribute was acknowledged by the experienced practice nurse, mutual learning occurred that enabled both groups of nurses to become better practitioners. Graduate nurses of the millennial generation were identified as a resource for experienced practice nurses who belong to the baby boomer generation and generation X. © 2013 John Wiley & Sons Ltd.

The mystery of altruism and transcultural nursing.

PubMed

Dowd, Steven; Davidhizar, Ruth; Giger, Joyce Newman

2007-01-01

Why do some individuals choose the professions they do? Is it for altruistic reasons? This article examines this question from the standpoints of sociobiology, evolutionary biology, game theory, and memetics. Implications for transcultural nursing are included. The Giger-Davidhizar Transcultural Assessment Model is presented as a nursing model and might explain altruism even beyond other models. An overview of the Giger-Davidhizar Transcultural Assessment Model is included.

A new assessment model and tool for pediatric nurse practitioners.

PubMed

Burns, C

1992-01-01

This article presents a comprehensive assessment model for pediatric nurse practitioner (PNP) practice that integrates familiar elements of the classical medical history, Gordon's Functional Health Patterns, and developmental fields into one system. This model drives the diagnostic reasoning process toward consideration of a broad range of disease, daily living (nursing diagnosis), and developmental diagnoses, which represents PNP practice better than the medical model does.

A model for using the VIPS framework for person-centred care for persons with dementia in nursing homes: a qualitative evaluative study.

PubMed

Røsvik, Janne; Kirkevold, Marit; Engedal, Knut; Brooker, Dawn; Kirkevold, Øyvind

2011-09-01

The 'VIPS' framework sums up the elements in Kitwood's philosophy of person-centred care (PCC) for persons with dementia as values, individualised approach, the perspective of the person living with dementia and social environment. There are six indicators for each element. Aim.  To conduct an initial evaluation of a model aimed at facilitating the application of the VIPS framework. Qualitative evaluative study. A model was trialled in a 9-week pilot study in two nursing homes and evaluated in four focus groups using qualitative content analysis. Five themes emerged: (1) Legitimacy of the model was secured when central roles were held by nurses representing the majority of the staff; (2) The model facilitated the staff's use of their knowledge of PCC; (3) Support to the persons holding the internal facilitating roles in the model was needed; (4) The authority of the leading registered nurse in the ward was crucial to support the legitimacy of the model and (5) Form of organisation seemed to be of importance in how the model was experienced. The model worked best in wards organised with a leading registered nurse who could support an auxiliary nurse holding the facilitating function. © 2011 Blackwell Publishing Ltd.

[An overview of clinical practice education models for nursing students: a literature review].

PubMed

Canzan, Federica; Marognolli, Oliva; Bevilacqua, Anita; Defanti, Francesca; Ambrosi, Elisa; Cavada, Luisa; Saiani, Luisa

2017-01-01

. An overview of education models for nursing students clinical practice: a literature review. In the past decade the nursing education research developed and tested a number of clinical educational models. To describe the most used clinical educational models and to analyze their strengths and weaknesses in fostering the learning processes of nursing students. A literature review of studies on clinical education models for undergraduate nursing student, published in English, was performed. Electronic database Pubmed and Cinhal were searched until November 2016. Nineteen studies were included in the review and five clinical education model identified: 1) the university tutor supervises a group of students and selects learning opportunities; 2) a clinical expert/tutor nurse works side by side with one student; 3) the student is responsible of his/her learning process with the supervision of the ward staff; 4) a clinical tutor of the ward is dedicated to the students' supervision; 5) the student is not assigned to a ward but clinical learning opportunities matched with his/her needs are selected by the university. All the clinical education models shared the focus on students' learning needs. Their specific characteristics better suit them for different stages of students' education and to different clinical settings.

Competency Model 101. The Process of Developing Core Competencies.

ERIC Educational Resources Information Center

Eichelberger, Lisa Wright; Hewlett, Peggy O'Neill

1999-01-01

The Mississippi Competency Model defines nurses' roles as provider (caregiver, teacher, counselor, advocate), professional (scholar, collaborator, ethicist, researcher), and manager (leader, facilitator, intrapreneur, decision maker, technology user) for four levels of nursing: licensed practical nurse, associate degree, bachelor's degree, and…

Intention to comply with post-exposure management among nurses exposed to blood and body fluids in Taiwan: application of the theory of planned behaviour.

PubMed

Ko, N-Y; Yeh, S-H; Tsay, S-L; Ma, H-J; Chen, C-H; Pan, S-M; Feng, M-C; Chiang, M-C; Lee, Y-W; Chang, L-H; Jang, J-F

2011-04-01

Nurses are at significant risk from occupationally acquired bloodborne virus infections following a needlestick and sharps injury. This study aimed to apply the theory of planned behaviour (TPB) to predict nurses' intention to comply with occupational post-exposure management. A cross-sectional survey was applied to select registered nurses who worked in human immunodeficiency virus (HIV)-designated hospitals. An anonymous, self-administered questionnaire based on the TPB was distributed to 1630 nurses and 1134 (69.5%) questionnaires were returned. From these, a total of 802 nurses (71%) reported blood and body fluid exposure incidents during 2003-2005 and this group was used for analysis. Only 44.6% of the 121 exposed nurses who were prescribed post-exposure prophylaxis (PEP) by infectious disease doctors returned to the clinic for interim monitoring, and only 56.6% of exposed nurses confirmed their final serology status. Structural equation modelling was used to test the TPB indicating perceived behavioural control (the perception of the difficulty or ease of PEP management, β=0.58), subjective norm (the perception of social pressure to adhere to PEP, β=0.15), and attitudes (β=0.12) were significant direct effects on nurses' intention to comply with post-exposure management. The hypothesised model test indicated that the model fitted with the expected relationships and directions of theoretical constructs [χ(2) (14, N=802)=23.14, P=0.057, GFI=0.987, RMSEA=0.039]. The TPB model constructs accounted for 54% of the variance in nurses' intention to comply with post-exposure management. The TPB is an appropriate model for predicting nurses' intention to comply with post-exposure management. Healthcare facilities should have policies to decrease the inconvenience of follow-up to encourage nurses to comply with post-exposure management. Copyright © 2010 the Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Nursing Challenges in Motivating Nursing Students through Clinical Education: A Grounded Theory Study.

PubMed

Nasrin, Hanifi; Soroor, Parvizy; Soodabeh, Joolaee

2012-01-01

Nurses are the first role models for students in clinical settings. They can have a significant role on students' motivation. The purpose of this study was to explore the understanding of nursing students and instructors concerning the role of nurses in motivating nursing students through clinical education. The sampling was first started purposefully and continued with theoretical sampling. The study collected qualitative data through semistructured and interactive interviews with 16 nursing students and 4 nursing instructors. All interviews were recorded, transcribed, and analyzed using grounded theory approach. One important pattern emerged in this study was the "concerns of becoming a nurse," which itself consisted of three categories: "nurses clinical competency," "nurses as full-scale mirror of the future," and "Monitoring and modeling through clinical education" (as the core variable). The findings showed that the nurses' manners of performance as well as the profession's prospect have a fundamental role in the process of formation of motivation through clinical education. Students find an insight into the nursing profession by substituting themselves in the place of a nurse, and as result, are or are not motivated towards the clinical education.

Creativity and connections: the future of nursing education and practice: the Massachusetts Initiative.

PubMed

Sroczynski, Maureen; Gravlin, Gayle; Route, Paulette Seymour; Hoffart, Nancy; Creelman, Patricia

2011-01-01

Education and practice partnerships are key to effective academic program design and implementation in a time of decreasing supply and increasing demands on the nursing profession. An integrated education/practice competency model can positively impact patient safety, improve patient care, increase retention, and ensure a sufficient and competent nursing workforce, which is paramount to survival of the health care system. Through the contributions of nursing leaders from the broad spectrum of nursing and industry organizations within the state, the Massachusetts Nurse of the Future project developed a competency-based framework for the future design of nursing educational programs to meet current and future practice needs. The Massachusetts Nurse of the Future Nursing Core Competencies(©) expand on the Institute of Medicine's core competencies for all health care professionals and the Quality and Safety Education for Nurses competencies for quality and safety to define the expectations for all professional nurses of the future. The Massachusetts Nurse of the Future Nursing Core Competencies define the knowledge, attitude, and skills required as the minimal expectations for initial nursing practice following completion of a prelicensure professional nursing education program. These competencies are now being integrated into new models for seamless, coordinated nursing curriculum and transition into practice within the state and beyond. Copyright © 2011 Elsevier Inc. All rights reserved.

Evaluating and improving a model of nursing care delivery: a process of partnership.

PubMed

Hall, Catherine; McCutcheon, Helen; Deuter, Kate; Matricciani, Lisa

2012-01-01

Evaluating and improving a model of nursing care is a fundamental part of clinical practice improvement. While Australian nurses are showing increasing interest in improving models of care delivery, more research is needed that addresses and articulates the processes attendant upon evaluating, re-designing and implementing improvements to the provision of nursing care. Providing nurses with an open opportunity to plan, act, observe and reflect on their practice promotes successful partnerships between academics and clinicians. The aim of this study was to evaluate and improve the model of nursing care delivery to patients in a general surgical ward using participatory action research. Researchers conducted non-participant observations (n = 9) of two hours duration across the 24 h period. Focus groups (n = 3) were used to share non-participant observation data with staff, providing them with an opportunity to reflect on their practice and explore possible solutions. Data was collected in 2008-2009. Two main problem areas were identified as impeding the nurses' ability to provide care to patients: (i) practices and behaviours of nurses and (ii) infrastructure and physical layout of the ward. An overview of issues within each problem area is presented. Shifting the focus of task-centred care towards a more patient-centred care approach, results directly in improvements in resource utilisation, improved cost-effectiveness and job satisfaction for nursing staff. New ways of thinking about nursing processes and systems, workflow design and skill allocation will guide hospital administrators and managers in the effective and efficient allocation of nursing work in similar settings.

Construction of a new model of job engagement, psychological empowerment and perceived work environment among Chinese registered nurses at four large university hospitals: implications for nurse managers seeking to enhance nursing retention and quality of care.

PubMed

Fan, Yuying; Zheng, Qiulan; Liu, Shiqing; Li, Qiujie

2016-07-01

To explore the relationships among perceived work environment, psychological empowerment and job engagement of clinical nurses in Harbin, China. Previous studies have focused on organisational factors or nurses' personal characteristics contributing to job engagement. Limited studies have examined the effects of perceived work environment and psychological empowerment on job engagement among Chinese nurses. A cross-sectional quantitative survey with 923 registered nurses at four large university hospitals in China was carried out. Research instruments included the Chinese versions of the perceived nurse work environment scale, the psychological empowerment scale and the job engagement scale. The relationships of the variables were tested using structural equation modelling. Structural equation modelling revealed a good fit of the model, χ(2) /df = 4.46, GFI = 0.936, CFI = 0.957. Perceived work environment was a significant positive direct predictor of psychological empowerment and job engagement. Psychological empowerment was a significant positive direct contributor to job engagement and had a mediating effect on the relationship between perceived work environment and job engagement. Perceived work environment may result in increased job engagement by facilitating the development of psychological empowerment. For nurse managers wishing to increase nurse engagement and to achieve effective management, both perceived work environment and psychological empowerment are factors that need to be well controlled in the process of nurse administration. © 2016 John Wiley & Sons Ltd.

Hospital nurse staffing models and patient and staff-related outcomes.

PubMed

Butler, Michelle; Collins, Rita; Drennan, Jonathan; Halligan, Phil; O'Mathúna, Dónal P; Schultz, Timothy J; Sheridan, Ann; Vilis, Eileen

2011-07-06

Nurse staffing interventions have been introduced across countries in recent years in response to changing patient requirements, developments in patient care, and shortages of qualified nursing staff. These include changes in skill mix, grade mix or qualification mix, staffing levels, nursing shifts or nurses' work patterns. Nurse staffing has been closely linked to patient outcomes, organisational outcomes such as costs, and staff-related outcomes. Our aim was to explore the effect of hospital nurse staffing models on patient and staff-related outcomes. We searched the following databases from inception through to May 2009: Cochrane/EPOC resources (DARE, CENTRAL, the EPOC Specialised Register), PubMed, EMBASE, CINAHL Plus, CAB Health, Virginia Henderson International Nursing Library, the Joanna Briggs Institute database, the British Library, international theses databases, as well as generic search engines. Randomised control trials, controlled clinical trials, controlled before and after studies and interrupted time series analyses of interventions relating to hospital nurse staffing models. Participants were patients and nursing staff working in hospital settings. We included any objective measure of patient or staff-related outcome. Seven reviewers working in pairs independently extracted data from each potentially relevant study and assessed risk of bias. We identified 6,202 studies that were potentially relevant to our review. Following detailed examination of each study, we included 15 studies in the review. Despite the number of studies conducted on this topic, the quality of evidence overall was very limited. We found no evidence that the addition of specialist nurses to nursing staff reduces patient death rates, attendance at the emergency department, or readmission rates, but it is likely to result in shorter patient hospital stays, and reductions in pressure ulcers. The evidence in relation to the impact of replacing Registered Nurses with unqualified nursing assistants on patient outcomes is very limited. However, it is suggested that specialist support staff, such as dietary assistants, may have an important impact on patient outcomes. Self-scheduling and primary nursing may reduce staff turnover. The introduction of team midwifery (versus standard care) may reduce medical procedures in labour and result in a shorter length of stay without compromising maternal or perinatal safety. We found no eligible studies of educational interventions, grade mix interventions, or staffing levels and therefore we are unable to draw conclusions in relation to these interventions. The findings suggest interventions relating to hospital nurse staffing models may improve some patient outcomes, particularly the addition of specialist nursing and specialist support roles to the nursing workforce. Interventions relating to hospital nurse staffing models may also improve staff-related outcomes, particularly the introduction of primary nursing and self-scheduling. However, these findings should be treated with extreme caution due to the limited evidence available from the research conducted to date.

Promoting the Self-Regulation of Clinical Reasoning Skills in Nursing Students

PubMed Central

Kuiper, R; Pesut, D; Kautz, D

2009-01-01

Aim: The purpose of this paper is to describe the research surrounding the theories and models the authors united to describe the essential components of clinical reasoning in nursing practice education. The research was conducted with nursing students in health care settings through the application of teaching and learning strategies with the Self-Regulated Learning Model (SRL) and the Outcome-Present-State-Test (OPT) Model of Reflective Clinical Reasoning. Standardized nursing languages provided the content and clinical vocabulary for the clinical reasoning task. Materials and Methods: This descriptive study described the application of the OPT model of clinical reasoning, use of nursing language content, and reflective journals based on the SRL model with 66 undergraduate nursing students over an 8 month period of time. The study tested the idea that self-regulation of clinical reasoning skills can be developed using self-regulation theory and the OPT model. Results: This research supports a framework for effective teaching and learning methods to promote and document learner progress in mastering clinical reasoning skills. Self-regulated Learning strategies coupled with the OPT model suggest benefits of self-observation and self-monitoring during clinical reasoning activities, and pinpoints where guidance is needed for the development of cognitive and metacognitive awareness. Recommendations and Conclusions: Thinking and reasoning about the complexities of patient care needs requires attention to the content, processes and outcomes that make a nursing care difference. These principles and concepts are valuable to clinical decision making for nurses globally as they deal with local, regional, national and international health care issues. PMID:19888432

The influences of nursing transformational leadership style on the quality of nurses' working lives in Taiwan: a cross-sectional quantitative study.

PubMed

Lin, Ping-Yi; MacLennan, Sara; Hunt, Nigel; Cox, Tom

2015-01-01

Taiwan's NHI system is one of the most successful health care models for countries around the globe. However, little research has demonstrated the mental health issues associated with nursing transformational leadership style under the NHI system, especially in the quality of nurses' working lives in Taiwan. It is important to know the relationship between transformational leadership style and the mental health of nurses, organisational commitment and job satisfaction. The research aimed to understand the influences of nursing transformational leadership style on the quality of nurses' working lives in Taiwan. The research hypothesis was that transformational leadership styles would have positive influence on the quality of nurses' working lives. This was a cross-sectional quantitative study. Nurses from each type of hospital ownership (private, public and religious) were recruited. Participation was voluntary and signed informed consent was obtained. The inclusion criteria were nurses with at least one year's work experience in the hospitals. Self-administrated questionnaires were used. A total of 807 participants were contacted and 651 questionnaires were fully completed (response rate 80.7 %). A theory driven model was used to test the research hypotheses using structural equation modelling performed with AMOS 16.0. Transformational leadership contributes significantly to supervisor support. Workplace support, particularly from the supervisor, is an important mediator variable that explains the relationship between transformational leadership and job satisfaction. Organisational commitment was the strongest factor relevant to the general health well-being in Taiwanese nurses than job satisfaction. The hypothesized positive relationships between transformational leadership and all variables were supported by the data. Our findings have important consequences for organisational health. Our model demonstrates a complete picture of the work relationships on the quality of nurses' working lives. The results provided information about the subordinates' perceptions of transformational nursing leadership styles and mental health outcomes in different hospital settings, as well as identified organisational factors that could improve the quality of nurses' working lives.

Establishing nurse-led active surveillance for men with localised prostate cancer: development and formative evaluation of a model of care in the ProtecT trial.

PubMed

Wade, Julia; Holding, Peter N; Bonnington, Susan; Rooshenas, Leila; Lane, J Athene; Salter, C Elizabeth; Tilling, Kate; Speakman, Mark J; Brewster, Simon F; Evans, Simon; Neal, David E; Hamdy, Freddie C; Donovan, Jenny L

2015-09-18

To develop a nurse-led, urologist-supported model of care for men managed by active surveillance or active monitoring (AS/AM) for localised prostate cancer and provide a formative evaluation of its acceptability to patients, clinicians and nurses. Nurse-led care, comprising an explicit nurse-led protocol with support from urologists, was developed as part of the AM arm of the Prostate testing for cancer and Treatment (ProtecT) trial. Interviews and questionnaire surveys of clinicians, nurses and patients assessed acceptability. Nurse-led clinics were established in 9 centres in the ProtecT trial and compared with 3 non-ProtecT urology centres elsewhere in UK. Within ProtecT, 22 men receiving AM nurse-led care were interviewed about experiences of care; 11 urologists and 23 research nurses delivering ProtecT trial care completed a questionnaire about its acceptability; 20 men managed in urology clinics elsewhere in the UK were interviewed about models of AS/AM care; 12 urologists and three specialist nurses working in these clinics were also interviewed about management of AS/AM. Nurse-led care was commended by ProtecT trial participants, who valued the flexibility, accessibility and continuity of the service and felt confident about the quality of care. ProtecT consultant urologists and nurses also rated it highly, identifying continuity of care and resource savings as key attributes. Clinicians and patients outside the ProtecT trial believed that nurse-led care could relieve pressure on urology clinics without compromising patient care. The ProtecT AM nurse-led model of care was acceptable to men with localised prostate cancer and clinical specialists in urology. The protocol is available for implementation; we aim to evaluate its impact on routine clinical practice. NCT02044172; ISRCTN20141297. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Establishing nurse-led active surveillance for men with localised prostate cancer: development and formative evaluation of a model of care in the ProtecT trial

PubMed Central

Wade, Julia; Holding, Peter N; Bonnington, Susan; Rooshenas, Leila; Lane, J Athene; Salter, C Elizabeth; Tilling, Kate; Speakman, Mark J; Brewster, Simon F; Evans, Simon; Neal, David E; Hamdy, Freddie C; Donovan, Jenny L

2015-01-01

Objectives To develop a nurse-led, urologist-supported model of care for men managed by active surveillance or active monitoring (AS/AM) for localised prostate cancer and provide a formative evaluation of its acceptability to patients, clinicians and nurses. Nurse-led care, comprising an explicit nurse-led protocol with support from urologists, was developed as part of the AM arm of the Prostate testing for cancer and Treatment (ProtecT) trial. Design Interviews and questionnaire surveys of clinicians, nurses and patients assessed acceptability. Setting Nurse-led clinics were established in 9 centres in the ProtecT trial and compared with 3 non-ProtecT urology centres elsewhere in UK. Participants Within ProtecT, 22 men receiving AM nurse-led care were interviewed about experiences of care; 11 urologists and 23 research nurses delivering ProtecT trial care completed a questionnaire about its acceptability; 20 men managed in urology clinics elsewhere in the UK were interviewed about models of AS/AM care; 12 urologists and three specialist nurses working in these clinics were also interviewed about management of AS/AM. Results Nurse-led care was commended by ProtecT trial participants, who valued the flexibility, accessibility and continuity of the service and felt confident about the quality of care. ProtecT consultant urologists and nurses also rated it highly, identifying continuity of care and resource savings as key attributes. Clinicians and patients outside the ProtecT trial believed that nurse-led care could relieve pressure on urology clinics without compromising patient care. Conclusions The ProtecT AM nurse-led model of care was acceptable to men with localised prostate cancer and clinical specialists in urology. The protocol is available for implementation; we aim to evaluate its impact on routine clinical practice. Trial registration numbers NCT02044172; ISRCTN20141297. PMID:26384727

Nurses' leadership self-efficacy, motivation, and career aspirations.

PubMed

Cziraki, Karen; Read, Emily; Spence Laschinger, Heather K; Wong, Carol

2018-02-05

Purpose This paper aims to test a model examining precursors and outcomes of nurses' leadership self-efficacy, and their aspirations to management positions. Design/methodology/approach A cross-sectional survey of 727 registered nurses across Canada was conducted. Structural equation modelling using Mplus was used to analyse the data. Findings Results supported the hypothesized model: χ 2 (312) = 949.393; CFI = 0.927; TLI = 0.919; RMSEA = 0.053 (0.049-0.057); SRMR 0.044. Skill development opportunities ( ß = 0.20), temporary management roles ( ß = 0.12) and informal mentoring ( ß = 0.11) were significantly related to nurses' leadership self-efficacy, which significantly influenced motivation to lead ( ß = 0.77) and leadership career aspirations ( ß = 0.23). Motivation to lead was significantly related to leadership career aspirations ( ß = 0.50). Practical implications Nurses' leadership self-efficacy is an important determinant of their motivation and intention to pursue a leadership career. Results suggest that nurses' leadership self-efficacy can be influenced by providing opportunities for leadership mastery experiences and mentorship support. Leadership succession planning should include strategies to enhance nurses' leadership self-efficacy and increase front-line nurses' interest in leadership roles. Originality value With an aging nurse leader workforce, it is important to understand factors influencing nurses' leadership aspirations to develop and sustain nursing leadership capacity. This research study makes an important contribution to the nursing literature by showing that nurses' leadership self-efficacy appears to be an important determinant of their motivation to lead and desire to pursue a career as a nurse leader.

Social Support Behaviors and Work Stressors among Nurses: A Comparative Study between Teaching and Non-Teaching Hospitals.

PubMed

Amarneh, Basil Hameed

2017-01-29

The concept of "work stressors" has been well studied. However, in the field of nursing, studies concerning social support behaviors are limited. The aim of this study was to compare nurse work stressors, social support behaviors, and predictors of these variables among nurses in Jordanian teaching and non-teaching hospitals. A convenience sampling technique and a comparative quantitative research design were used in the current study. Two hundred and ninety-one nurses were recruited from five teaching hospitals, and 172 were recruited from eight non-teaching hospitals in Jordan. The Nursing Stress Scale (NSS) and the Inventory of Social Supportive Behaviors (ISSB) were used to collect data. The studied variables differed across hospitals. In some subscales, as well as in some individual items of the scales, nurse work stressors and social support behaviors differed between teaching and non-teaching hospitals. In teaching hospitals, the work shift was the only predictor of nurses' work stressors, whereas the work shift and model of nursing care were predictors of social support behaviors. In non-teaching hospitals, the work shift, level of education, and model of nursing care were predictors of nurse work stressors. Predictors of social support behaviors were marital status, model of nursing, and organizational structure. Regardless of the type of hospital, nurse stressors should be assessed and, once identified, managed by providing various social support behaviors. By turning a work environment into a healthy workplace, researchers and nurse leaders believe that improvements can be realized in recruitment and patient safety and quality.

"Coming to grips with the nursing question": the politics of nursing education reform in 1960s America.

PubMed

Tobbell, Dominique A

2014-01-01

The 1950s and 1960s were decades of change for the American nursing profession. A new generation of nurse educators sought to create greater professional autonomy for the nurse by introducing new models of education that emphasized science-based learning over technical skills and bedside care, and creating new clinical roles for the nurse, based on advanced graduate education. They confronted resistance from an older generation of nurses who feared becoming "second-class citizens" in increasingly academic nursing schools, and from academic health care institutions all too comfortable with the gendered hierarchy on which the traditional model of nursing education and practice was predicated. Using the University of Minnesota and University of California-Los Angeles (UCLA) as case studies, and based on institutional records and more than 40 oral histories with nursing and medical faculty, this article describes the generational conflicts this new cadre of nurse educators confronted within schools of nursing, and the institutional politics they struggled with as they sought to secure greater institutional status for the schools among the universities' other health science units.

Registered nurse job satisfaction and satisfaction with the professional practice model.

PubMed

McGlynn, Karen; Griffin, Mary Quinn; Donahue, Moreen; Fitzpatrick, Joyce J

2012-03-01

This paper describes the initial assessment of job satisfaction and satisfaction with the professional practice environment of registered nurses working on units where a professional practice model was implemented and the relationship between these two variables. The nursing shortage has been linked to overall job satisfaction and specifically to nurses' satisfaction with the professional practice environment. Initiatives to increase retention and recruitment and decrease turnover have been linked to work satisfaction among nurses. A descriptive, cross-sectional design was used with participants (N = 101) from four patient care units; this represented a 55% response rate. The nurses were moderately satisfied with the professional practice environment but had overall low job satisfaction. There was a significant negative relationship between overall work satisfaction and satisfaction with the professional practice environment (P < 0.0001). The introduction of the professional practice model may have raised awareness of the components of job satisfaction that were not being met. Thus, the nurses may have become more knowledgeable about the potential needs in these areas. Nurse managers and leaders must recognize that job satisfaction consists of many dimensions, and each of these dimensions is important to nurse retention. Implementation of a professional practice model may heighten awareness of the missing components within a practice environment and lead to decreased overall satisfaction. A broader understanding of characteristics associated with increased satisfaction may aid in development of organizational change necessary to retain and attract nurses. © 2012 Blackwell Publishing Ltd.

Can We Predict Burnout among Student Nurses? An Exploration of the ICWR-1 Model of Individual Psychological Resilience

PubMed Central

Rees, Clare S.; Heritage, Brody; Osseiran-Moisson, Rebecca; Chamberlain, Diane; Cusack, Lynette; Anderson, Judith; Terry, Victoria; Rogers, Cath; Hemsworth, David; Cross, Wendy; Hegney, Desley G.

2016-01-01

The nature of nursing work is demanding and can be stressful. Previous studies have shown a high rate of burnout among employed nurses. Recently, efforts have been made to understand the role of resilience in determining the psychological adjustment of employed nurses. A theoretical model of resilience was proposed recently that includes several constructs identified in the literature related to resilience and to psychological functioning. As nursing students are the future of the nursing workforce it is important to advance our understanding of the determinants of resilience in this population. Student nurses who had completed their final practicum were invited to participate in an online survey measuring the key constructs of the ICWR-1 model. 422 students from across Australia and Canada completed the survey between July 2014 and July 2015. As well as several key demographics, trait negative affect, mindfulness, self-efficacy, coping, resilience, and burnout were measured. We used structural equation modeling and found support for the major pathways of the model; namely that resilience had a significant influence on the relationship between mindfulness, self-efficacy and coping, and psychological adjustment (burnout scores). Furthermore, as predicted, Neuroticism moderated the relationship between coping and burnout. Results are discussed in terms of potential approaches to supporting nursing students who may be at risk of burnout. PMID:27486419

Reflective practice groups for nurses: a consultation liaison psychiatry nursing initiative: part 1--The model.

PubMed

Dawber, Chris

2013-04-01

In the present study, we outline the evolution of a process-focused reflective practice group (RPG) model for nurses working in clinical settings. The groups were initiated at Redcliffe and Caboolture hospitals by the consultation liaison psychiatry nurse and author. An associated article provides an evaluation of these RPG. The literature review identifies the key themes and theories on which the model is based, and the article outlines the process and practicalities of facilitating RPG in critical care, midwifery, and oncology specialties over a 3-year period. The model proposes that the effectiveness and sustainability of RPG arises from adequate preparation and engagement with prospective participants. Group rules, based on principles of confidentially, supportiveness, and diversity, were collaboratively developed for each group. Facilitation utilized a group-as-a-whole approach to manage process and stimulate reflection. While the purpose of RPG was a reflection on interpersonal aspects of nursing, contextual workplace issues were frequently raised in groups. Acknowledgement and containment of such issues were necessary to maintain clinical focus. The literature highlights facilitator credibility and style as crucial factors in the overall success of RPG, and it is proposed that reflective practice as a process-focused model for groups succeeds when nurse facilitators are trained in group process and receive concurrent supervision. © 2012 The Author; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

Can We Predict Burnout among Student Nurses? An Exploration of the ICWR-1 Model of Individual Psychological Resilience.

PubMed

Rees, Clare S; Heritage, Brody; Osseiran-Moisson, Rebecca; Chamberlain, Diane; Cusack, Lynette; Anderson, Judith; Terry, Victoria; Rogers, Cath; Hemsworth, David; Cross, Wendy; Hegney, Desley G

2016-01-01

The nature of nursing work is demanding and can be stressful. Previous studies have shown a high rate of burnout among employed nurses. Recently, efforts have been made to understand the role of resilience in determining the psychological adjustment of employed nurses. A theoretical model of resilience was proposed recently that includes several constructs identified in the literature related to resilience and to psychological functioning. As nursing students are the future of the nursing workforce it is important to advance our understanding of the determinants of resilience in this population. Student nurses who had completed their final practicum were invited to participate in an online survey measuring the key constructs of the ICWR-1 model. 422 students from across Australia and Canada completed the survey between July 2014 and July 2015. As well as several key demographics, trait negative affect, mindfulness, self-efficacy, coping, resilience, and burnout were measured. We used structural equation modeling and found support for the major pathways of the model; namely that resilience had a significant influence on the relationship between mindfulness, self-efficacy and coping, and psychological adjustment (burnout scores). Furthermore, as predicted, Neuroticism moderated the relationship between coping and burnout. Results are discussed in terms of potential approaches to supporting nursing students who may be at risk of burnout.

Attitudes of nursing staff toward interprofessional in-patient-centered rounding.

PubMed

Sharma, Umesh; Klocke, David

2014-09-01

Historically, medicine and nursing has had a hierarchical and patriarchal relationship, with physicians holding monopoly over knowledge-based practice of medical care, thus impeding interprofessional collaboration. Power gradient prevents nurses from demanding cooperative patient rounding. We surveyed attitudes of nursing staff at our tertiary care community hospital, before and after implementation of a patient-centered interprofessional (hospitalist-nurse) rounding process for patients. There was a substantial improvement in nursing staff satisfaction related to the improved communication (7%-54%, p < 0.001) and rounding (3%-49%, p < 0.001) by hospitalist providers. Patient-centered rounding also positively impacted nursing workflow (5%-56%, p < 0.001), nurses' perceptions of value as a team member (26%-56%, p = 0.018) and their job satisfaction (43%-59%, p = 0.010). Patient-centered rounding positively contributed to transforming the hospitalist-nurse hierarchical model to a team-based collaborative model, thus enhancing interprofessional relationships.

Organizational Effectiveness: Toward an Integrated Model for Schools of Nursing.

ERIC Educational Resources Information Center

Baker, Constance M.; And Others

1997-01-01

Literature review on organizational effectiveness focuses on major assessment models: goal attainment, human relations, open systems, internal processes, culture, and life cycle. A review of studies of nursing school effectiveness is used to present an agenda for nursing research. (SK)

Maintaining the balance: New Zealand secondary school nurses' perceptions of skin infections in young people--a grounded theory.

PubMed

Lambe, Catherine I; Hoare, Karen J

2016-01-01

The objective of this study was to explore the perceptions of New Zealand secondary school nurses regarding skin infections in young people aged 14-18 years. A constructivist grounded theory method was adopted. Ten non-structured interviews were conducted with secondary school nurses working in Auckland, New Zealand, between January and July 2013. Interviews were audiotaped, transcribed and analysed using all tenets of grounded theory that included writing memos, theoretical sampling and the constant comparative method. Analysis revealed the core category Maintaining the balance, which is presented as a grounded theory model. It represents the constant state of balancing the school nurse undergoes in trying to counter the risk to the student. The nurse attempts to tip the balance in favour of action, by reducing barriers to healthcare, providing youth-friendly, affordable and accessible healthcare, and following up until resolution is achieved. The nurse is aware that failing to monitor until resolution can again tip the fulcrum back to inaction, placing the young person at risk again. It is concluded that nurses are knowledgeable about the risks present in the communities they serve and are innovative in the methods they employ to ensure satisfactory outcomes for young people experiencing skin infections. School nursing is an evolving model for delivering primary healthcare to young people in New Zealand. The grounded theory model 'Maintaining the balance' describes a model of care where nursing services are delivered where young people spend time, and the nurse is immersed in the community. This model of care may be transferable to other healthcare situations. © 2015 John Wiley & Sons Ltd.

Professional practice models for nurses in low-income countries: an integrative review.

PubMed

Ng'ang'a, Njoki; Byrne, Mary Woods

2015-01-01

Attention is turning to nurses, who form the greatest proportion of health personnel worldwide, to play a greater role in delivering health services amidst a severe human resources for health crisis and overwhelming disease burden in low-income countries. Nurse leaders in low-income countries must consider essential context for nurses to fulfill their professional obligation to deliver safe and reliable health services. Professional practice models (PPMs) have been proposed as a framework for strategically positioning nurses to impact health outcomes. PPMs comprise 5 elements: professional values, patient care delivery systems, professional relationships, management approach and remuneration. In this paper, we synthesize the existing literature on PPMs for nurses in low-income countries. An integrative review of CINAHL-EBSCO, PubMed and Scopus databases for English language journal articles published after 1990. Search terms included nurses, professionalism, professional practice models, low-income countries, developing countries and relevant Medical Subject Heading Terms (MeSH). Sixty nine articles published between 1993 and 2014 were included in the review. Twenty seven articles examined patient care delivery models, 17 professional relationships, 12 professional values, 11 remuneration and 1 management approach. One article looked at comprehensive PPMs. Adopting comprehensive PPMs or their components can be a strategy to exploit the capacity of nurses and provide a framework for determining the full expression of the nursing role.

Community transformation through culturally competent nursing leadership: application of theory of culture care diversity and universality and tri-dimensional leader effectiveness model.

PubMed

Shapiro, Mina L; Miller, June; White, Kathleen

2006-04-01

Transcultural knowledge and competency have become a critical need for nurses to accommodate the global trends in cultural diversity and health care disparities. Today, nurses are increasingly taking on leadership roles in community settings. This article addresses the application of Leininger's culture care theory with the sunrise model and Hersey and Blanchard's tri-dimensional leader effectiveness model as potential collaborating theories for capacity building and community transformation from a global, transcultural nursing perspective. The two theories, used in collaboration, view the provision of competent leadership as the delivery of effective, culturally congruent nursing care in promoting health and health equity at the community level.

A global service-learning experience for nursing students in Tanzania: a model for collaboration.

PubMed

Kreye, Judy; Oetker-Black, Sharon

2013-01-01

This article addresses a model for creating a short-term global service-learning program. The Global Standards for the Initial Education of Professional Nurses and Midwives guided the development of a collaborative program involving a school of nursing in the Midwestern United States and one in Tanzania. Evaluation of the school of nursing and subsequent collaborative planning led to development and implementation of a 3-week global service-learning experience for nursing students. International academic partnerships, developed in accordance with WHO standards, will enhance educational experiences for nursing students both in the United States and abroad. © 2013 Wiley Periodicals, Inc.

E-documentation as a process management tool for nursing care in hospitals.

PubMed

Rajkovic, Uros; Sustersic, Olga; Rajkovic, Vladislav

2009-01-01

Appropriate documentation plays a key role in process management in nursing care. It includes holistic data management based on patient's data along the clinical path with regard to nursing care. We developed an e-documentation model that follows the process method of work in nursing care. It assesses the patient's status on the basis of Henderson's theoretical model of 14 basic living activities and is aligned with internationally recognized nursing classifications. E-documentation development requires reengineering of existing documentation and facilitates process reengineering. A prototype solution of an e-nursing documentation, already being in testing process at University medical centres in Ljubljana and Maribor, will be described.

Components of nurse innovation: a model from acute care hospitals.

PubMed

Neidlinger, S H; Drews, N; Hukari, D; Bartleson, B J; Abbott, F K; Harper, R; Lyon, J

1992-12-01

Components that promote nurse innovation in acute care hospitals are explicated in the Acute Care Nursing Innovation Model. Grounded in nursing care delivery systems and excellent management-organizations perspectives, nurse executives and 30 nurse "intrapreneurs" from 10 innovative hospitals spanning the United States shared their experiences and insights through semistructured, tape-recorded telephone interviews. Guided by interpretive interactionist strategies, the essential components, characteristics, and interrelationships are conceptualized and described so that others may be successful in their innovative endeavors. Successful innovation is dependent on the fit between and among the components; the better the fit, the more likely the innovation will succeed.

Antecedents and consequences of intra-group conflict among nurses.

PubMed

Almost, Joan; Doran, Diane M; McGillis Hall, Linda; Spence Laschinger, Heather K

2010-11-01

To test a theoretical model linking selected antecedent variables to intra-group conflict among nurses, and subsequently conflict management style, job stress and job satisfaction. A contributing factor to the nursing shortage is job dissatisfaction as a result of conflict among nurses. To develop strategies to reduce conflict, research is needed to understand the causes and outcomes of conflict in nursing work environments. A predictive, non-experimental design was used in a random sample of 277 acute care nurses. Structural equation modelling was used to analyse the hypothesised model. Nurses' core self-evaluations, complexity of care and relationships with managers and nursing colleagues influenced their perceived level of conflict. Conflict management style partially mediated the relationship between conflict and job satisfaction. Job stress had a direct effect on job satisfaction and core self-evaluation had a direct effect on job stress. Conflict and its associated outcomes is a complex process, affected by dispositional, contextual and interpersonal factors. How nurses manage conflict may not prevent the negative effects of conflict, however, learning to manage conflict using collaboration and accommodation may help nurses experience greater job satisfaction. Strategies to manage and reduce conflict include building interactional justice practices and positive interpersonal relationships. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

The link between leadership and safety outcomes in hospitals.

PubMed

Squires, Mae; Tourangeau, Ann; Spence Laschinger, Heather K; Doran, Diane

2010-11-01

To test and refine a model examining relationships among leadership, interactional justice, quality of the nursing work environment, safety climate and patient and nurse safety outcomes. The quality of nursing work environments may pose serious threats to patient and nurse safety. Justice is an important element in work environments that support safety initiatives yet little research has been done that looks at how leader interactional justice influences safety outcomes. A cross-sectional survey was conducted with 600 acute care registered nurses (RNs) to test and refine a model linking interactional justice, the quality of nurse leader-nurse relationships, work environment and safety climate with patient and nurse outcomes. In general the hypothesized model was supported. Resonant leadership and interactional justice influenced the quality of the leader-nurse relationship which in turn affected the quality of the work environment and safety climate. This ultimately was associated with decreased reported medication errors, intentions to leave and emotional exhaustion. Quality relationships based on fairness and empathy play a pivotal role in creating positive safety climates and work environments. To advocate for safe work environments, managers must strive to develop high-quality relationships through just leadership practices. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

Leader empowering behaviours, staff nurse empowerment and work engagement/burnout.

PubMed

Greco, Paula; Laschinger, Heather K Spence; Wong, Carol

2006-12-01

Efforts to improve nursing working conditions are critical to retaining nurses currently in the system and attracting newcomers to the profession (Laschinger et al. 2003b). The nurse leader's empowering behaviours can be pivotal in the way nurses react to their work environment. The purpose of this study was to test a model examining the relationship between nurse leaders' empowerment behaviours, perceptions of staff empowerment, areas of work life and work engagement using Kanter's theory of structural power in organizations. A cross-sectional correlational survey design tested the model in a random sample of 322 staff nurses in acute care hospitals across Ontario. Overall, staff nurses perceived their leaders' behaviours to be somewhat empowering and their work environment to be moderately empowering. Fifty-three percent reported severe levels of burnout. Leader empowering behaviour had an indirect effect on emotional exhaustion (burnout) through structural empowerment and overall fit in the six areas of work life. The final model statistics revealed a good fit (chi(2)=30.4, chi=3, chi=0.96, chi=0.95, chi=0.95). These findings suggest that the Leader's empowering behaviours can enhance person-job fit and prevent burnout. These findings have important implications in the current nursing shortage.

A legacy building model for holistic nursing.

PubMed

Lange, Bernadette; Zahourek, Rothlyn P; Mariano, Carla

2014-06-01

This pilot project was an effort to record the historical roots, development, and legacy of holistic nursing through the visionary spirit of four older American Holistic Nurses Association (AHNA) members. The aim was twofold: (a) to capture the holistic nursing career experiences of elder AHNA members and (b) to begin to create a Legacy Building Model for Holistic Nursing. The narratives will help initiate an ongoing, systematic method for the collection of historical data and serve as a perpetual archive of knowledge and inspiration for present and future holistic nurses. An aesthetic inquiry approach was used to conduct in-depth interviews with four older AHNA members who have made significant contributions to holistic nursing. The narratives provide a rich description of their personal and professional evolution as holistic nurses. The narratives are presented in an aesthetic format of the art forms of snapshot, pastiche, and collage rather than traditional presentations of research findings. A synopsis of the narratives is a dialogue between the three authors and provides insight for how a Legacy Model can guide our future. Considerations for practice, education, and research are discussed based on the words of wisdom from the four older holistic nurses.

Can Nursing Students Practice What Is Preached? Factors Impacting Graduating Nurses' Abilities and Achievement to Apply Evidence-Based Practices.

PubMed

Blackman, Ian R; Giles, Tracey M

2017-04-01

In order to meet national Australian nursing registration requisites, nurses need to meet competency requirements for evidence-based practices (EBPs). A hypothetical model was formulated to explore factors that influenced Australian nursing students' ability and achievement to understand and employ EBPs related to health care provision. A nonexperimental, descriptive survey method was used to identify self-reported EBP efficacy estimates of 375 completing undergraduate nursing students. Factors influencing participants' self-rated EBP abilities were validated by Rasch analysis and then modeled using the partial least squares analysis (PLS Path) program. Graduating nursing students' ability to understand and apply EBPs for clinical improvement can be directly and indirectly predicted by eight variables including their understanding in the analysis, critique and synthesis of clinically based nursing research, their ability to communicate research to others and whether they had actually witnessed other staff delivering EBP. Forty-one percent of the variance in the nursing students' self-rated EBP efficacy scores is able to be accounted for by this model. Previous exposure to EBP studies facilitates participants' confidence with EBP, particularly with concurrent clinical EBP experiences. © 2017 Sigma Theta Tau International.

Thinking like a nurse: a research-based model of clinical judgment in nursing.

PubMed

Tanner, Christine A

2006-06-01

This article reviews the growing body of research on clinical judgment in nursing and presents an alternative model of clinical judgment based on these studies. Based on a review of nearly 200 studies, five conclusions can be drawn: (1) Clinical judgments are more influenced by what nurses bring to the situation than the objective data about the situation at hand; (2) Sound clinical judgment rests to some degree on knowing the patient and his or her typical pattern of responses, as well as an engagement with the patient and his or her concerns; (3) Clinical judgments are influenced by the context in which the situation occurs and the culture of the nursing care unit; (4) Nurses use a variety of reasoning patterns alone or in combination; and (5) Reflection on practice is often triggered by a breakdown in clinical judgment and is critical for the development of clinical knowledge and improvement in clinical reasoning. A model based on these general conclusions emphasizes the role of nurses' background, the context of the situation, and nurses' relationship with their patients as central to what nurses notice and how they interpret findings, respond, and reflect on their response.

Nurse managers and the sandwich support model.

PubMed

Chisengantambu, Christine; Robinson, Guy M; Evans, Nina

2018-03-01

To explore the interplay between the work of nurse managers and the support they receive and provide. Support is the cornerstone of management practices and is pivotal in employees feeling committed to an organisation. Support for nurse managers is integral to effective health sector management; its characteristics merit more attention. The experiences of 15 nurse managers in rural health institutions in South Australia were explored using structured interviews, observation and document review. Effective decision making requires adequate support, which influences the perceptions and performance of nurse managers, creating an environment in which they feel appreciated and valued. An ideal support system is proposed, the "sandwich support model," to promote effective functioning and desirable patient outcomes via support "from above" and "from below." The need to support nurse managers effectively is crucial to how they function. The sandwich support model can improve management practices, more effectively assisting nurse managers. Organisations should revisit and strengthen support processes for nurse managers to maximize efficiencies. This paper contributes to understanding the importance of supporting nurse managers, identifying the processes used and the type of support offered. It highlights challenges and issues affecting support practices within the health sector. © 2017 John Wiley & Sons Ltd.

Excellence and evidence in staffing: a data-driven model for excellence in staffing (2nd edition).

PubMed

Baggett, Margarita; Batcheller, Joyce; Blouin, Ann Scott; Behrens, Elizabeth; Bradley, Carol; Brown, Mary J; Brown, Diane Storer; Bolton, Linda Burnes; Borromeo, Annabelle R; Burtson, Paige; Caramanica, Laura; Caspers, Barbara A; Chow, Marilyn; Christopher, Mary Ann; Clarke, Sean P; Delucas, Christine; Dent, Robert L; Disser, Tony; Eliopoulos, Charlotte; Everett, Linda Q; Garcia, Amy; Glassman, Kimberly; Goodwin, Susan; Haagenson, Deb; Harper, Ellen; Harris, Kathy; Hoying, Cheryl L; Hughes-Rease, Marsha; Kelly, Lesly; Kiger, Anna J; Kobs-Abbott, Ann; Krueger, Janelle; Larson, Jackie; March, Connie; Martin, Deborah Maust; Mazyck, Donna; Meenan, Penny; McGaffigan, Patricia; Myers, Karen K; Nell, Kate; Newcomer, Britta; Cathy, Rick; O'Rourke, Maria; Rosa, Billy; Rose, Robert; Rudisill, Pamela; Sanford, Kathy; Simpson, Roy L; Snowden, Tami; Strickland, Bob; Strohecker, Sharon; Weems, Roger B; Welton, John; Weston, Marla; Valentine, Nancy M; Vento, Laura; Yendro, Susan

2014-01-01

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.

Image: changing how women nurses think about themselves. Literature review.

PubMed

Fletcher, Karen

2007-05-01

This paper presents a review of the public and professional images of nursing in the literature and explores nurse image in the context of Strasen's self-image model. Nurses have struggled since the 1800s with the problem of image. What is known about nurses' image is from the perspective of others: the media, public or other healthcare professionals. Some hints of how nurses see themselves can be found in the literature that suggests how this image could be improved. A literature review for all dates up to 2006 was undertaken using PubMed, Medline and CINAHL databases. Additional references were identified from this literature. Sentinel articles and books were manually searched to identify key concepts. Search words used were nurse, nursing, image and self-image. The findings were examined using the framework of Strasen's self-image model. Public image appears to be intimately intertwined with nurse image. This creates the boundaries that confine and construct the image of nursing. As a profession, nurses do not have a very positive self-image nor do they think highly of themselves. Individually, each nurse has the power to shape the image of nursing. However, nurses must also work together to change the systems that perpetuate negative stereotypes of nurses' image.

Nurse-patient interaction: a resource for hope in cognitively intact nursing home patients.

PubMed

Haugan, Gørill; Moksnes, Unni Karin; Espnes, Geir Arild

2013-09-01

Nursing home care increasingly targets those elderly with the greatest needs in terms of personal daily activities, whereas services supporting spiritual needs such as hope tend to be ignored. Hope is seen to be a dynamic life force vital to well-being. Nursing home patients are frail, vulnerable, and dependent, which may lead to their hope being intimately related to the nurse-patient interaction. The purpose of this study was to investigate the relationship between nurse-patient interaction and hope among cognitively intact nursing home patients. Cross-sectional data were obtained by means of one-on-one interviews; 202 cognitively intact nursinghome patients representing 44 Norwegian nursing homes responded to the Herth Hope Index and the Nurse-Patient Interaction Scale. The hypothesized relationships between a two-factor construct of hope and nurse-patient interaction were assessed by means of structural equation modelling. The structural equation model revealed a good fit to the data, showing significant influence of nurse-patient interaction on nursing home patients' level of hope. Nurse-patient interaction significantly influences hope in cognitively intact nursing home patients. Offering connectedness should be a central and integral aspect of holistic nursing home care. Providing continuing educational programs for caregivers focusing on how to interact with patients in a health-promoting and hopeful manner seems essential.

Patients first! Engaging the hearts and minds of nurses with a patient-centered practice model.

PubMed

Small, Deborah C; Small, Robert M

2011-05-31

Like every healthcare system today, the Cleveland Clinic health system is a combination of medical hospitals, institutes, and services in which the implementation of uniform care methodologies faces significant barriers. The guiding principle of the Cleveland Clinic, 'Patients First,' focuses on the principle of patient- and family-centered care (PFCC) but deliberately lacks details due to the wide scope of care delivered by the organization. The Stanley Shalom Zielony Institute of Nursing Excellence (the Nursing Institute) at the Cleveland Clinic was charged with standardizing nursing practice across a system with 11,000 registered nurses and 800 advanced practice nurses. The challenge involved providing firm direction on delivering PFCC that was appropriate for all clinical disciplines and could be implemented quickly across existing practices and technologies. Successful implementation required full engagement in the concept of PFCC by what the Institute for Healthcare Improvement has termed the 'hearts and minds' of nurses. To achieve these ends, development of a systemwide nursing practice model was initiated. In this article the authors identify the essence of PFCC, consider barriers to PFCC, review their process of developing PFCC, and describe how the Cleveland Clinic health system has implemented a PFCC nursing practice model. In doing so the authors explore how the concept of 'Passion for Nursing' was used to stimulate nurse engagement in PFCC.

Building bridges: an interpretive phenomenological analysis of nurse educators' clinical experience using the T.R.U.S.T. Model for inclusive spiritual care.

PubMed

Scott Barss, Karen

2012-04-30

Educating nurses to provide evidence-based, non-intrusive spiritual care in today's pluralistic context is both daunting and essential. Qualitative research is needed to investigate what helps nurse educators feel more prepared to meet this challenge. This paper presents findings from an interpretive phenomenological analysis of the experience of nurse educators who used the T.R.U.S.T. Model for Inclusive Spiritual Care in their clinical teaching. The T.R.U.S.T. Model is an evidence-based, non-linear resource developed by the author and piloted in the undergraduate nursing program in which she teaches. Three themes are presented: "The T.R.U.S.T. Model as a bridge to spiritual exploration"; "blockades to the bridge"; and "unblocking the bridge". T.R.U.S.T. was found to have a positive influence on nurse educators' comfort and confidence in the teaching of spiritual care. Recommendations for maximizing the model's positive impact are provided, along with "embodied" resources to support holistic teaching and learning about spiritual care.

Nurse learners--do nurse tutors know them?

PubMed

Moule, P

1995-04-01

Research was undertaken to establish the social profile of Project 2000 (Diploma) learners, and to determine when, and with whose influence, learners make decisions to enter nursing. The image of nursing held by the group was sought and nurse tutors perceptions of the group were obtained, using a questionnaire method. Results analysed using statistical measures and content analysis showed that the majority of learners came from middle socio-economic backgrounds, generally decided to enter nursing whilst at school, and were influenced by nursing role models and the media. The learners perceptions and expectations of nursing were influenced by their experiences and showed some differences when compared with tutor responses. The findings from this small study imply the need for the dissemination of accurate and appropriate recruitment information to school personnel and career advisors. Effective marketing which addresses influences of the media and nursing role models should be employed, and finally nurse tutors need to be conversant with course content and learner expectations to facilitate effective recruitment policies and curriculum development.

Nursing home case mix. Patient classification by nursing resource use.

PubMed

Arling, G; Nordquist, R H; Brant, B A; Capitman, J A

1987-01-01

A model is presented for classifying nursing home patients according to nursing resource use. The model is derived from a study of 558 Medicaid nursing home patients in 12 facilities in Virginia. Data were obtained from self-reports of nursing staff for care delivered over a 52-hour period. The measure of care time was validated through concurrent work sampling. Project staff also assessed the patients' health and functional status using a standardized instrument. Using AID analysis patients were classified into six groups that were homogeneous in their use of nursing resources. Patients were initially categorized by presence or absence of conditions requiring specialized care (e.g., nutritional intake problems, quadriplegia, wounds or lesions, coma, and physical rehabilitation potential). For the specialized care category, two groups were formed by presence or absence of a catheter/ostomy. In the nonspecialized care category, four groups were formed by ADL impairment score and assistance required in eating/feeding. Mean resource use for the highest group was nearly four times that of the lowest group. The model accounted for 53% of the variance in nursing resource use.

Effects of a just-in-time educational intervention placed on wound dressing packages: a multicenter randomized controlled trial.

PubMed

Kent, Dea J

2010-01-01

I compared the effects of a just-in-time educational intervention (educational materials for dressing application attached to the manufacturer's dressing package) to traditional wound care education on reported confidence and dressing application in a simulated model. Nurses from a variety of backgrounds were recruited for this study. The nurses possessed all levels of education ranging from licensed practical nurse to master of science in nursing. Both novice and seasoned nurses were included, with no stipulations regarding years of nursing experience. Exclusion criteria included nurses who spent less than 50% of their time in direct patient care and nurses with advanced wound care training and/or certification (CWOCN, CWON). Study settings included community-based acute care facilities, critical access hospitals, long-term care facilities, long-term acute care facilities, and home care agencies. No level 1 trauma centers were included in the study for geographical reasons. Participants were randomly allocated to control or intervention groups. Each participant completed the Kent Dressing Confidence Assessment tool. Subjects were then asked to apply the dressing to a wound model under the observation of either the principal investigator or a trained observer, who scored the accuracy of dressing application according to established criteria. None of the 139 nurses who received traditional dressing packaging were able to apply the dressing to a wound model correctly. In contrast, 88% of the nurses who received the package with the educational guide attached to it were able to apply the dressing to a wound model correctly (χ2 = 107.22, df = 1, P = .0001). Nurses who received the dressing package with the attached educational guide agreed that this feature gave them confidence to correctly apply the dressing (88%), while no nurse agreed that the traditional package gave him or her the confidence to apply the dressing correctly (χ2 = 147.47, df = 4, P < .0001). A just-in-time education intervention improved nurses' confidence when applying an unfamiliar dressing and accuracy of application when applying the dressing to a simulated model compared to traditional wound care education.

Being a male nurse in Portugal during Salazar's dictatorship (1940-70).

PubMed

da Silva, Helena

2013-06-01

In several western countries, nursing was clearly seen as an occupation for women. With the creation of the first nursing schools, the gendering of the profession was accelerated. Male nurses' contribution to the development of the profession was limited in comparison with women's. However, the situation was slightly different in Portugal. This article aims at demonstrating a specific example of the gendering of the nursing profession, by simply copying the western model--considered the most developed--without questioning the consequences or even whether it was adapted to the country that had a different nursing tradition. Because the consequences of this gendering are still felt nowadays, this article opens a reflection on how complex it is to follow a foreign nursing model and on the issues associated with such a copy. Qualitative and quantitative analysis of several historical documents and interviews with several retired nurses contributed to an understanding of how men became nurses and how they worked in Portugal, despite gender discrimination, between 1940 and 1970. With different nursing training and job opportunities, Portuguese male nurses still managed to contribute, even beyond that of female nurses, to the improvement of the nursing profession. © 2012 John Wiley & Sons Ltd.

The nurse manager's work in the hospital environment during the 1990s and 2000s: responsibility, accountability and expertise in nursing leadership.

PubMed

Surakka, Tiina

2008-07-01

The aim of the study was to describe and compare the characteristics of the nurse manager's work in different hospital environments and at different times. Business values and pressures for cost efficiency have become a reality in health care. The data comprised the diaries of 155 nurse managers working in one Finnish health district's hospitals in the 1990s and 2000s. In addition, focus group interviews were used as a data source. The data were subjected to qualitative and quantitative content analysis. The nurse manager's work comprises responsibility activities, accountability activities, and traditional bedside nursing. They also described the recognition of the underlying premises of their work and outcome orientation. Their descriptions of work varied between university and rural hospitals, between psychiatric and somatic nursing and between different wards. The work changed in the 2000s as the nurse manager's role changed from nurse to nurse leader. It appears that nurse managers have succeeded in integrating different leadership models into their daily work pattern. A new leadership model was devised based on an emerging nursing framework. Nurse leaders should assess who can assume leadership positions in health care and on what grounds.

Evaluating Technical Efficiency of Nursing Care Using Data Envelopment Analysis and Multilevel Modeling.

PubMed

Min, Ari; Park, Chang Gi; Scott, Linda D

2016-05-23

Data envelopment analysis (DEA) is an advantageous non-parametric technique for evaluating relative efficiency of performance. This article describes use of DEA to estimate technical efficiency of nursing care and demonstrates the benefits of using multilevel modeling to identify characteristics of efficient facilities in the second stage of analysis. Data were drawn from LTCFocUS.org, a secondary database including nursing home data from the Online Survey Certification and Reporting System and Minimum Data Set. In this example, 2,267 non-hospital-based nursing homes were evaluated. Use of DEA with nurse staffing levels as inputs and quality of care as outputs allowed estimation of the relative technical efficiency of nursing care in these facilities. In the second stage, multilevel modeling was applied to identify organizational factors contributing to technical efficiency. Use of multilevel modeling avoided biased estimation of findings for nested data and provided comprehensive information on differences in technical efficiency among counties and states. © The Author(s) 2016.

Predicting emotional exhaustion among haemodialysis nurses: a structural equation model using Kanter's structural empowerment theory.

PubMed

Hayes, Bronwyn; Douglas, Clint; Bonner, Ann

2014-12-01

To test an explanatory model of the relationships between the nursing work environment, job satisfaction, job stress and emotional exhaustion for haemodialysis nurses, drawing on Kanter's theory of organizational empowerment. Understanding the organizational predictors of burnout (emotional exhaustion) in haemodialysis nurses is critical for staff retention and improving nurse and patient outcomes. Previous research has demonstrated high levels of emotional exhaustion among haemodialysis nurses, yet the relationships between nurses' work environment, job satisfaction, stress and emotional exhaustion in this population are poorly understood. A cross-sectional online survey. 417 nurses working in haemodialysis units completed an online survey between October 2011-April 2012 using validated measures of the work environment, job satisfaction, job stress and emotional exhaustion. Overall, the structural equation model demonstrated adequate fit and we found partial support for the hypothesized relationships. Nurses' work environment had a direct positive effect on job satisfaction, explaining 88% of the variance. Greater job satisfaction, in turn, predicted lower job stress, explaining 82% of the variance. Job satisfaction also had an indirect effect on emotional exhaustion by mitigating job stress. However, job satisfaction did not have a direct effect on emotional exhaustion. The work environment of haemodialysis nurses is pivotal to the development of job satisfaction. Nurses' job satisfaction also predicts their level of job stress and emotional exhaustion. Our findings suggest staff retention can be improved by creating empowering work environments that promote job satisfaction among haemodialysis nurses. © 2014 John Wiley & Sons Ltd.

Toward a mediation model for nurses' well-being and psychological distress effects of quality of leadership and social support at work.

PubMed

Van der Heijden, Beatrice I J M; Mulder, Regina H; König, Christoph; Anselmann, Veronika

2017-04-01

Given the lack of active nurses in industrialized countries throughout the world, in combination with demographic changes, it is of utmost importance to protect nurses' well-being and to prevent psychological distress, because of their strong association with premature occupational leave. The aim of this study was to investigate the effects of quality of leadership and social support at work on well-being and psychological distress of nurses and to determine whether nurses' overcommitment mediates the relationship between the abovementioned determinants and the outcomes. A cross-sectional survey design was used to gather our data. This study utilized part of the database of the Nurses' Early Exit Study. A total of 34,771 nurses (covering all nurse qualifications) working in hospitals, nursing homes, and home-care institutions in 8 European countries filled out a questionnaire (response rate = 51.4%). For all model variables (job satisfaction, satisfaction with salary, positive affectivity, personal burnout, negative affectivity, quality of leadership, social support from immediate supervisor, social support from near colleagues, and overcommitment), psychometrically sound, that is, valid and reliable measures were used. Outcomes from testing a structural equation mediation model indicated that, respectively, positive and negative influences of leadership quality and social support from supervisor and colleagues on nurses' well-being and psychological distress are partially mediated, that is, reduced, by nurses' overcommitment. Social work environment is highly important in relation to nurses' well-being and psychological distress.

The context & clinical evidence for common nursing practices during labor.

PubMed

Simpson, Kathleen Rice

2005-01-01

The purpose of this article is to review the context and current evidence for common nursing care practices during labor and birth. Although many nursing interventions during labor and birth are based on physician orders, there are a number of care processes that are mainly within the realm of nursing practice. In many cases, particularly in community hospitals, routine physician orders for intrapartum care provide wide latitude for nurses in how they ultimately carry out those orders. An important consideration of common nursing practices during labor is the context or practice model in which those practices occur. Nursing practice is not the same in all clinical environments. Intrapartum nursing practice consists of an assortment of different roles depending on the circumstances, hospital setting, and context in which it takes place. A variety of intrapartum nursing practice models have evolved as a result and in response to the range of sizes, locations, and provider practice styles found in hospitals providing obstetric services. A summary of intrapartum nursing models is presented. The evidence is reviewed for the three most common clinical practices for which nurses have primary responsibility in most settings and that comprise the majority of their time in caring for women during labor: (1) maternal-fetal assessment, (2) management of oxytocin infusions, and (3) second-stage care. Evidence exists for these nursing interventions that can be used to promote maternal-fetal well-being, minimize risk, and enhance patient safety.

Mitigating the impact of hospital restructuring on nurses: the responsibility of emotionally intelligent leadership.

PubMed

Cummings, Greta; Hayduk, Leslie; Estabrooks, Carole

2005-01-01

A decade of North American hospital restructuring in the 1990s resulted in the layoff of thousands of nurses, leading to documented negative consequences for both nurses and patients. Nurses who remained employed experienced significant negative physical and emotional health, decreased job satisfaction, and decreased opportunity to provide quality care. To develop a theoretical model of the impact of hospital restructuring on nurses and determine the extent to which emotionally intelligent nursing leadership mitigated any of these impacts. The sample was drawn from all registered nurses in acute care hospitals in Alberta, Canada, accessed through their professional licensing body (N = 6,526 nurses; 53% response rate). Thirteen leadership competencies (founded on emotional intelligence) were used to create 7 data sets reflecting different leadership styles: 4 resonant, 2 dissonant, and 1 mixed. The theoretical model was then estimated 7 times using structural equation modeling and the seven data sets. Nurses working for resonant leaders reported significantly less emotional exhaustion and psychosomatic symptoms, better emotional health, greater workgroup collaboration and teamwork with physicians, more satisfaction with supervision and their jobs, and fewer unmet patient care needs than did nurses working for dissonant leaders. Resonant leadership styles mitigated the impact of hospital restructuring on nurses, while dissonant leadership intensified this impact. These findings have implications for future hospital restructuring, accountabilities of hospital leaders, the achievement of positive patient outcomes, the development of practice environments, the emotional health and well-being of nurses, and ultimately patient care outcomes.

A Curriculum Model for Graduate Specialization in Nursing Informatics

PubMed Central

Romano, C.A.; Heller, B.R.

1988-01-01

The purpose of this paper is to describe the emerging role of the nurse as Information Systems Specialist and to delineate a prototype educational curriculum in Nursing Informatics that is designed to prepare nurses for this role. The major duties, knowledge required, and resulting interactions related to the role are discussed. Program objectives, admission requirements, and a description of the major areas of coursework are also outlined. The impact of this model program in strengthening the organization and management of nursing services in the health care system is also emphasized.

Beyond the tradition: test of an integrative conceptual model on nurse turnover.

PubMed

Battistelli, A; Portoghese, I; Galletta, M; Pohl, S

2013-03-01

This paper aimed to extend research on nurse turnover by developing and testing a theoretical model of turnover intention that includes two emergent key off-the-job constructs, work-family conflict (WFC) and community embeddedness (CE). Nurse turnover is considered one of the most significant issues in health care. There is a considerable body of knowledge that has focused on the study of the on-the-job factors of nurse turnover, showing the important role of job attitudes. Recently, WFC and job embeddedness (JE) have been identified as variables that could help explain levels of nurse turnover. Using structural equation modelling from a cross-sectional survey, the relationships between the variables were explored in a sample of 440 nurses from an Italian public hospital. The questionnaire measures demographic data and psychosocial factors such as job satisfaction, organizational commitment, WFC, CE and turnover intentions. The findings supported the importance of non-work dimensions in turnover models. The results suggest that when studying turnover phenomena in health organizations, the extra-work domains (WFC and JE) can contribute to a decrease in the intention to leave, in addition to the more typically emphasized attitude dimension. © 2012 The Authors. International Nursing Review © 2012 International Council of Nurses.

Nurse Training Act of 1975: Second Report to the Congress, March 15, 1979 (Revised).

ERIC Educational Resources Information Center

Health Resources Administration (DHEW/PHS), Bethesda, MD. Bureau of Health Manpower.

In compliance with section 951 of Public Law 94-63, this second annual report presents and anlayzes information on the supply and distribution of and requirements for nurses. Chapter 1 presents three models on the requirements for nursing personnel in the nation: The Vector Model (impact of health system changes), Pugh Roberts Model (the system…

Comparative Analysis of Four Manpower Nursing Requirements Models. Health Manpower References. [Nurse Planning Information Series, No. 6].

ERIC Educational Resources Information Center

Deane, Robert T.; Ro, Kong-Kyun

The analysis and description of four manpower nursing requirements models-- the Pugh-Roberts, the Vector, the Community Systems Foundation (CSF), and the Western Interstate Commission of Higher Education (WICHE)--are presented in this report. The introduction provides an overview of the project which was designed to analyze these different models.…

Evolution of a Nursing Model for Identifying Client Needs in a Disaster Shelter: A Case Study with the American Red Cross.

PubMed

Springer, Janice; Casey-Lockyer, Mary

2016-12-01

From the time of Clara Barton, Red Cross nursing has had a key role in the care and support of persons affected by disasters in the United States. Hurricane Katrina and other events brought to light the need for a shelter model that was inclusive of the whole community, including persons with disabilities, at-risk and vulnerable populations, and children. From an intake process to a nursing model for assessment, an evidence-guided process informed a systematic approach for a registered nurse-led model of care. Copyright © 2016 Elsevier Inc. All rights reserved.

Analysis of academic programs: comparing nursing and other university majors in the application of a quality, potential and cost model.

PubMed

Booker, Kathy; Hilgenberg, Cheryl

2010-01-01

Nursing is often considered expensive in the cost analysis of academic programs. Yet nursing programs have the power to attract many students, and the national nursing shortage has resulted in a high demand for nurses. Methods to systematically assess programs across an entire university academic division are often dissimilar in technique and outcome. At a small, private, Midwestern university, a model for comprehensive program assessment, titled the Quality, Potential and Cost (QPC) model, was developed and applied to each major offered at the university through the collaborative effort of directors, chairs, deans, and the vice president for academic affairs. The QPC model provides a means of equalizing data so that single measures (such as cost) are not viewed in isolation. It also provides a common language to ensure that all academic leaders at an institution apply consistent methods for assessment of individual programs. The application of the QPC model allowed for consistent, fair assessments and the ability to allocate resources to programs according to strategic direction. In this article, the application of the QPC model to School of Nursing majors and other selected university majors will be illustrated. Copyright 2010 Elsevier Inc. All rights reserved.

Gender-Based Wage Differentials in a Predominantly Female Profession: Observations from Nursing

ERIC Educational Resources Information Center

Jones, Cheryl, Bland; Gates, Michael

2004-01-01

Despite numerous studies examining nursing wages, very little attention has focused on nursing wage differentials. We build on previous research by modeling nursing wages and examining male-female wage differences within the context of the current nursing shortage. Our results show that male nurses do earn a wage premium, largely explained by…

Health Care Reform: How Will It Affect Nursing?--Nursing Education.

ERIC Educational Resources Information Center

Zalon, Margarete Lieb

Nursing educators have the opportunity to advance nursing's agenda for health care reform to ensure effective health care for all members of society. They have a key role in fostering the political involvement of student nurses and nurses who have returned to school for baccalaureate or graduate education. Role modeling is critical to increasing…

Strengthening Preceptors' Competency in Thai Clinical Nursing

ERIC Educational Resources Information Center

Mingpun, Renu; Srisa-ard, Boonchom; Jumpamool, Apinya

2015-01-01

The problem of lack of nurses can be solved by employing student nurses. Obviously, nurse instructors and preceptors have to work extremely hard to train student nurses to meet the standard of nursing. The preceptorship model is yet to be explored as to what it means to have an effective program or the requisite skills to be an effective…

Research environments that promote integrity.

PubMed

Jeffers, Brenda Recchia; Whittemore, Robin

2005-01-01

The body of empirical knowledge about research integrity and the factors that promote research integrity in nursing research environments remains small. To propose an internal control model as an innovative framework for the design and structure of nursing research environments that promote integrity. An internal control model is adapted to illustrate its use for conceptualizing and designing research environments that promote integrity. The internal control model integrates both the organizational elements necessary to promote research integrity and the processes needed to assess research environments. The model provides five interrelated process components within which any number of research integrity variables and processes may be used and studied: internal control environment, risk assessment, internal control activities, monitoring, and information and communication. The components of the proposed research integrity internal control model proposed comprise an integrated conceptualization of the processes that provide reasonable assurance that research integrity will be promoted within the nursing research environment. Schools of nursing can use the model to design, implement, and evaluate systems that promote research integrity. The model process components need further exploration to substantiate the use of the model in nursing research environments.

Conceptualising a model to guide nursing and midwifery in the community guided by an evidence review.

PubMed

Leahy-Warren, Patricia; Mulcahy, Helen; Benefield, Lazelle; Bradley, Colin; Coffey, Alice; Donohoe, Ann; Fitzgerald, Serena; Frawley, Tim; Healy, Elizabeth; Healy, Maria; Kelly, Marcella; McCarthy, Bernard; McLoughlin, Kathleen; Meagher, Catherine; O'Connell, Rhona; O'Mahony, Aoife; Paul, Gillian; Phelan, Amanda; Stokes, Diarmuid; Walsh, Jessica; Savage, Eileen

2017-01-01

Successful models of nursing and midwifery in the community delivering healthcare throughout the lifespan and across a health and illness continuum are limited, yet necessary to guide global health services. Primary and community health services are the typical points of access for most people and the location where most care is delivered. The scope of primary healthcare is complex and multifaceted and therefore requires a practice framework with sound conceptual and theoretical underpinnings. The aim of this paper is to present a conceptual model informed by a scoping evidence review of the literature. A scoping evidence review of the literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Databases included CINAHL, MEDLINE, PsycINFO and SocINDEX using the EBSCO platform and the Cochrane Library using the keywords: model, nursing, midwifery, community, primary care. Grey literature for selected countries was searched using the Google 'advanced' search interface. Data extraction and quality appraisal for both empirical and grey literature were conducted independently by two reviewers. From 127 empirical and 24 non-empirical papers, data extraction parameters, in addition to the usual methodological features, included: the nature of nursing and midwifery; the population group; interventions and main outcomes; components of effective nursing and midwifery outcomes. The evidence was categorised into six broad areas and subsequently synthesised into four themes. These were not mutually exclusive: (1) Integrated and Collaborative Care; (2) Organisation and Delivery of Nursing and Midwifery Care in the Community; (3) Adjuncts to Nursing Care and (4) Overarching Conceptual Model. It is the latter theme that is the focus of this paper. In essence, the model depicts a person/client on a lifespan and preventative-curative trajectory. The health related needs of the client, commensurate with their point position, relative to both trajectories, determines the nurse or midwife intervention. Consequently, it is this need, that determines the discipline or speciality of the nurse or midwife with the most appropriate competencies. Use of a conceptual model of nursing and midwifery to inform decision-making in primary/community based care ensures clinical outcomes are meaningful and more sustainable. Operationalising this model for nursing and midwifery in the community demands strong leadership and effective clinical governance.

A comprehensive model for predicting burnout in Korean nurses.

PubMed

Lee, Haejung; Song, Rhayun; Cho, Young Suk; Lee, Gil Za; Daly, Barbara

2003-12-01

Although burnout among nurses has been studied in a great deal, this work has not included Korean nurses. Furthermore, the role of personal resources such as empathy and empowerment in predicting the variance in burnout has never been examined. The purpose of this study was to understand the phenomenon of burnout among Korean nurses. A comprehensive model of burnout was examined to identify significant predictors among individual characteristics, job stress and personal resource, with the intention of providing a basis for individual and organizational interventions to reduce levels of burnout experienced by Korean nurses. A cross-sectional correlational design was used. A sample of 178 nurses from general hospitals in southern Korea was surveyed from May 1999 to March 2000. The data were collected using paper and pencil self-rating questionnaires and analysed using descriptive statistics, Pearson correlations, and hierarchical multiple regression. Korean nurses reported higher levels of burnout than nurses in western countries such as Germany, Canada, the United Kingdom and the United States of America. Nurses who experienced higher job stress, showed lower cognitive empathy and empowerment, and worked in night shifts at tertiary hospitals were more likely to experience burnout. Identifying a comprehensive model of burnout among Korean nurses is an essential step to develop effective managerial strategies to reduce the problem. Suggestions to reduce the level of burnout include enhancing nurses' cognitive empathy and perceived power, providing clear job descriptions and work expectations, and exploring nurses' shift preferences, especially at tertiary hospitals. In future research we recommend recruiting nurses from broader geographical areas using random selection in order to increase the generalizability of the findings.

Patient satisfaction with nursing care: a concept analysis within a nursing framework.

PubMed

Wagner, Debra; Bear, Mary

2009-03-01

This paper is a report of a concept analysis of patient satisfaction with nursing care. Patient satisfaction is an important indicator of quality of care, and healthcare facilities are interested in maintaining high levels of satisfaction in order to stay competitive in the healthcare market. Nursing care has a prominent role in patient satisfaction. Using a nursing model to measure patient satisfaction with nursing care helps define and clarify this concept. Rodgers' evolutionary method of concept analysis provided the framework for this analysis. Data were retrieved from the Cumulative Index of Nursing and Allied Health Literature and MEDLINE databases and the ABI/INFORM global business database. The literature search used the keywords patient satisfaction, nursing care and hospital. The sample included 44 papers published in English, between 1998 and 2007. Cox's Interaction Model of Client Health Behavior was used to analyse the concept of patient satisfaction with nursing care. The attributes leading to the health outcome of patient satisfaction with nursing care were categorized as affective support, health information, decisional control and professional/technical competencies. Antecedents embodied the uniqueness of the patient in terms of demographic data, social influence, previous healthcare experiences, environmental resources, intrinsic motivation, cognitive appraisal and affective response. Consequences of achieving patient satisfaction with nursing care included greater market share of healthcare finances, compliance with healthcare regimens and better health outcomes. The meaning of patient satisfaction continues to evolve. Using a nursing model to measure patient satisfaction with nursing care delineates the concept from other measures of patient satisfaction.

Determinants of hospital nurse intention to remain employed: broadening our understanding

PubMed Central

Tourangeau, Ann E; Cummings, Greta; Cranley, Lisa A; Ferron, Era Mae; Harvey, Sarah

2010-01-01

Title Determinants of hospital nurse intention to remain employed: broadening ourunderstanding. Aim This paper is a report of a study to identify nurse reported determinants of intention to remain employed and to develop a model explaining determinants of hospital nurse intention to remain employed. Background A worsening shortage of nurses globally suggests that efforts must be made to promote retention of nurses. However, effective retention promotion strategies depend on understanding the factors influencing nurse retention. Methods A descriptive study using focus group methodology was implemented. Thirteen focus groups including 78 nurses were carried out in two Canadian provinces in 2007. Thematic analysis strategies were incorporated to analyse the data. Findings Eight thematic categories reflecting factors nurses described as influencing their intentions to remain employed emerged from focus groups: (1) relationships with co-workers, (2) condition of the work environment, (3) relationship with and support from one’s manager, (4) work rewards, (5) organizational support and practices, (6) physical and psychological responses to work, (7) patient relationships and other job content, and (8) external factors. A model of determinants of hospital nurse intention to remain employed is hypothesized. Conclusion Findings were both similar to and different from previous research. The overriding concept of job satisfaction was not found. Rather, nurse assessments of satisfaction within eight thematic categories were found to influence intentions to remain employed. Further testing of the hypothesized model is required to determine its global utility. Understanding determinants of intention to remain employed can lead to development of strategies that strengthen nurse retention. Incorporation of this knowledge in nurse education programmes is essential. PMID:20423434

Social Support Behaviors and Work Stressors among Nurses: A Comparative Study between Teaching and Non-Teaching Hospitals

PubMed Central

Amarneh, Basil Hameed

2017-01-01

Purpose: The concept of “work stressors” has been well studied. However, in the field of nursing, studies concerning social support behaviors are limited. The aim of this study was to compare nurse work stressors, social support behaviors, and predictors of these variables among nurses in Jordanian teaching and non-teaching hospitals. Design: A convenience sampling technique and a comparative quantitative research design were used in the current study. Two hundred and ninety-one nurses were recruited from five teaching hospitals, and 172 were recruited from eight non-teaching hospitals in Jordan. Methods: The Nursing Stress Scale (NSS) and the Inventory of Social Supportive Behaviors (ISSB) were used to collect data. Results: The studied variables differed across hospitals. In some subscales, as well as in some individual items of the scales, nurse work stressors and social support behaviors differed between teaching and non-teaching hospitals. In teaching hospitals, the work shift was the only predictor of nurses’ work stressors, whereas the work shift and model of nursing care were predictors of social support behaviors. In non-teaching hospitals, the work shift, level of education, and model of nursing care were predictors of nurse work stressors. Predictors of social support behaviors were marital status, model of nursing, and organizational structure. Conclusions: Regardless of the type of hospital, nurse stressors should be assessed and, once identified, managed by providing various social support behaviors. Clinical relevance: By turning a work environment into a healthy workplace, researchers and nurse leaders believe that improvements can be realized in recruitment and patient safety and quality. PMID:28146045

Psychological factors related to nurses' intentions to initiate an antipsychotic or psychosocial intervention with nursing home residents.

PubMed

Ludwin, Brian M; Meeks, Suzanne

2018-05-03

This study examined the validity of a psychological model for understanding nursing home providers' treatment choices when managing challenging dementia-related behaviors. Ninety-nine nurses from 26 long-term care facilities responded to a case study with their intentions to initiate an antipsychotic or psychosocial intervention and completed self-report measures of their attitudes, descriptive norms, self-efficacy, and outcome expectancies. The multi-level modeling results demonstrated that nurses with more positive outcome expectancies for the effect of an antipsychotic on resident behavior, and those with more positive attitudes towards antipsychotics, had greater intentions to initiate an antipsychotic. Intentions to initiate a psychosocial intervention were greater when nurses perceived a lower prevalence of antipsychotics and in facilities with nurses who collectively had higher self-efficacy to implement such interventions. The findings offer partial support for the proposed model and possible intervention targets to improve psychosocial intervention use and antipsychotic prescribing. Published by Elsevier Inc.

Nurse turnover: the mediating role of burnout.

PubMed

Leiter, Michael P; Maslach, Christina

2009-04-01

This study tested whether the mediation model of burnout could predict nurses' turnover intentions. A better understanding of what factors support a commitment to a nursing career could inform both policies and workplace practices. The mediation model of burnout provides a way of linking the quality of a nurse's worklife to various outcomes, such as turnover. Data on areas of worklife, burnout, and turnover intentions were collected by surveying 667 Canadian nurses in the Atlantic Provinces. The findings supported the mediation model of burnout, in which areas of worklife predicted burnout, which in turn predicted turnover intentions. Cynicism was the key burnout dimension for turnover, and the most critical areas of worklife were value conflicts and inadequate rewards. The results of this study provide some new insights into how the intention of nurses to leave their job is related to particular aspects of their worklife and to burnout. These results suggest what may be the most appropriate areas to target for interventions to reduce the risk of nurses exiting early from their chosen career.

An Innovative Academic Progression in Nursing Model in New York State.

PubMed

Markowitz, Marianne; Bastable, Susan B

2017-05-01

The Dual Degree Partnership in Nursing (DDPN) is a unique articulation model created in 2005 between two nursing programs that provides a seamless pathway for students to earn both an associate's degree and a bachelor's degree in nursing while benefiting from the strengths of each program. Archival data has been systematically collected for a decade on admission, progression, retention, satisfaction, graduation, and NCLEX-RN pass rates to measure the reliability, validity, and integrity of this DDPN model for nursing education. The findings demonstrate consistent performance and positive outcomes on all factors measured, which have been benchmarked against available state and national results. This innovative approach to academic progression in nursing is replicable and serves as a prototype to educate more nurses at the baccalaureate level, which directly contributes to the Institute of Medicine's goal of 80% of RNs having a minimum of a bachelor's degree by 2020. [J Nurs Educ. 2017;56(5):266-273.]. Copyright 2017, SLACK Incorporated.

Professional responsibility and decision-making in the context of a disease-focused model of nursing care: The difficulties experienced by Spanish nurses.

PubMed

Rodrigo, Olga; Caïs, Jordi; Monforte-Royo, Cristina

2017-10-01

When, in 1977, nurse education in Spain was transferred to universities a more patient-centred, the Anglo-American philosophy of care was introduced into a context in which nurses had traditionally prioritised their technical skills. This paper examines the characteristics of the nurse's professional role in Spain, where the model of nursing practice has historically placed them in a position akin to that of physician assistants. The study design was qualitative and used the method of analytic induction. Participants were selected by means of theoretical sampling and then underwent in-depth interviews. The resulting material was analysed using an approach based on the principles of grounded theory. Strategies were applied to ensure the credibility, transferability, dependability and confirmability of the findings. The main conclusion is that nurses in Spain continue to work within a disease-focused model of care, making it difficult for them to take responsibility for decision-making. © 2017 John Wiley & Sons Ltd.

Nurses who work outside nursing.

PubMed

Duffield, Christine; Pallas, Linda O'Brien; Aitken, Leanne M

2004-09-01

The desire to care for people, a family history of professional health care work, and security in career choice are documented reasons for entering nursing. Reasons for leaving include workload, unsafe work environments and harassment. The relationship between these factors and the time nurses spend in the profession has not been explored. This paper reports a study with people who have left nursing, to investigate why they became a nurse, how long they stayed in nursing, and their reasons for leaving. A questionnaire was mailed to Registered Nurses currently working outside nursing, seeking respondents' reasons for entering and leaving nursing, and perceptions of the skills gained from nursing and the ease of adjustment to working in a non-nursing environment. Data analysis included descriptive statistics, exploratory and confirmatory factor analysis, correlational analysis and linear and multiple regression analysis. A model incorporating the factors 'altruistic reasons', 'default choice' and 'stepping stone' explained 36.2% of the variance in reasons for becoming a nurse. A model incorporating the factors 'legal and employer', 'external values and beliefs about nursing', 'professional practice', 'work life/home life' and 'contract requirements' explained 55.4% of the variance in reasons for leaving nursing. Forty-eight per cent of the variance in tenure in nursing practice was explained through personal characteristics of nurses (36%), reasons for becoming a nurse (7%) and reasons for leaving (6%). The reasons why nurses entered or left the profession were varied and complex. While personal characteristics accounted for a large component of tenure in nursing, those managing the nursing workforce should consider professional practice issues and the balance between work life and home life.

Improved nurse job satisfaction and job retention with the transition from a "mandatory consultation" model to a "semiclosed" surgical intensive care unit: a 1-year prospective evaluation.

PubMed

Haut, Elliott R; Sicoutris, Corinna P; Meredith, Denise M; Sonnad, Seema S; Reilly, Patrick M; Schwab, C William; Hanson, C William; Gracias, Vicente H

2006-02-01

The change from a "mandatory consultation" to a "semiclosed" surgical intensive care unit (SICU) model will impact nurses considerably. We hypothesize that nurse job satisfaction, job turnover rates, and hospital costs for temporary agency nurses will improve and these improvements will be more dramatic in SICU sections with greater involvement of a dedicated surgical critical care service (SCCS). Prospective longitudinal survey. Tertiary-care university hospital. SICU staff nurses. Change from mandatory consultation to semiclosed SICU. We surveyed SICU nurses during the year-long transition to a semiclosed SICU service (five time points, 3-month intervals). The first four surveys included ten questions on nurse job satisfaction. The final survey included two additional questions. All questions were on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree). Nurse job turnover rates and money spent on agency nurses were compared over time; 503 of a possible 914 surveys were completed (55% overall return rate). Nurse job satisfaction scores significantly improved over time for all questions (p < .05). Hospital spending on agency nurses decreased significantly (p = .0098). The yearly nurse job turnover rate dropped from 25% to 16% (p = .15). The scores for both year-end statements ("I am more satisfied with my job now than 1 year ago" and "The SCCS management of all orders has improved my job satisfaction") were significantly higher in sections with greater SCCS involvement (p = .0070 and p < .0001). Nurse job satisfaction improved significantly with the transition to a semiclosed SICU. This higher satisfaction was associated with a significant decrease in spending on temporary agency nurses and a trend toward increased staff nurse job retention. SICU sections with greater SCCS involvement had more dramatic improvements. This semiclosed SICU model may help retain SICU nurses in a competitive job market in which experienced nurses are in short supply.

Nursing resources and responsibilities according to hospital organizational model for management of inflammatory bowel disease in Spain.

PubMed

Marín, Laura; Torrejón, Antonio; Oltra, Lorena; Seoane, Montserrat; Hernández-Sampelayo, Paloma; Vera, María Isabel; Casellas, Francesc; Alfaro, Noelia; Lázaro, Pablo; García-Sánchez, Valle

2011-06-01

Nurses play an important role in the multidisciplinary management of inflammatory bowel disease (IBD), but little is known about this role and the associated resources. To improve knowledge of resource availability for health care activities and the different organizational models in managing IBD in Spain. Cross-sectional study with data obtained by questionnaire directed at Spanish Gastroenterology Services (GS). Five GS models were identified according to whether they have: no specific service for IBD management (Model A); IBD outpatient office for physician consultations (Model B); general outpatient office for nurse consultations (Model C); both, Model B and Model C (Model D); and IBD Unit (Model E) when the hospital has a Comprehensive Care Unit for IBD with telephone helpline, computer, including a Model B. Available resources and activities performed were compared according to GS model (chi-square test and test for linear trend). Responses were received from 107 GS: 33 Model A (31%), 38 Model B (36%), 4 Model C (4%), 16 Model D (15%) and 16 Model E (15%). The model in which nurses have the most resources and responsibilities is the Model E. The more complete the organizational model, the more frequent the availability of nursing resources (educational material, databases, office, and specialized software) and responsibilities (management of walk-in appointments, provision of emotional support, health education, follow-up of drug treatment and treatment adherence) (p<0.05). Nurses have more resources and responsibilities the more complete is the organizational model for IBD management. Development of these areas may improve patient outcomes. Copyright © 2011 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

Social media use profile, social skills, and nurse-patient interaction among Registered Nurses in tertiary hospitals: A structural equation model analysis.

PubMed

Mariano, Micah Celine O; Maniego, John Christian M; Manila, Hariette Lou Marie D; Mapanoo, Ram Cedrick C; Maquiran, Kerwin Miguel A; Macindo, John Rey B; Tejero, Lourdes Marie S; Torres, Gian Carlo S

2018-04-01

Social media has become increasingly important over the past decades and has been integrated in various environments, including the healthcare setting. Yet, the influence of social media use on the social skills and nurse-patient interaction of nurses is an area in nursing that requires further studies. This study determined the interrelationships among social media use profile, social skills, and nurse-patient interaction of Registered Nurses in tertiary hospitals. Employing structural equation modeling, a descriptive-correlational study was conducted among 212 consecutively-selected nurses from two tertiary hospitals. Consenting respondents completed a two-part survey composed of the respondent profile sheet and the Social Skills Inventory. The respondent profile sheet assessed demographic profile and social media use profile in terms of the mode, frequency, and duration of utilization. Three trained team members observed each nurse-patient dyad and completed the Nurse-Patient Bonding Instrument. A good fit model illustrated the negative effects of frequent social media use to patient openness (β = -0.18, p < 0.05) and engagement (β = -0.11, p ≤ 0.05). Longer use of social media on a daily basis, however, positively affected both dimensions of social skills. Accessing social media platforms using non-handheld devices showed the most influential positive effects to social skills and nurse-patient interaction. Additionally, although verbal social skills positively affected most dimensions of nurse-patient interaction, non-verbal social skills negatively influenced patient engagement (β = -0.19, p = 0.019) and nurse openness (β = -0.38, p ≤ 0.05). The structural model illustrates the effects of using social media on the social skills and nurse-patient interaction of nurses and emphasizes the need for implementing institutional policies on the judicious use and application of social media in the workplace. Further, social skills development programs geared toward having a balanced social skill must be implemented. Copyright © 2018 Elsevier Ltd. All rights reserved.

Informing Leadership Models: Nursing and Organizational Characteristics of Neonatal Intensive Care Units in Freestanding Children's Hospitals.

PubMed

Toole, Cheryl A; DeGrazia, Michele; Connor, Jean Anne; Gauvreau, Kimberlee; Kuzdeba, Hillary Bishop; Hickey, Patricia A

Neonatal intensive care units (NICUs) located in freestanding children's hospitals may exhibit significant variation in nursing and organizational characteristics, which can serve as opportunities for collaboration to understand optimal staffing models and linkages to patient outcomes. Adopting methods used by Hickey et al in pediatric cardiovascular critical care, the purpose of this study was to provide a foundational description of the nursing and organizational characteristics for NICUs located in freestanding children's hospitals in the United States. Clinical nurse leaders in NICUs located in freestanding children's hospitals were invited to participate in an electronic cross-sectional survey. Descriptive analyses were used to summarize nursing and organizational characteristics. The response rate was 30% (13/43), with 69.2% of NICUs classified as level III/IV and 30.8% classified as level II/III. Licensed bed capacity varied significantly (range, 24-167), as did the proportion of full-time equivalent nurses (range, 71.78-252.3). Approximately three-quarters of staff nurses held baccalaureate degrees or higher. A quarter of nurses had 16 or more years (26.3%) of experience, and 36.9% of nurses had 11 or more years of nursing experience. Nearly one-third (29.2%) had 5 or less years of total nursing experience. Few nurses (10.6%) held neonatal specialty certification. All units had nurse educators, national and unit-based quality metrics, and procedural checklists. This study identified (1) variation in staffing models signaling an opportunity for collaboration, (2) the need to establish ongoing processes for sites to participate in future collaborative efforts, and (3) survey modifications necessary to ensure a more comprehensive understanding of nursing and organizational characteristics in freestanding children's hospital NICUs.

Advancing nursing scholarship: the Mozambique model

PubMed Central

Bruce, Judith C.; Dippenaar, Joan; Schmollgruber, Shelley; Mphuthi, David D.; Huiskamp, Agnes

2017-01-01

ABSTRACT Background: Despite the importance of Human Resources for Health for the development and functioning of health systems worldwide, many countries continue to be plagued by poor health systems and a lack of adequate health care. Health systems failures may be attributed to both quantitative and qualitative nursing shortages including the lack of advanced skills to lead health initiatives, to conduct research and to educate other nurses. The response by development partners is usually framed around the production of skilled nurses through the processes of up-skilling and scaling-up. The outcome is expanded practice but with scant attention to the professional advancement of nurses. Objectives: In this paper we present a two-phased capacity development model that adopted professionalization strategies to advance nursing scholarship and consequent postgraduate specialization of the first cohort of nurses in Mozambique. The main objectives were to: develop and implement a clinical course work master’s degree in nursing; and ensure sustainability by capacitating the host institution to continue with the master’s programme following graduation. Methods: Rigorous processes for project discussions, negotiations and monitoring were necessary amid limited resources and a challenging political climate. Forging in-country partnerships, sustaining alliances and government investment are thus key to the success of the Mozambique model. Outcomes: Notwithstanding some difficulties, the process unfolded over a five-year period, graduating the first cohort of 11 senior nurses with a master’s degree, specializing either in critical care and trauma nursing, or maternal and neonatal health. Conclusions: Bridging the skills gap between generalist and specialist nurses is essential for them to manage complex and high acuity cases and to reverse associated morbidity and mortality. We conclude that this model serves as a professionalization strategy to advance nurses’ scholarship of clinical practice, research and teaching. PMID:28771092

Task-sharing with nurses to enhance access to HIV treatment in Côte d'Ivoire.

PubMed

McNairy, Margaret L; Bashi, Jules B; Chung, Hannah; Wemin, Louise; Lorng, Marie-Nicole Akpro; Brou, Hermann; Nioble, Cyprien; Lokossue, A; Abo, Kouame; Achi, Delphine; Ouattara, Kiyali; Sess, Daniel; Sanogo, Pongathie Adama; Ekra, Alexandre; Ettiegne-Traore, Virginie; Diabate, Conombo J; Abrams, Elaine J; El-Sadr, Wafaa M

2017-04-01

We report the first national programme in Côte d'Ivoire to evaluate the feasibility of nurse-led HIV care as a model of task-sharing with nurses to increase coverage and decentralisation of HIV services. Twenty-six public HIV facilities implemented either a nurse-with-onsite-physician or a nurse-with-visiting-physician model of HIV task-sharing. Routinely collected patient data were reviewed to analyse patient characteristics of those enrolling in care and initiating antiretroviral therapy (ART). Retention, loss to programme and death were compared across facility-level characteristics. A total of 1224 patients enrolled in HIV care, with 666 initiating ART, from January 2012 to May 2013 (median follow-up 13 months). The majority (94%) were adults ≥15 years. Fourteen facilities provided ART initiation for the first time during the pilot period; 20 facilities were primary level. Nurse-led care with a visiting physician was provided in 14 of the primary-level facilities. Nurse-led ART care with an onsite physician was provided in all secondary-level facilities and six of the primary-level facilities. During the pilot, 567 (85%) of patients were retained, 28 (4.2%) died, 47 (7.1%) were lost to follow-up, and 24 (3.6%) transferred. Five deaths (10.9%) were recorded among children as compared to 23 deaths (3.7%) among adults (P = 0.037). There were no differences in retention by model of nurse-led ART care. Task-sharing of HIV care and ART initiation with nurses in Côte d'Ivoire is feasible. This pilot illustrates two models of nurse-led HIV care and has informed national policy on nurse-led HIV care in Côte d'Ivoire. © 2017 John Wiley & Sons Ltd.

Nursing work in NHS Direct: constructing a nursing identity in the call-centre environment.

PubMed

Snelgrove, Sherrill Ray

2009-12-01

The introduction of nurse-led telephone helplines for patients to have access to information and advice has led to the development of a new kind of practise for nurses. This study focuses on the ways NHS Direct (NHSD) nurses construct a nursing identity and shape their work in a call-centre environment. The empirical findings are drawn from a study investigating the impact of NHSD on professional nursing issues that was part of a wider evaluation of the service in South Wales, UK. Data were gathered from responses to free text questions included in a questionnaire sent to nurses in three NHSD sites. Further data were collected from focus groups held with NHSD nurses. The nurses defend their identity as nurses rather than call-centre workers. The discourses of the nurses show a strong alignment with the traditional values of nursing, encompassing holistic and empathetic practise that has moved with the nurses across locales. We argue that the nurses frame a nursing identity in NHSD around the importance of previous experience and claim to practise holistic nursing. However, the development of new skills and adaptation of old skills in response to the demand of NHSD work challenges normative notions of traditional 'hands-on' models of practise and indicates a possible movement towards a cognitive model of nursing based upon knowledge, analytical and communication skills that reflects the transformative and dynamic nature of professional identity and boundaries.

Developing nursing care plans.

PubMed

Ballantyne, Helen

2016-02-24

This article aims to enhance nurses' understanding of nursing care plans, reflecting on the past, present and future use of care planning. This involves consideration of the central theories of nursing and discussion of nursing models and the nursing process. An explanation is provided of how theories of nursing may be applied to care planning, in combination with clinical assessment tools, to ensure that care plans are context specific and patient centred.

Effects of work environment and job characteristics on the turnover intention of experienced nurses: The mediating role of work engagement.

PubMed

Wan, Qiaoqin; Li, Zhaoyang; Zhou, Weijiao; Shang, Shaomei

2018-06-01

To assess turnover intention among experienced nurses and explore the effects of work environment, job characteristics and work engagement on turnover intention. The nursing shortage is an urgent concern in China. A high turnover rate of experienced nurses could have serious effects on the quality of care, costs and the efficiency of hospitals. It is crucial to explore the predictors of turnover intention and develop strategies tailored to experienced nurses. A descriptive, cross-sectional survey design. A total of 778 experienced nurses from seven hospitals was surveyed on their work engagement, job characteristics, work environment and turnover intention in March-May 2017. Structural equation modelling was used to test a theoretical model and the hypotheses. The results showed that 35.9% of experienced nurses had high-level turnover intention. The final model explained 50% of the variance in experienced nurses' turnover intention and demonstrated that: (1) work environment was positively associated with higher work engagement and lower turnover intention and work engagement partially mediated the relationship between work environment and turnover intention; and (2) job characteristics were positively related to higher work engagement and lower turnover intention and work engagement fully mediated the relationship between job characteristics and turnover intention. The study confirms the intrinsic and extrinsic motivators on work engagement posited by job demands-resources model. Theory-driven strategies to improve work environment, enhance job characteristics and promote wok engagement are needed to address the nursing shortage and high turnover intention among experienced nurses. © 2018 John Wiley & Sons Ltd.

Factors influencing new graduate nurse burnout development, job satisfaction and patient care quality: a time-lagged study.

PubMed

Boamah, Sheila A; Read, Emily A; Spence Laschinger, Heather K

2017-05-01

To test a hypothesized model linking new graduate nurses' perceptions of their manager's authentic leadership behaviours to structural empowerment, short-staffing and work-life interference and subsequent burnout, job satisfaction and patient care quality. Authentic leadership and structural empowerment have been shown to reduce early career burnout among nurses. Short-staffing and work-life interference are also linked to burnout and may help explain the impact of positive, empowering leadership on burnout, which in turn influences job satisfaction and patient care quality. A time-lagged study of Canadian new graduate nurses was conducted. At Time 1, surveys were sent to 3,743 nurses (November 2012-March 2013) and 1,020 were returned (27·3% response rate). At Time 2 (May-July 2014), 406 nurses who responded at Time 1 completed surveys (39·8% response rate). Descriptive analysis was conducted in SPSS. Structural equation modelling in Mplus was used to test the hypothesized model. The hypothesized model was supported. Authentic leadership had a significant positive effect on structural empowerment, which in turn decreased both short-staffing and work-life interference. Short-staffing and work-life imbalance subsequently resulted in nurse burnout, lower job satisfaction and lower patient care quality 1 year later. The findings suggest that short-staffing and work-life interference are important factors influencing new graduate nurse burnout. Developing nurse managers' authentic leadership behaviours and working with them to create and sustain empowering work environments may help reduce burnout, increase nurse job satisfaction and improve patient care quality. © 2016 John Wiley & Sons Ltd.

The Impact of Different Nursing Skill Mix Models on Patient Outcomes in a Respiratory Care Center

PubMed Central

Yang, Pei-Hsuan; Hung, Chich-Hsiu; Chen, Yao-Mei; Hu, Chuan-Yu; Shieh, Sheng-Lan

2012-01-01

Background Many hospitals have reformed hospital policies and changed nursing models to cope with shortages in nursing staff and control medical costs. However, the nursing skill mix model that most successfully achieves both cost effectiveness and quality care has yet to be determined. Aim The aim of this study was to explore the impact of different nurse staffing models on patient outcomes in a respiratory care center (RCC). Methods Retrospective data from 2006 to 2008 were obtained from records monitoring nursing care quality, as well as patient records and nursing personnel costs in an RCC as a medical center, in southern Taiwan. A total of 487 patients were categorized into two groups according to the RCC's mix of nursing staff. The “RN/Aide” group comprised 247 patients who received RN and aide care, with a 0.7–0.8 proportion of RNs, from July 2006 to June 2007. The other 240 patients (“All-RN”) received 100% RN care from January 2008 to December 2008. Results The results of this study indicated no significant differences in occurrence of pressure ulcer or respiratory tract infections, days of hospitalization, mortality, or nursing costs. However, significant differences were observed in ventilator weaning and occurrence of urinary tract and bloodstream infections. Conclusions A higher proportion of RNs was associated not only with a lower rate of urinary tract infection but also with more patients being weaned successfully from ventilators. The findings of this study have implications for how managers and administrators manage nurse staffing in respiratory care. PMID:22489996

Nursing Student Retention in Associate Degree Nursing Programs Utilizing a Retention Specialist

ERIC Educational Resources Information Center

Schrum, Ronna A.

2014-01-01

The purpose of this study was to examine specific variables associated with nursing student retention in Associate Degree Nursing (ADN) Programs. Jeffreys (2004) Nursing Undergraduate Retention and Success (NURS) conceptual model provided the framework for this descriptive correlational study. One hundred sixty eight pre-licensure associate degree…

A practice model for rural district nursing success in end-of-life advocacy care.

PubMed

Reed, Frances M; Fitzgerald, Les; Bish, Melanie R

2017-08-24

The development of a practice model for rural district nursing successful end-of-life advocacy care. Resources to help people live well in the end stages of life in rural areas can be limited and difficult to access. District nurse advocacy may promote end-of-life choice for people living at home in rural Australia. The lack of evidence available internationally to inform practice in this context was addressed by exploratory study. A pragmatic mixed method study approved by the University Faculty Ethics Committee and conducted from March 2014 to August 2015 was used to explore the successful end-of-life advocacy of 98 rural Australian district nurses. The findings and results were integrated then compared with theory in this article to develop concepts for a practice model. The model illustrates rural district nurse advocacy success based on respect for the rights and values of people. Advocacy action is motivated by the emotional responses of nurses to the end-of-life vulnerability people experience. The combination of willing investment in relationships, knowing the rural people and resources, and feeling supported, together enables district nurses to develop therapeutic emotional intelligence. This skill promotes moral agency in reflection and advocacy action to overcome emotional and ethical care challenges of access and choice using holistic assessment, communication, organisation of resources and empowering support for the self-determination of person-centred end-of-life goals. Recommendations are proposed from the theoretical concepts in the model. Testing the model in practice is recommended to gain the perceptions of a broader range of rural people both giving and receiving end-of-life-care. A model developed by gathering and comparing district nursing experiences and understanding using mixed methods and existing theory offers evidence for practice of a philosophy of successful person-centred advocacy care in a field of nursing that lacks specific guidance. © 2017 Nordic College of Caring Science.

Using a nursing theory or a model in nursing PhD dissertations: a qualitative study from Turkey.

PubMed

Mete, Samiye; Gokçe İsbir, Gozde

2015-04-01

The aim of this study was to reveal experiences of nursing students and their advisors using theories and models in their PhD dissertations. The study adopted a descriptive qualitative approach. This study was performed with 10 PhD candidates and their five advisors from nursing faculty. The results of the study were categorized into four. These are reasons for using a theory/model in a PhD dissertation, reasons for preferring a given model, causes of difficulties in using models in PhD dissertations, and facilitating factors of using theories and models in PhD of dissertations. It was also reported to contribute to the methodology of research and professional development of the students and advisors. © 2014 NANDA International, Inc.

Necessary organizational changes according to Burke-Litwin model in the head nurses system of management in healthcare and social welfare institutions - the Slovenia experience.

PubMed

Filej, Bojana; Skela-Savic, Brigita; Vicic, Visnja H; Hudorovic, Narcis

2009-05-01

To discover which changes should be implemented in the system of head nursing management in Slovenian healthcare institutions and social welfare institutions. The questionnaire was distributed to 155 head nurses of Slovenian hospitals, primary healthcare centres and social welfare institutions. The Burke-Litwin organizational change model has been used to look at which changes have to be implemented in the management system of head nurses. In hospitals head nurses have greater independent competence for planning professional training of nursing employees (p<.022) and are also more independent when it comes to selecting employees when it comes to new job openings (M=4.20, S.D.=.83, p<.004). According to the Burke-Litwin organizational change model, the elements to which changes should be introduced include "external environment" for primary healthcare centres and social welfare institutions, and "system (policies and procedures)" for primary healthcare centres. According to results of our study, changes are needed in leadership and management of nursing in primary healthcare centres. In social welfare institutions changes are only required in leadership. Organizational changes are not necessary for any element of the Burke-Litwin model for hospitals.

Linking Nurse Leadership and Work Characteristics to Nurse Burnout and Engagement.

PubMed

Lewis, Heather Smith; Cunningham, Christopher J L

2016-01-01

Burnout and engagement are critical conditions affecting patient safety and the functioning of healthcare organizations; the areas of worklife model suggest that work environment characteristics may impact employee burnout and general worklife quality. The purpose was to present and test a conditional process model linking perceived transformational nurse leadership to nurse staff burnout and engagement via important work environment characteristics. Working nurses (N = 120) provided perceptions of the core study variables via Internet- or paper-based survey. The hypothesized model was tested using the PROCESS analysis tool, which enables simultaneous testing of multiple, parallel, indirect effects within the SPSS statistical package. Findings support the areas of worklife model and suggest that transformational leadership is strongly associated with work environment characteristics that are further linked to nurse burnout and engagement. Interestingly, different work characteristics appear to be critical channels through which transformational leadership impacts nurse burnout and engagement. There are several methodological and practical implications of this work for researchers and practitioners interested in preventing burnout and promoting occupational health within healthcare organizations. These implications are tied to the connections observed between transformational leadership, specific work environment characteristics, and burnout and engagement outcomes.

Linking Nurses' Clinical Leadership to Patient Care Quality: The Role of Transformational Leadership and Workplace Empowerment.

PubMed

Boamah, Sheila

2018-03-01

Background While improving patient safety requires strong nursing leadership, there has been little empirical research that has examined the mechanisms by which leadership influences patient safety outcomes. Aim To test a model examining relationships among transformational leadership, structural empowerment, staff nurse clinical leadership, and nurse-assessed adverse patient outcomes. Methods A cross-sectional survey was conducted with a randomly selected sample of 378 registered nurses working in direct patient care in acute care hospitals across Ontario, Canada. Structural equation modeling was used to test the hypothesized model. Results The model had an acceptable fit, and all paths were significant. Transformational leadership was significantly associated with decreased adverse patient outcomes through structural empowerment and staff nurse clinical leadership. Discussion This study highlights the importance of transformational leadership in creating empowering practice environments that foster high-quality care. The findings indicate that a more complete understanding of what drives desired patient outcomes warrants the need to focus on how to empower nurses and foster clinical leadership practices at the point of care. Conclusion In planning safety strategies, managers must demonstrate transformational leadership behaviors in order to modify the work environment to create better defenses for averting adverse events.

Proposing a New Conceptual Model and an Exemplar Measure Using Health Information: Technology to Examine the Impact of Relational Nurse Continuity on Hospital-Acquired Pressure Ulcers

PubMed Central

STIFTER, Janet; YAO, Yingwei; LOPEZ, Karen Dunn; KHOKHAR, Ashfaq; WILKIE, Diana J.; KEENAN, Gail M.

2015-01-01

The influence of the staffing variable nurse continuity on patient outcomes has been rarely studied and with inconclusive results. Multiple definitions and an absence of systematic methods for measuring the influence of continuity have resulted in its exclusion from nurse-staffing studies and conceptual models. We present a new conceptual model and an innovative use of health information technology to measure nurse continuity and to demonstrate the potential for bringing the results of big data science back to the bedside. Understanding the power of big data to address critical clinical issues may foster a new direction for nursing administration theory development. PMID:26244480

Administrator Leadership Styles and Their Impact on School Nursing Part II. A High-Performance School Nurse-Building Administrator Relationship Model.

PubMed

Davis, Charles R; Lynch, Erik J

2018-06-01

There is a significant disparity in roles, responsibilities, education, training, and expertise between the school nurse and building administrator. Because of this disparity, a natural chasm must be bridged to optimize student health, safety, well-being, and achievement in the classroom while meeting the individual needs of both professionals. This article constructs and presents a new school nurse-building administrator relationship model, the foundation of which is formed from the pioneering and seminal work on high-performance professional relationships and outcomes of Lewin and Drucker. The authors posit that this new model provides the framework for successful school nurse-building administrator interactions that will lead to optimal student outcomes.

Animal Models in Genomic Research: Techniques, Applications, and Roles for Nurses

PubMed Central

Osier, Nicole D.; Pham, Lan; Savarese, Amanda; Sayles, Kendra

2016-01-01

Animal research has been conducted by scientists for over two millennia resulting in a better understanding of human anatomy, physiology, and pathology, as well as testing of novel therapies. In the molecular genomic era, pre-clinical models represent a key tool for understanding the genomic underpinnings of health and disease and are relevant to precision medicine initiatives. Nurses contribute to improved health by collecting and translating evidence from clinically relevant pre-clinical models. Using animal models, nurses can ask questions that would not be feasible or ethical to address in humans, and establish the safety and efficacy of interventions before translating them to clinical trials. Two advantages of using pre-clinical models are reduced variability between test subjects and the opportunity for precisely controlled experimental exposures. Standardized care controls the effects of diet and environment, while the availability of inbred strains significantly reduces the confounding effects of genetic differences. Outside the laboratory, nurses can contribute to the approval and oversight of animal studies, as well as translation to clinical trials and, ultimately, patient care. This review is intended as a primer on the use of animal models to advance nursing science; specifically, the paper discusses the utility of preclinical models for studying the pathophysiologic and genomic contributors to health and disease, testing interventions, and evaluating effects of environmental exposures. Considerations specifically geared to nurse researchers are also introduced, including discussion of how to choose an appropriate model and controls, potential confounders, as well as legal and ethical concerns. Finally, roles for nurse clinicians in pre-clinical research are also highlighted. PMID:27969037

Animal models in genomic research: Techniques, applications, and roles for nurses.

PubMed

Osier, Nicole D; Pham, Lan; Savarese, Amanda; Sayles, Kendra; Alexander, Sheila A

2016-11-01

Animal research has been conducted by scientists for over two millennia resulting in a better understanding of human anatomy, physiology, and pathology, as well as testing of novel therapies. In the molecular genomic era, pre-clinical models represent a key tool for understanding the genomic underpinnings of health and disease and are relevant to precision medicine initiatives. Nurses contribute to improved health by collecting and translating evidence from clinically relevant pre-clinical models. Using animal models, nurses can ask questions that would not be feasible or ethical to address in humans, and establish the safety and efficacy of interventions before translating them to clinical trials. Two advantages of using pre-clinical models are reduced variability between test subjects and the opportunity for precisely controlled experimental exposures. Standardized care controls the effects of diet and environment, while the availability of inbred strains significantly reduces the confounding effects of genetic differences. Outside the laboratory, nurses can contribute to the approval and oversight of animal studies, as well as translation to clinical trials and, ultimately, patient care. This review is intended as a primer on the use of animal models to advance nursing science; specifically, the paper discusses the utility of preclinical models for studying the pathophysiologic and genomic contributors to health and disease, testing interventions, and evaluating effects of environmental exposures. Considerations specifically geared to nurse researchers are also introduced, including discussion of how to choose an appropriate model and controls, potential confounders, as well as legal and ethical concerns. Finally, roles for nurse clinicians in pre-clinical research are also highlighted. Copyright © 2016 Elsevier Inc. All rights reserved.

Representing nursing guideline with unified modeling language to facilitate development of a computer system: a case study.

PubMed

Choi, Jeeyae; Choi, Jeungok E

2014-01-01

To provide best recommendations at the point of care, guidelines have been implemented in computer systems. As a prerequisite, guidelines are translated into a computer-interpretable guideline format. Since there are no specific tools to translate nursing guidelines, only a few nursing guidelines are translated and implemented in computer systems. Unified modeling language (UML) is a software writing language and is known to well and accurately represent end-users' perspective, due to the expressive characteristics of the UML. In order to facilitate the development of computer systems for nurses' use, the UML was used to translate a paper-based nursing guideline, and its ease of use and the usefulness were tested through a case study of a genetic counseling guideline. The UML was found to be a useful tool to nurse informaticians and a sufficient tool to model a guideline in a computer program.

Aesthetic Leadership: Its Place in the Clinical Nursing World.

PubMed

Mannix, Judy; Wilkes, Lesley; Daly, John

2015-05-01

Clinical leadership has been identified as crucial to positive patient/client outcomes, across all clinical settings. In the new millennium, transformational leadership has been the dominant leadership style and in more recent times, congruent leadership theory has emerged to explain clinical leadership in nursing. This article discusses these two leadership models and identifies some of the shortcomings of them as models for clinical leadership in nursing. As a way of overcoming some of these limitations, aesthetic leadership is proposed as a style of leadership that is not antithetical to either model and reflects nursing's recognition of the validity of art and aesthetics to nursing generally. Aesthetic leadership is also proposed as a way to identify an expert clinical leader from a less experienced clinical leader, taking a similar approach to the way Benner (1984) has theorised in her staging of novice to expert clinical nurse.

Conceptual model for partnership and sustainability in global health.

PubMed

Leffers, Jeanne; Mitchell, Emma

2011-01-01

Although nursing has a long history of service to the global community, the profession lacks a theoretical and empirical base for nurses to frame their global practice. A study using grounded theory methodology to investigate partnership and sustainability for global health led to the development of a conceptual model. Interviews were conducted with 13 global health nurse experts. Themes from the interviews were: components for engagement, mutual goal setting, cultural bridging, collaboration, capacity building, leadership, partnership, ownership, and sustainability. Next, the identified themes were reviewed in the literature in order to evaluate their conceptual relationships. Finally, careful comparison of the interview transcripts and the supporting literature led to the Conceptual Framework for Partnership and Sustainability in Global Health Nursing. The model posits that engagement and partnership must precede any planning and intervention in order to create sustainable interventions. This conceptual framework will offer nurses important guidance for global health nursing practice. © 2010 Wiley Periodicals, Inc.

E-nursing documentation as a tool for quality assurance.

PubMed

Rajkovic, Vladislav; Sustersic, Olga; Rajkovic, Uros

2006-01-01

The article presents the results of a project with which we describe the reengineering of nursing documentation. Documentation in nursing is an efficient tool for ensuring quality health care and consequently quality patient treatment along the whole clinical path. We have taken into account the nursing process and patient treatment based on Henderson theoretical model of nursing that consists of 14 basic living activities. The model of new documentation enables tracing, transparency, selectivity, monitoring and analyses. All these factors lead to improvements of a health system as well as to improved safety of patients and members of nursing teams. Thus the documentation was developed for three health care segments: secondary and tertiary level, dispensaries and community health care. The new quality introduced to the documentation process by information and communication technology is presented by a database model and a software prototype for managing documentation.

[Nursing care systematization in rehabilitation unit, in accordance to Horta's conceptual model].

PubMed

Neves, Rinaldo de Souza

2006-01-01

The utilization of a conceptual model in the Nursing Attendance Systemization allows the development of activities based on theoretical references that can guide the implantation and the implementation of nursing proceedings in hospitals. In this article we examine the option made for the implementation of the Horta's conceptual model in the construction of a nursing attendance system in the Rehabilitation Unit of a public hospital located in the Federal District of Brazil. Through the utilization of these theoretical references it was possible to make available a data collection tool based on the basic human needs. The identification of these needs made possible the construction of the hierarchically disposed pyramid of the neurological patients' modified basic needs. Through this reference paper we intend to elaborate the prescription and nursing evolution based in the concepts and standards of the Horta's nursing process, making possible the inter-relationship of all phases of this attendance methodology.

From Blank Canvas to Masterwork: Creating a Professional Practice Model at a Magnet Hospital

PubMed Central

Tydings, Donna M.; Nickoley, Sue; Nichols, Lynn W.; Krenzer, Maureen E.

2016-01-01

Objective. The purpose of this study was to engage registered nurses (RNs) in the creation of a Professional Practice Model (PPM). Background. PPMs are essential as the philosophical underpinnings for nursing practice. The study institution created a new PPM utilizing the voice of their RNs. Methods. Qualitative inquiry with focus groups was conducted to explore RNs values and beliefs about their professional practice. Constant-comparative analysis was used to code data and identify domains. Results. The 92 RN participants represented diverse roles and practice settings. The four domains identified were caring, knowing, navigating, and leading. Conclusions. Nurse leaders face the challenge of assisting nurses in articulating their practice using a common voice. In this study, nurses described their identity, their roles, and how they envisioned nursing should be practiced. The results align with the ANCC Magnet® Model, ANA standards, and important foundational and organization specific documents. PMID:28097022

A nurse-led model of chronic disease management in general practice: Patients' perspectives.

PubMed

Young, Jacqueline; Eley, Diann; Patterson, Elizabeth; Turner, Catherine

2016-12-01

Evidence suggests that current models of chronic disease management within general practice are not effective in meeting the needs of the community. The objective of this article is to examine patients' perceptions of a nurse-led collaborative model of care trialled in three general practices in Australia. This article reports on the second phase of a mixed-methods study in which semi-structured interviews with purposively selected patients were conducted to elicit information about their perceptions of nurse-led care. Three themes emerged from the data - time, ambiance and dimensions of the nurse role. The results suggest that general practice nurses had a positive impact on patients' ability to manage their chronic disease. This infers that there is scope for general practice nurses to expand their role in chronic disease management to assist patients to better self-manage their chronic diseases.

A primary shift rotation nurse scheduling using zero-one linear goal programming.

PubMed

Huarng, F

1999-01-01

In this study, the author discusses the effect of nurse shift schedules on circadian rhythm and some important ergonomics criteria. The author also reviews and compares different nurse shift scheduling methods via the criteria of flexibility, fairness, continuity in shift assignments, nurses' preferences, and ergonomics principles. In this article, a primary shift rotation system is proposed to provide better continuity in shift assignments to satisfy nurses' preferences. The primary shift rotation system is modeled as a zero-one linear goal programming (LGP) problem. To generate the shift assignment for a unit with 13 nurses, the zero-one LGP model takes less than 3 minutes on average, whereas the head nurses spend approximately 2 to 3 hours on shift scheduling. This study reports the process of implementing the primary shift rotation system.

Advanced Practice Nursing Committee on Process Improvement in Trauma: An Innovative Application of the Strong Model.

PubMed

West, Sarah Katherine

2016-01-01

This article aims to summarize the successes and future implications for a nurse practitioner-driven committee on process improvement in trauma. The trauma nurse practitioner is uniquely positioned to recognize the need for clinical process improvement and enact change within the clinical setting. Application of the Strong Model of Advanced Practice proves to actively engage the trauma nurse practitioner in process improvement initiatives. Through enhancing nurse practitioner professional engagement, the committee aims to improve health care delivery to the traumatically injured patient. A retrospective review of the committee's first year reveals trauma nurse practitioner success in the domains of direct comprehensive care, support of systems, education, and leadership. The need for increased trauma nurse practitioner involvement has been identified for the domains of research and publication.

A Multiple-Track Nursing Sequence: Supplement to Research Report No. 1.

ERIC Educational Resources Information Center

Gilpatrick, Eleanor

Following a survey of 2,361 practical nurses in New York City municipal hospitals in 1968, a specific multiple-track nursing sequence was developed to meet manpower shortages and upgrade licensed practical nurses (LPN's) to registered nurses (RN's) and nurse's aides (NA's) to LPN's. The two models designed were for use in New York City but it is…

Beyond profession: nursing leadership in contemporary healthcare.

PubMed

Sorensen, Roslyn; Iedema, Rick; Severinsson, Elisabeth

2008-07-01

To examine nursing leadership in contemporary health care and its potential contribution to health service organization and management. As the nursing profession repositions itself as an equal partner in health care beside medicine and management, its enhanced nursing standards and clinical knowledge are not leading to a commensurate extension of nursing's power and authority in the organization. An ethnographic study of an ICU in Sydney, Australia, comprising: interviews with unit nursing managers (4); focus groups (3) with less experienced, intermediate and experienced nurses (29 in total); and interviews with senior nurse manager (1). Inter- and intra-professional barriers in the workplace, fragmentation of multidisciplinary clinical systems that collectively deliver care, and clinical and administrative disconnection in resolving organizational problems, prevented nurses articulating a model of intensive and end-of-life care. Professional advocacy skills are needed to overcome barriers and to articulate and operationalize new nursing knowledge and standards if nurses are to enact and embed a leadership role. The profession will need to move beyond a reliance on professional clinical models to become skilled multidisciplinary team members and professional advocates for nurses to take their place as equal partners in health care.

Team Learning and Team Composition in Nursing

ERIC Educational Resources Information Center

Timmermans, Olaf; Van Linge, Roland; Van Petegem, Peter; Elseviers, Monique; Denekens, Joke

2011-01-01

Purpose: This study aims to explore team learning activities in nursing teams and to test the effect of team composition on team learning to extend conceptually an initial model of team learning and to examine empirically a new model of ambidextrous team learning in nursing. Design/methodology/approach: Quantitative research utilising exploratory…

The financial impact of a clinical academic practice partnership.

PubMed

Greene, Mary Ann; Turner, James

2014-01-01

New strategies to provide clinical experiences for nursing students have caused nursing schools and hospitals to evaluate program costs. A Microsoft Excel model, which captures costs and associated benefits, was developed and is described here. The financial analysis shows that the Clinical Academic Practice Program framework for nursing clinical education, often preferred by students, can offer financial advantages to participating hospitals and schools of nursing. The model is potentially a tool for schools of nursing to enlist hospitals and to help manage expenses of clinical education. Hospitals may also use the Hospital Nursing Unit Staffing and Expense Worksheet in planning staffing when students are assigned to units and the cost/benefit findings to enlist management support.

Gordon's model applied to nursing care of people with depression.

PubMed

Temel, M; Kutlu, F Y

2015-12-01

Psychiatric nurses should consider the patient's biological, psychological and social aspects. Marjory Gordon's Functional Health Pattern Model ensures a holistic approach for the patient. To examine the effectiveness of Gordon's Functional Health Pattern Model in reducing depressive symptoms, increasing self-efficacy, coping with depression and increasing hope in people with depression. A quasi-experimental two-group pre-test and post-test design was adopted. Data were collected from April 2013 to May 2014 from people with depression at the psychiatry clinic of a state hospital in Turkey; they were assigned to the intervention (n = 34) or control group (n = 34). The intervention group received nursing care according to Gordon's Functional Health Pattern Model and routine care, while the control group received routine care only. The Beck Depression Inventory, Beck Hopelessness Scale and Depression Coping Self-Efficacy Scale were used. The intervention group had significantly lower scores on the Beck Depression Inventory and Beck Hopelessness Scale at the post-test and 3-month follow-up; they had higher scores on the Depression Coping Self-Efficacy Scale at the 3-month follow-up when compared with the control group. The study was conducted at only one psychiatry clinic. The intervention and control group patients were at the clinic at the same time and influenced each other. Moreover, because clinical routines were in progress during the study, the results cannot only be attributed to nursing interventions. Nursing models offer guidance for the care provided. Practices based on the models return more efficient and systematic caregiving results with fewer health problems. Gordon's Functional Health Pattern Model was effective in improving the health of people with depression and could be introduced as routine care with ongoing evaluation in psychiatric clinics. More research is needed to evaluate Gordon's Nursing Model effect on people with depression. Future studies could focus on the effects of this nursing model on people with other psychiatric disorders. This study highlighted that psychiatric nurses' role decreased depressive symptoms and hopelessness, and increased coping and self-efficacy in people with depression. © 2015 International Council of Nurses.

Creating and sustaining an academic-practice Partnership Engagement Model.

PubMed

Schaffer, Marjorie A; Schoon, Patricia M; Brueshoff, Bonnie L

2017-11-01

Public health clinical educators and practicing public health nurses (PHNs) are experiencing challenges in creating meaningful clinical learning experiences for nursing students due to an increase in nursing programs and greater workload responsibilities for both nursing faculty and PHNs. The Henry Street Consortium (HSC), a collaborative group of PHNs and nursing faculty, conducted a project to identify best practices for public health nursing student clinical learning experiences. Project leaders surveyed HSC members about preferences for teaching-learning strategies, facilitated development of resources and tools to guide learning, organized faculty/PHN pilot teams to test resources and tools with students, and evaluated the pilot team experiences through two focus groups. The analysis of the outcomes of the partnership engagement project led to the development of the Partnership Engagement Model (PEM), which may be used by nursing faculty and their public health practice partners to guide building relationships and sustainable partnerships for educating nursing students. © 2017 Wiley Periodicals, Inc.

Exploring the Influence of Nurse Work Environment and Patient Safety Culture on Attitudes Toward Incident Reporting.

PubMed

Yoo, Moon Sook; Kim, Kyoung Ja

2017-09-01

The aim of this study was to explore the influence of nurse work environments and patient safety culture on attitudes toward incident reporting. Patient safety culture had been known as a factor of incident reporting by nurses. Positive work environment could be an important influencing factor for the safety behavior of nurses. A cross-sectional survey design was used. The structured questionnaire was administered to 191 nurses working at a tertiary university hospital in South Korea. Nurses' perception of work environment and patient safety culture were positively correlated with attitudes toward incident reporting. A regression model with clinical career, work area and nurse work environment, and patient safety culture against attitudes toward incident reporting was statistically significant. The model explained approximately 50.7% of attitudes toward incident reporting. Improving nurses' attitudes toward incident reporting can be achieved with a broad approach that includes improvements in work environment and patient safety culture.

Outcomes of acutely ill older hospitalized patients following implementation of tailored models of care: a repeated measures (pre- and post-intervention) design.

PubMed

Chang, Esther; Hancock, Karen; Hickman, Louise; Glasson, Janet; Davidson, Patricia

2007-09-01

There is a lack of research investigating models of nursing care for older hospitalised patients that address the nursing needs of this group. The objective of this study is to evaluate the efficacy of models of care for acutely older patients tailored to two contexts: an aged care specific ward and a medical ward. This is a repeated measures design. Efficacy of the models was evaluated in terms of: patient and nurses' satisfaction with care provided; increased activities of daily living; reduced unplanned hospital readmissions; and medication knowledge. An aged care specific ward and a medical ward in two Sydney teaching hospitals. There were two groups of patients aged 65 years or older who were admitted to hospital for an acute illness: those admitted prior to model implementation (n=232) and those admitted during model implementation (n=116). Patients with moderate or severe dementia were excluded. The two groups of nurses were the pre-model group (n=90) who were working on the medical and aged care wards for the study prior to model implementation, and the post-model group (n=22), who were the nurses working on the wards during model implementation. Action research was used to develop the models of care in two wards: one for an aged care specific ward and another for a general medical ward where older patients were admitted. The models developed were based on empirical data gathered in an earlier phase of this study. The models were successful in both wards in terms of increasing satisfaction levels in patients and nurses (p<0.001), increasing functional independence as measured by activities of daily living (p<0.01), and increasing medication knowledge (p<0.001). Findings indicate that models of care developed by nurses using an evidence-based action research strategy can enhance both satisfaction and health outcomes in older patients.

Listening to nursing leaders: using national database of nursing quality indicators data to study excellence in nursing leadership.

PubMed

Anderson, Barbara Jo; Manno, Martin; O'Connor, Pricilla; Gallagher, Eileen

2010-04-01

There are varying and overlapping leadership characteristics that exemplify excellence in nursing leadership. To assess aspects of leadership that helps create a healthy work environment that supports nurses' provision of quality care at the bedside, the authors used a national survey instrument to examine the characteristics of nurse managers identified as excellent nurse leaders by their staff. The authors discuss their findings and a proposed theoretical model to explain specific nursing leadership characteristics that support staff nurse job satisfaction and retention.

Burnout in Nurses Working With Youth With Chronic Pain: A Mixed-Methods Analysis.

PubMed

Rodrigues, Nikita P; Cohen, Lindsey L; Swartout, Kevin M; Trotochaud, Karen; Murray, Eileen

2018-05-01

Nursing is a rewarding but also challenging profession. Nurses are at risk for burnout and premature exit from the profession, which is detrimental to them, their patients, and the healthcare system. There are few studies examining the unique correlates of burnout in nurses working with pediatric populations. The current 2-study project used mixed-methods (qualitative and then quantitative) analysis to explore burnout in nurses working in an inpatient unit with youth with chronic pain. Study I participants included all of the 32 nurses who worked in an inpatient pediatric unit, which admits patients with chronic pain. Qualitative analyses of focus groups were used to extract themes. These themes were examined via a quantitative battery completed by 41 nurses from 2 inpatient pediatric units with youth with chronic pain. The themes were burnout, moral distress, negative beliefs about chronic pain, barriers to pain management, fear of losing compassion, coworker support as a coping method, time worked in the unit, professional self-efficacy, and negative views of the hospital environment. Quantitative results supported most of the qualitative findings, and taken together, the findings supported a model of burnout in nurses working with youth with chronic pain. Conclusions We integrated qualitative and quantitative findings to develop a model of nurse burnout. This model provides a framework for evaluating and targeting burnout in nurses working with pediatric patients with chronic pain.

A Trial of Nursing Cost Accounting using Nursing Practice Data on a Hospital Information System.

PubMed

Miyahira, Akiko; Tada, Kazuko; Ishima, Masatoshi; Nagao, Hidenori; Miyamoto, Tadashi; Nakagawa, Yoshiaki; Takemura, Tadamasa

2015-01-01

Hospital administration is very important and many hospitals carry out activity-based costing under comprehensive medicine. However, nursing cost is unclear, because nursing practice is expanding both quantitatively and qualitatively and it is difficult to grasp all nursing practices, and nursing cost is calculated in many cases comprehensively. On the other hand, a nursing information system (NIS) is implemented in many hospitals in Japan and we are beginning to get nursing practical data. In this paper, we propose a nursing cost accounting model and we simulate a cost by nursing contribution using NIS data.

Faculty role modeling of professional writing: one baccalaureate nursing program's experience.

PubMed

Newton, Sarah E

2008-01-01

According to The Essentials of Baccalaureate Education for Professional Nursing Practice (American Association of Colleges of Nursing, 1998), professional writing is an important outcome of baccalaureate nursing education. Most baccalaureate nursing programs in the United States expect formally written student papers to adhere to the style requirements outlined in the Publication Manual of the American Psychological Association (APA, 2001). It is essential for the baccalaureate nursing faculty members who evaluate student papers to be role models for the desired writing behaviors to facilitate student attainment of professional writing outcomes. However, to what extent nursing faculty members' writing behaviors and knowledge of the APA style requirements impact student writing outcomes is not known because the issue has not been addressed in the literature. The purpose of this article is to describe one Midwestern baccalaureate nursing program's faculty development efforts to assess faculty familiarity with the APA style requirements and how such knowledge may impact baccalaureate nursing students' writing outcomes.

Lateral Violence in Nursing: Implications and Strategies for Nurse Educators.

PubMed

Sanner-Stiehr, Ericka; Ward-Smith, Peggy

Lateral violence among nurses persists as a prevalent problem, contributing to psychological distress, staff turnover, and attrition. Newly graduated nurses are at particular risk for being targets of lateral violence and experiencing its negative sequelae. Preparing student nurses to respond to lateral violence prior to entering the nursing may alter this scenario. A review of the literature was conducted to determine the potential for nursing faculty to change the cycle of lateral violence. Based on this review, we recommend 3 main strategies, specifically for nursing faculty, aimed at reducing incidences of lateral violence and preparing students to manage this phenomenon. First, curricular content can address integrating lateral violence content into simulation experiences and facilitating this knowledge into clinical experiences. Second, codes of conduct should guide behaviors for both students and faculty. Finally, as role models, faculty should be aware of their own behaviors, role model respectful communication, facilitate a courteous academic environment, and develop nurses capable of identifying and appropriately responding to lateral violence. Copyright © 2016 Elsevier Inc. All rights reserved.

Hiring appropriate providers for different populations: acute care nurse practitioners.

PubMed

Haut, Cathy; Madden, Maureen

2015-06-01

Acute care nurse practitioners, prepared as providers for a variety of populations of patients, continue to make substantial contributions to health care. Evidence indicates shorter stays, higher satisfaction among patients, increased work efficiency, and higher quality outcomes when acute care nurse practitioners are part of unit- or service-based provider teams. The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, and Education outlines detailed guidelines for matching nurse practitioners' education with certification and practice by using a population-focused algorithm. Despite national support for the model, nurse practitioners and employers continue to struggle with finding the right fit. Nurse practitioners often use their interest and previous nursing experience to apply for an available position, and hospitals may not understand preparation or regulations related to matching the appropriate provider to the work environment. Evidence and regulatory guidelines indicate appropriate providers for population-focused positions. This article presents history and recommendations for hiring acute care nurse practitioners as providers for different populations of patients. ©2015 American Association of Critical-Care Nurses.

Healthy Lifestyle Behaviors and Health Promotion Attitudes in Preregistered Nurses: A Questionnaire Study.

PubMed

Blake, Holly; Stanulewicz, Natalia; Griffiths, Katherine

2017-02-01

Nurses report inadequacies in health promotion practices. This study investigated attitudes toward being role models for healthy eating, and examined predictors of health promotion attitudes in preregistered nurses. A questionnaire was completed by 493 preregistered nurses. Measures included health promotion attitudes, healthy lifestyle index, self-esteem, and body satisfaction. Preregistered nurses (89.5%) felt that nurses should be role models for health. However, 37% had a negative health promotion attitude and were more likely to be dissatisfied with their body and lead less healthy lifestyles. Most preregistered nurses (96%) felt that delivering health promotion would be a key element of their job and held positive health promotion attitudes. Healthy lifestyle was the most consistent significant predictor of health promotion attitude. Preregistered nurses with an unhealthy lifestyle and lower self-esteem held a more negative health promotion attitude. Intervention is needed to support preregistered nurses in making healthy lifestyle choices, improving their self-perception and health promotion attitude. [J Nurs Educ. 2017;56(2):94-103.]. Copyright 2017, SLACK Incorporated.

Research utilization in nursing: the power of one.

PubMed

Jacobson, A F

2000-01-01

Common barriers to research utilization in nursing include characteristics of the setting in which nurses practice, nurses themselves, and nursing's dependence on rituals and traditions in practice. Nurses can overcome these barriers by questioning their practice and adopting attitudes and values that prioritize research utilization. The "Power of One" Model of Research Utilization guides nurses to examine everyday practices, assess their research foundations, and implement and evaluate changes to research-based practice.

Nursing regulation, the nurse licensure compact, and nurse administrators: working together for patient safety.

PubMed

Poe, Laura

2008-01-01

Maintaining the concept of states rights, boards of nursing responded to the need for removal of barriers in meeting nursing manpower needs. One mechanism to accomplish this end was the development of the Nurse Licensure Compact, a multistate nurse license structured in much the same way as driver's license compacts. Representatives of State Boards of Nursing developed model compact structure and rules which allow nurses licensed in their state of residence to practice in other participating states without having to obtain additional licenses. Monitoring of nurse licensure and disciplinary information is facilitated through Nursys (nurse system). Nurses, nurse administrators, and the public benefit from the experiences of the 23 states that have implemented the Nurse Licensure Compact.

Perception of and satisfaction with the clinical learning environment among nursing students.

PubMed

D'Souza, Melba Sheila; Karkada, Subrahmanya Nairy; Parahoo, Kader; Venkatesaperumal, Ramesh

2015-06-01

Clinical nursing education provides baccalaureate nursing students an opportunity to combine cognitive, psychomotor, and affective skills in the Middle East. The aim of the paper is to assess the satisfaction with and effectiveness of the clinical learning environment among nursing students in Oman. A cross-sectional descriptive design was used. A convenience sample consisting of 310 undergraduate nursing students was selected in a public school of nursing in Oman. Ethical approval was obtained from the Research and Ethics Committee, College of Nursing in 2011. A standardized, structured, validated and reliable Clinical Learning Environment Supervision Teacher Evaluation instrument was used. Informed consent was obtained from all the students. Data was analyzed with ANOVA and structural equation modeling. Satisfaction with the clinical learning environment (CLE) sub-dimensions was highly significant and had a positive relationship with the total clinical learning environment. In the path model 35% of its total variance of satisfaction with CLE is accounted by leadership style, clinical nurse commitment (variance=28%), and patient relationships (R(2)=27%). Higher age, GPA and completion of a number of clinical courses were significant in the satisfaction with the CLE among these students. Nurse educators can improvise clinical learning placements focusing on leadership style, premises of learning and nursing care, nurse teacher, and supervision while integrating student, teacher and environmental factors. Hence the clinical learning environment is integral to students' learning and valuable in providing educational experiences. The CLE model provides information to nurse educators regarding best clinical practices for improving the CLE for BSN students. Copyright © 2015 Elsevier Ltd. All rights reserved.

An innovative professional practice model: adaptation of Carper's patterns of knowing, patterns of research, and Aristotle's intellectual virtues.

PubMed

Jacobs, Barbara Bennett

2013-01-01

Professional practice models have emerged as the way hospital-based nursing expresses its consensus-derived philosophy. Magnet recognition influences this practice, while extant nursing theories continue the quest to bridge scholarship with practice. The innovative model presented in this article is an adaptation of Carper's patterns of knowing into a nursing meta-language of science, ethics, art, and advocacy. In this model, boundaries of the patterns of knowing blur and synchronous movement of values, patterns of research, and Aristotelian intellectual virtues blend. Patient and nurse in an intersubjective relationship share the end of human flourishing as the patient's narrative evolves and shared meaning of the ultimate good is actualized.

CAN-Care: an innovative model of practice-based learning.

PubMed

Raines, Deborah A

2006-01-01

The "Collaborative Approach to Nursing Care" (CAN-Care) Model of practice-based education is designed to meet the unique learning needs of the accelerated nursing program student. The model is based on a synergistic partnership between the academic and service settings, the vision of which is to create an innovative practice-based learning model, resulting in a positive experience for both the student and unit-based nurse. Thus, the objectives of quality outcomes for both the college and Health Care Organization are fulfilled. Specifically, the goal is the education of nurses ready to meet the challenges of caring for persons in the complex health care environment of the 21st century.

A nursing data base for initial patient assessment.

PubMed

Hartman, D; Knudson, J

1991-01-01

The introduction of nursing diagnoses at Saddleback Memorial Medical Center, Laguna Hills, CA, resulted in the nursing process becoming the basis for the documentation system. However, the medical model or body system remained the organizational structure for nursing data collection and narrative charting. The need for a model that would aid in identification and treatment of illness and not negatively affect the nursing process was the impetus behind the selection of Gordon's functional health patterns as the assessment format. These patterns provide a standard method for data collection and a holistic approach to assessment and diagnosis.

Do nurse sows and foster litters have impaired animal welfare? Results from a cross-sectional study in sow herds.

PubMed

Sørensen, J T; Rousing, T; Kudahl, A B; Hansted, H J; Pedersen, L J

2016-04-01

Increasing litter size has led to introduction of so-called nurse sows in several EU countries. A nurse sow is a sow receiving piglets after having weaned her own piglets and thereby experiencing an extended lactation. In order to analyse whether nurse sows have more welfare problems than non-nurse sows a cross-sectional study was conducted in 57 sow herds in Denmark. Clinical observations were made on nurse and non-nurse sows and their litters. The clinical observations were dichotomized and the effect of being a nurse sow was analysed based on eight parameters: thin (body condition score<2.5), swollen bursae on legs, dew claw wounds, vulva lesions, poor hygiene, poor skin condition, shoulder lesions and cuts and wounds on the udder. Explanatory variables included in the eight models were: nurse sow (yes=1/no=0), age of piglets (weeks old, 1 to 7), parity (1 to 8+) and all first order interactions between these three variables. The effect of using nurse sows on piglet welfare was analysed with five models. The outcomes were: huddling, poor hygiene, lameness, snout cuts and carpal abrasions. The explanatory variables included in the five models were: nurse sow (yes=1/no=0), age of piglets (weeks old, 1 to 7), parity (1 to 8+) and all first order interactions between these three variables. Herd identity was included as a random factor in all models. The nurse sows had a significantly higher risk of swollen bursae on legs (P=0.038) and udder wounds (P=0.001). No differences in risk of being thin or having shoulder lesions were found. Foster litters had significantly higher risk of being dirty (P=0.026) and getting carpal abrasions (P=0.024) than non-foster litters. There was a tendency for higher lameness in foster litters than in non-foster litters (P=0.052). The results show that nurse sows and their piglets to some extent experience more welfare problems than non-nurse sows with piglets at a similar age.

Hospital restructuring and nursing leadership: a journey from research question to research program.

PubMed

Cummings, Greta G

2006-01-01

The 1990s brought new fiscal realities to healthcare, leading to nursing job loss estimates in tens of thousands following widespread hospital restructuring to manage costs and improve efficiency. This research aimed at examining (a) how multiple episodes of hospital restructuring leading to layoff of nurses affected nurses who remained employed and (b) whether and how nursing leadership mitigated or intensified the negative effects of hospital restructuring on nurses. This dissertation comprised 3 empirical studies leading to 5 publications. The first study was a systematic literature review; the second and third used structural equation modeling to develop and test theoretical models addressing nursing practice environments and effects of hospital restructuring on nurses. The combined findings in this dissertation illustrate that hospital restructuring had significant negative physical/emotional health effects on nurses who remained employed. Nurses who worked for resonant (emotionally intelligent) leadership reported positive health and well-being, and opportunities to provide quality patient care. Nurses who worked for dissonant leadership reported greater negative effects of hospital restructuring. These findings led to a beginning theory of relational energy--a mechanism of mitigation whereby resonant nursing leaders invest energy into collaborative relationships with nurses, thereby positively influencing health and well-being, and, ultimately, outcomes for patients.

Nurse assistant mental models, sensemaking, care actions, and consequences for nursing home residents.

PubMed

Anderson, Ruth A; Ammarell, Natalie; Bailey, Donald; Colón-Emeric, Cathleen; Corazzini, Kirsten N; Lillie, Melissa; Piven, Mary Lynn Scotton; Utley-Smith, Queen; McDaniel, Reuben R

2005-10-01

In a nursing home case study using observation and interview data, the authors described two mental models that guided certified nurse assistants (CNAs) in resident care. The Golden Rule guided CNAs to respond to residents as they would want someone to do for them. Mother wit guided CNAs to treat residents as they would treat their own children. These mental models engendered self-control and affection but also led to actions such as infantilization and misinterpretations about potentially undiagnosed conditions such as depression or pain. Furthermore, the authors found that CNAs were isolated from clinicians; little resident information was exchanged. They suggest ways to alter CNA mental models to give them a better basis for action and strategies for connecting CNAs and clinical professionals to improve information flow about residents. Study results highlight a critical need for registered nurses (RNs) to be involved in frontline care.

Aims and theoretical frameworks in nursing students' Bachelor's theses in Sweden: A descriptive study.

PubMed

Silén, Marit; Johansson, Linda

2016-02-01

Nursing students' independent projects in Sweden not only provide an opportunity to receive a professional qualification as a nurse but also gain a Bachelor's degree in nursing. The aim of these projects is to demonstrate knowledge and understanding within the major field of the education. This study aimed to describe and analyze the topics as well as theoretical frameworks and concepts in nursing students' independent projects, which lead to a Bachelor's degree, in a Swedish context. A total of 491 independent projects, written by nursing students in Sweden, were included in the study. Topics together with theoretical frameworks and concepts in the projects were identified. Similar topics and theoretical frameworks and concepts, respectively, were grouped into subcategories, and similar subcategories were then merged into a main category. The number of entries in each category was counted for descriptive statistics in order to allow for the demonstration of magnitude. The most common topics concerned experiences and managing when having an illness, experiences of care and of being a caregiver, and healthcare staff's care and knowledge. The nursing theories/models that were most often used were Eriksson's Theory of Caritative Caring, Travelbee's Human-to-Human Relationship Model, and Orem's Self-care Theory. Among the non-nursing theories/models, perspectives and concepts lifeworld, ethical values and principles, existential concepts and quality of life/health-related quality of life, were most often used by these students. There may be some difficulty in finding a topic for the project that is relevant for both a professional qualification as a nurse, as well as for achieving the requirements of a Bachelor's degree in nursing. The study indicates that there is a need to widen the student's understanding of different nursing theories/perspectives/models/concepts during nursing education so that students are familiar with a broad range of these when conducting their independent project. Copyright © 2015 Elsevier Ltd. All rights reserved.

A feminist perspective on nursing education.

PubMed

Hedin, B A; Donovan, J

1989-01-01

Models of nursing education that mirror the human, caring side of nursing that we expect students to put into practice in the clinical arena are needed in the classroom. In that interest, the authors explore the relationship between feminism and nursing education and outline the characteristics of a nursing education process based on feminist principles and values.

Practical ethical theory for nurses responding to complexity in care.

PubMed

Fairchild, Roseanne Moody

2010-05-01

In the context of health care system complexity, nurses need responsive leadership and organizational support to maintain intrinsic motivation, moral sensitivity and a caring stance in the delivery of patient care. The current complexity of nurses' work environment promotes decreases in work motivation and moral satisfaction, thus creating motivational and ethical dissonance in practice. These and other work-related factors increase emotional stress and burnout for nurses, prompting both new and seasoned nurse professionals to leave their current position, or even the profession. This article presents a theoretical conceptual model for professional nurses to review and make sense of the ethical reasoning skills needed to maintain a caring stance in relation to the competing values that must coexist among nurses, health care administrators, patients and families in the context of the complex health care work environments in which nurses are expected to practice. A model, Nurses' Ethical Reasoning Skills, is presented as a framework for nurses' thinking through and problem solving ethical issues in clinical practice in the context of complexity in health care.

Implementing a sustainable clinical supervision model for Isles nurses in Orkney.

PubMed

Hall, Ian

2018-03-02

The Isles Network of Care (INOC) community nurses work at the extreme of the remote and rural continuum, working mostly as lone practitioners. Following the development of sustainable clinical supervision model for Isles nurses in Orkney, clinical supervision was found to improve both peer support and governance for this group of isolated staff. A literature overview identified the transition of clinical supervision in general nursing over 24 years from 'carrot' to 'stick'. The study included a questionnaire survey that was sent to the 2017 Queen's Nursing Institute Scotland cohort to elicit information about the nurses' experience of clinical supervision. The survey found that 55% provide supervision and 40% receive it. Health board encouragement of its use was found to be disappointingly low at 40%. The INOC nurses were surveyed about the new peer-support (restorative) model, which relies on video-conference contact to allow face to face interaction between isolated isles nurses. Feedback prompted a review of clinical supervision pairings, and the frequency and methods of meeting. The need for supervisor training led to agreement with the Remote and Rural Health Education Alliance to provide relevant support. The perceived benefits of supervision included increased support and reflection, and improved relationships with isolated colleagues.

The influence of leadership practices and empowerment on Canadian nurse manager outcomes.

PubMed

Spence Laschinger, Heather K; Wong, Carol A; Grau, Ashley L; Read, Emily A; Pineau Stam, Lisa M

2012-10-01

To examine the influence of senior nurse leadership practices on middle and first-line nurse managers' experiences of empowerment and organizational support and ultimately on their perceptions of patient care quality and turnover intentions. Empowering leadership has played an important role in staff nurse retention but there is limited research to explain the mechanisms by which leadership influences nurse managers' turnover intentions. This study was a secondary analysis of data collected using non-experimental, predictive mailed survey design. Data from 231 middle and 788 first-line Canadian acute care managers was used to test the hypothesized model using path analysis in each group. The results showed an adequate fit of the hypothesized model in both groups but with an added path between leadership practices and support in the middle line group. Transformational leadership practices of senior nurses empower middle- and first-line nurse managers, leading to increased perceptions of organizational support, quality care and decreased intent to leave. Empowered nurse managers at all levels who feel supported by their organizations are more likely to stay in their roles, remain committed to achieving quality patient care and act as influential role models for potential future leaders. © 2011 Blackwell Publishing Ltd.

Hospital nurses' wellbeing at work: a theoretical model.

PubMed

Utriainen, Kati; Ala-Mursula, Leena; Kyngäs, Helvi

2015-09-01

To develop a theoretical model of hospital nurses' wellbeing at work. The concept of wellbeing at work is presented without an exact definition and without considering different contents. A model was developed in a deductive manner and empirical data collected from nurses (n = 233) working in a university hospital. Explorative factor analysis was used. The main concepts were: patients' experience of high-quality care; assistance and support among nurses; nurses' togetherness and cooperation; fluent practical organisation of work; challenging and meaningful work; freedom to express diverse feelings in the work community; well-conducted everyday nursing; status related to the work itself; fair and supportive leadership; opportunities for professional development; fluent communication with other professionals; and being together with other nurses in an informal way. Themes included: collegial relationships; enhancing high-quality patient care; supportive and fair leadership; challenging, meaningful and well organised work; and opportunities for professional development. Object-dependent wellbeing was supported. Managers should focus on strengthening the positive aspect of wellbeing at work, focusing on providing fluently organised work practices, fair and supportive leadership and togetherness while allowing nurses to implement their own ideas and promote the experience of meaningfulness. © 2014 John Wiley & Sons Ltd.

Understanding cultural competence in a multicultural nursing workforce: registered nurses' experience in Saudi Arabia.

PubMed

Almutairi, Adel F; McCarthy, Alexandra; Gardner, Glenn E

2015-01-01

In Saudi Arabia, the health system is mainly staffed by expatriate nurses from different cultural and linguistic backgrounds. Given the potential risks this situation poses for patient care, it is important to understand how cultural diversity can be effectively managed in this multicultural environment. The purpose of this study was to explore notions of cultural competence with non-Saudi Arabian nurses working in a major hospital in Saudi Arabia. Face-to-face, audio-recorded, semistructured interviews were conducted with 24 non-Saudi Arabian nurses. Deductive data collection and analysis were undertaken drawing on Campinha-Bacote's cultural competence model. The data that could not be explained by this model were coded and analyzed inductively. Nurses within this culturally diverse environment struggled with the notion of cultural competence in terms of each other's cultural expectations and those of the dominant Saudi culture. The study also addressed the limitations of Campinha-Bacote's model, which did not account for all of the nurses' experiences. Subsequent inductive analysis yielded important themes that more fully explained the nurses' experiences in this environment. The findings can inform policy, professional education, and practice in the multicultural Saudi setting. © The Author(s) 2014.

An Excel Spreadsheet Model for States and Districts to Assess the Cost-Benefit of School Nursing Services.

PubMed

Wang, Li Yan; O'Brien, Mary Jane; Maughan, Erin D

2016-11-01

This paper describes a user-friendly, Excel spreadsheet model and two data collection instruments constructed by the authors to help states and districts perform cost-benefit analyses of school nursing services delivered by full-time school nurses. Prior to applying the model, states or districts need to collect data using two forms: "Daily Nurse Data Collection Form" and the "Teacher Survey." The former is used to record daily nursing activities, including number of student health encounters, number of medications administered, number of student early dismissals, and number of medical procedures performed. The latter is used to obtain estimates for the time teachers spend addressing student health issues. Once inputs are entered in the model, outputs are automatically calculated, including program costs, total benefits, net benefits, and benefit-cost ratio. The spreadsheet model, data collection tools, and instructions are available at the NASN website ( http://www.nasn.org/The/CostBenefitAnalysis ).

Clinical ethics residency for nurses: an education model to decrease moral distress and strengthen nurse retention in acute care.

PubMed

Grace, Pamela J; Robinson, Ellen M; Jurchak, Martha; Zollfrank, Angelika A; Lee, Susan M

2014-12-01

The experience of unaddressed moral distress can lead to nurse attrition and/or distancing from patients, compromising patient care. Nurses who are confident in their ethical decision making abilities and moral agency have the antidote to moral distress for themselves and their colleagues and can act as local or institutional ethics resources. We describe a grant-funded model education program designed to increase ethics competence throughout the institution.

Empowering nurses for work engagement and health in hospital settings.

PubMed

Laschinger, Heather K Spence; Finegan, Joan

2005-10-01

Employee empowerment has become an increasingly important factor in determining employee health and wellbeing in restructured healthcare settings. The authors tested a theoretical model which specified the relationships among structural empowerment, 6 areas of worklife that promote employee engagement, and staff nurses' physical and mental health. A predictive, non-experimental design was used to test the model in a random sample of staff nurses. The authors discuss their findings and the implication for nurse administrators.

Conflict engagement: a new model for nurses.

PubMed

Gerardi, Debra

2015-03-01

This article is one in a series on conflict. It is part of an ongoing series on leadership coordinated by the American Organization of Nurse Executives (AONE), highlighting topics of interest to nurse managers and emerging nurse leaders. The AONE provides leadership, professional development, advocacy, and research to advance nursing practice and patient care, promote nursing leadership excellence, and shape public policy for health care.

Mediating effects of workplace violence on the relationships between emotional labour and burnout among clinical nurses.

PubMed

Kim, Hyejin; Kim, Ji-Su; Choe, Kwisoon; Kwak, Yeunhee; Song, Jae-Seok

2018-06-05

To test a model of the relationship between nurses' burnout and emotional labour using structural equation modelling to identify the mediating effects of workplace violence. Nurses are a group that experiences high emotional labour and are exposed to various types of violence in the clinical setting. Burnout is related to emotional labour as well as exposure of workplace violence, but alternatives to reduce burnout in the context of emotional labour (e.g. reduction of workplace violence) have not been extensively investigated. This study adopted a cross-sectional design. A convenience sample comprising 400 nurses from 4 university hospitals in Korea was selected from 10 - 30 October 2016. Data on nurses' level of emotional labour, burnout and workplace violence were collected from participants. A composite-indicator structural equation model was used to examine the mediation model. Overall, 356 nurses (89.0%) returned the completed questionnaires. Burnout was significantly and positively associated with emotional labour and workplace violence. In addition, workplace violence mediated the relationship between emotional labour and burnout related to the nursing job. The findings suggest that, to alleviate burnout in clinical nurses due to emotional labour, various programs and policy measures should be adopted to prevent their exposure to workplace violence and to enhance the organizational management of violence. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

General and professional values of student nurses and nurse educators.

PubMed

Riklikiene, Olga; Karosas, Laima; Kaseliene, Snieguole

2018-03-01

The aim of this study was to explore and compare the self-reported general and professional values in undergraduate student nurses and nurse educators in Lithuania. Contemporary nursing requires strong moral motivation and clear values as nurses confront many ethical dilemas in their practice. Students acquire essential values of the nursing profession through the appropriate role modelling of their educators. Nursing students seek to become capable in providing ethical and professional patient care while their educators attempt to model desired behaviours. A national cross-sectional comparative study was carried out in March 2011. Four-hundred eight respondents participated: 316 undergraduate nursing students and 92 nurse educators. A 57-item questionnaire was delivered to nursing programs at three universities and six colleges. Permission to conduct the study was granted by The Center on Bioethics. Student nurses and their educators rated the general value of altruism equally. Educators, in comparison with students, ranked honesty and intellectualism significantly higher and more often admired truth-telling in any circumstance. Students were more likely to avoid intellectual challenges in reading and placed lower importance on academic qualifications for career advancement. The professional nursing values of honesty, intellectualism and authority were ranked significantly higher by nurse educators than student nurses. The study revealed differences in self-reported general and professional values in undergraduate student nurses and nurse educators. The values of nurse educators were not always stronger than those of students. Positive relationships between particular general and professional values in both students and educators confirmed the link between professional and personal values. © 2017 John Wiley & Sons Ltd.

Fatigue in hospital nurses - 'Supernurse' culture is a barrier to addressing problems: A qualitative interview study.

PubMed

Steege, Linsey M; Rainbow, Jessica G

2017-02-01

Fatigue in hospital nurses is associated with decreased nurse satisfaction, increased turnover and negative patient outcomes. Addressing fatigue in nurses has been identified as a priority by many organizations worldwide in an effort to promote both a culture of patient safety and a healthy nursing workforce. The overall aim of this study was to explore barriers and facilitators within the hospital nurse work system to nurse coping and fatigue. The purpose of this paper is to describe emergent themes that offer new insight describing the relationships among nurse perceptions of fatigue, nursing professional culture, and implications for the nursing workforce. A qualitative exploratory study was used to explore nurse identified sources, barriers to addressing, and consequences of fatigue. Twenty-two nurses working in intensive care and medical-surgical units within a large academic medical center in the United States participated in the interviews. Interviews with the participants followed a semi-structured interview guide that included questions eliciting participants' views on nurse fatigue levels, consequences of fatigue, and barriers to addressing fatigue. The interview transcripts were analyzed using directed content analysis guided by the Systems Engineering Initiative for Patient Safety (SEIPS) model. Additional themes that did not directly align with the SEIPS model were also identified. All nurses in the current study experienced fatigue; yet they had varying perspectives on the importance of addressing fatigue in relation to other health systems challenges. A new construct related to nursing professional culture was identified and defined as "Supernurse". Identified subthemes of Supernurse include: extraordinary powers used for good; cloak of invulnerability; no sidekick; Kryptonite, and an alterego. These values, beliefs, and behaviors define the specific aspects of nursing professional culture that can act as barriers to fatigue risk management programs and achieving safety culture in hospital organizations. Nurse fatigue and attributes of nurse professional culture also have implications for nurse satisfaction and retention. Findings from this study further support the role of nursing professional culture as an important barrier to effectively addressing fatigue in nursing work systems. Future work is needed to identify and evaluate innovative culture change models and strategies to target these barriers. Copyright © 2016 Elsevier Ltd. All rights reserved.

The influence of authentic leadership and empowerment on nurses' relational social capital, mental health and job satisfaction over the first year of practice.

PubMed

Read, Emily A; Laschinger, Heather K S

2015-07-01

To examine a theoretical model testing the effects of authentic leadership, structural empowerment and relational social capital on the mental health and job satisfaction of new graduate nurses over the first year of practice. Relational social capital is an important interpersonal organizational resource that may foster new graduate nurses' workplace well-being and promote retention. Evidence shows that authentic leadership and structural empowerment are key aspects of the work environment that support new graduate nurses; however, the mediating role of relational social capital has yet to be explored. A longitudinal survey design was used to test the hypothesized model. One hundred ninety-one new graduate nurses in Ontario with <2 years of experience completed mail surveys in January-March 2010 and 1 year later in 2011. Path analysis using structural equation modelling was used to test the theoretical model. Participants were mostly female, working full time in medicine/surgery or critical care. All measures demonstrated acceptable reliability and validity. Path analysis results supported our hypothesized model; structural empowerment mediated the relationship between authentic leadership and nurses' relational social capital, which in turn had a negative effect on mental health symptoms and a positive effect on job satisfaction. All indirect paths in the model were significant. By creating structurally empowering work environments, authentic leaders foster relational social capital among new graduate nurses leading to positive health and retention outcomes. © 2015 John Wiley & Sons Ltd.

[Structural Equation Modeling of Quality of Work Life in Clinical Nurses based on the Culture-Work-Health Model].

PubMed

Kim, Miji; Ryu, Eunjung

2015-12-01

The purpose of this study was to construct and test a structural equation model of quality of work life for clinical nurses based on Peterson and Wilson's Culture-Work-Health model (CWHM). A structured questionnaire was completed by 523 clinical nurses to analyze the relationships between concepts of CWHM-organizational culture, social support, employee health, organizational health, and quality of work life. Among these conceptual variables of CWHM, employee health was measured by perceived health status, and organizational health was measured by presenteeism. SPSS21.0 and AMOS 21.0 programs were used to analyze the efficiency of the hypothesized model and calculate the direct and indirect effects of factors affecting quality of work life among clinical nurses. The goodness-of-fit statistics of the final modified hypothetical model are as follows: χ²=586.03, χ²/df=4.19, GFI=.89, AGFI=.85, CFI=.91, TLI=.90, NFI=.89, and RMSEA=.08. The results revealed that organizational culture, social support, organizational health, and employee health accounted for 69% of clinical nurses' quality of work life. The major findings of this study indicate that it is essential to create a positive organizational culture and provide adequate organizational support to maintain a balance between the health of clinical nurses and the organization. Further repeated and expanded studies are needed to explore the multidimensional aspects of clinical nurses' quality of work life in Korea, including various factors, such as work environment, work stress, and burnout.

Impact of nurses' cross-cultural competence on nursing intellectual capital from a social cognitive theory perspective.

PubMed

Lin, Hsien-Cheng

2016-05-01

To understand the relationships among certain key factors such as organizational climate, self-efficacy and outcome expectation on registered nurses, with regard to the development of registered nurses' cross-cultural competence. The focus is specifically on the use of a social cognitive framework for nurses for providing intercultural nursing care to international patients. This study also aims to examine the relationship between nurses' cross-cultural competence and nursing intellectual capital. Given the influence of globalization on healthcare services, healthcare providers need to have enough cross-cultural competence to effectively care for patients from different cultures. Thus, the development of cross-cultural competence in nursing care has become an important issue. A quantitative method and a cross-sectional design were employed in this study. Data were collected from 309 RN working in 16 healthcare institutions in Taiwan from May to August 2013. Structural equation modelling, in combination with the smart partial least squares method, was used to measure the relationships in the research model. The results show that outcome expectation has a stronger impact on nurses' cross-cultural competence than self-efficacy. In addition, it was found that the cross-cultural competence of nurses has a positive impact on nursing intellectual capital. Nursing supervisors should promote a higher level of outcome expectation on nurses to enhance the improvement of their cross-cultural competence. Raising the cross-cultural competence of nurses will aid in the accumulation of nursing intellectual capital. © 2016 John Wiley & Sons Ltd.

Nursing research and bibliographic citation models.

PubMed

Angordans, Jordi Piqué; Puig, Ramón Camaño; Noguera, Carmen Piqué

2009-01-01

This research focuses on the analysis of how nursing journals publish their papers. Basically, two models are analyzed, Vancouver, by the International Committee of Medical Journal Editors, and APA by the American Psychological Association. Their advantages and disadvantages are discussed. In view of how research papers are currently published and how research is judged, the authors propose that nursing journals adopt their own model, irrespective of how medical professionals publish.

[Applying Neuman's Systems Model to a neuroleptic malignant syndrome psychiatric patient and his caregiver].

PubMed

Wang, Shu-Mi; Lai, Chien-Yu

2010-04-01

This article describes a nurse's experience using Neuman's Systems Model to care for a chronic psychiatric patient and his caregiver. The patient was diagnosed as suffering from neuroleptic malignant syndrome (NMS). Nursing care described in this article was administered from October 23 to December 4, 2007. The patient developed NMS in the third month of a three-month period of hospitalization, which endangered his life as well as the health of his caregiver. Nursing care was provided to the patient and his caregiver based on Neuman's Systems Model, which included assessments of intrapersonal, interpersonal, and extra-personal forces as well as of environmental factors affecting the health of the patient and his caregiver. The four nursing care issues identified included: existing self-care deficit, sensory/perceptual alteration, sleep pattern disturbance, and caregiver role strain. Following Neuman's systems model, primary, secondary, and tertiary prevention were used to strengthen the flexible lines of defense, internal lines of resistance, and supporting existing strengths of both patient and caregiver, as well as to conserve client system energy. Significant improvements in patient and caregiver abilities were apparent in nursing intervention outcomes. This experience shows the Neuman's systems model to be an efficient model in psychiatric nursing care.

The effect of nurse-patient interaction on anxiety and depression in cognitively intact nursing home patients.

PubMed

Haugan, Gørill; Innstrand, Siw T; Moksnes, Unni K

2013-08-01

To test the effects of nurse-patient interaction on anxiety and depression among cognitively intact nursing home patients. Depression is considered the most frequent mental disorder among the older population. Specifically, the depression rate among nursing home patients is three to four times higher than among community-dwelling older people, and a large overlap of anxiety is found. Therefore, identifying nursing strategies to prevent and decrease anxiety and depression is of great importance for nursing home patients' well-being. Nurse-patient interaction is described as a fundamental resource for meaning in life, dignity and thriving among nursing home patients. The study employed a cross-sectional design. The data were collected in 2008 and 2009 in 44 different nursing homes from 250 nursing home patients who met the inclusion criteria. A sample of 202 cognitively intact nursing home patients responded to the Nurse-Patient Interaction Scale and the Hospital Anxiety and Depression Scale. A structural equation model of the hypothesised relationships was tested by means of Lisrel 8.8 (Scientific Software International Inc., Lincolnwood, IL, USA). The SEM model tested demonstrated significant direct relationships and total effects of nurse-patient interaction on depression and a mediated influence on anxiety. Nurse-patient interaction influences depression, as well as anxiety, mediated by depression. Hence, nurse-patient interaction might be an important resource in relation to patients' mental health. Nurse-patient interaction is an essential factor of quality of care, perceived by long-term nursing home patients. Facilitating nurses' communicating and interactive skills and competence might prevent and decrease depression and anxiety among cognitively intact nursing home patients. © 2013 Blackwell Publishing Ltd.

Demonstrating the Relationship between School Nurse Workload and Student Outcomes

ERIC Educational Resources Information Center

Daughtry, Donna; Engelke, Martha Keehner

2018-01-01

This article describes how one very large, diverse school district developed a Student Acuity Tool for School Nurse Assignment and used a logic model to successfully advocate for additional school nurse positions. The logic model included three student outcomes that were evaluated: provide medications and procedures safely and accurately, increase…

A Comprehensive Community Nursing Center Model: Maximizing Practice Income--A Challenge to Educators.

ERIC Educational Resources Information Center

Walker, Patricia Hinton

1994-01-01

The University of Rochester's community nursing center is an entrepreneurial model for faculty practice based on sound business principles to enhance financial success. These principles include development and pricing of the product of nursing services, consumer dialogue instead of advertising monologue, and a diversified income base. (SK)

A Scoping Review: Conceptualizations and Pedagogical Models of Learning in Nursing Simulation

ERIC Educational Resources Information Center

Poikela, Paula; Teräs, Marianne

2015-01-01

Simulations have been implemented globally in nursing education for years with diverse conceptual foundations. The aim of this scoping review is to examine the literature regarding the conceptualizations of learning and pedagogical models in nursing simulations. A scoping review of peer-reviewed articles published between 2000 and 2013 was…

Draft Model Curriculum in Nursing Education for Alcohol and Other Drug Abuse.

ERIC Educational Resources Information Center

Naegle, Madeline A.; Burns, Elizabeth M.

This document contains three model curricula in nursing education for alcohol and other drug abuse, one graduate and one baccalaureate level from New York University's (NYU) Division of Nursing, and the third combining graduate and undergraduate level curricula for Ohio State University (OSU). The NYU undergraduate curriculum contains a pilot test…

Curriculum-Integrated Information Literacy (CIIL) in a Community College Nursing Program: A Practical Model

ERIC Educational Resources Information Center

Argüelles, Carlos

2016-01-01

This article describes a strategy to integrate information literacy into the curriculum of a nursing program in a community college. The model is articulated in four explained phases: preparatory, planning, implementation, and evaluation. It describes a collaborative process encouraging librarians to work with nursing faculty, driving students to…

How nurses can use social enterprise to improve services in health care.

PubMed

Dawes, David

This article describes the concept of social enterprise in nursing, and outlines how this model can help to improve care delivered to patients. It provides advice for nurses interested in pursuing this entrepreneurial route and also offers case studies demonstrating how the social enterprise model has been implemented in practice.

Belief in the "free choice" model of homosexuality: a correlate of homophobia in registered nurses.

PubMed

Blackwell, Christopher W

2007-01-01

A great amount of social science research has supported the positive correlation between heterosexuals' belief in the free choice model of homosexuality and homophobia. Heterosexuals who believe gay, lesbian, bisexual, and transgender (GLBT) persons consciously choose their sexual orientation and practice a lifestyle conducive to that choice are much more likely to possess discriminatory, homophobic, homonegative, and heterosexist beliefs. In addition, these individuals are less likely to support gay rights initiatives such as nondiscrimination policies or same-sex partner benefits in the workplace or hate crime enhancement legislation inclusive of GLBT persons. Although researchers have demonstrated this phenomenon in the general population, none have specifically assessed it in the nursing workforce. The purpose of this study was to examine registered nurses' overall levels of homophobia and attitudes toward a workplace policy protective of gays and lesbians. These variables were then correlated with belief in the free choice model of homosexuality. Results indicated that belief in the free choice model of homosexuality was the strongest predictor of homophobia in nurses. Implications for nursing leadership and management, nursing education, and future research are discussed.

Green House Adoption and Nursing Home Quality.

PubMed

Afendulis, Christopher C; Caudry, Daryl J; O'Malley, A James; Kemper, Peter; Grabowski, David C

2016-02-01

To evaluate the impact of the Green House (GH) model on nursing home resident-level quality of care measures. Resident-level minimum data set (MDS) assessments merged with Medicare inpatient claims for the period 2005 through 2010. Using a difference-in-differences framework, we compared changes in care quality and outcomes in 15 nursing homes that adopted the GH model relative to changes over the same time period in 223 matched nursing homes that had not adopted the GH model. For individuals residing in GH homes, adoption of the model lowered readmissions and several MDS measures of poor quality, including bedfast residents, catheter use, and pressure ulcers, but these results were not present across the entire GH organization, suggesting possible offsetting effects for residents of non-GH "legacy" units within the GH organization. GH adoption led to improvement in rehospitalizations and certain nursing home quality measures for individuals residing in a GH home. The absence of evidence of a decline in other clinical quality measures in GH nursing homes should reassure anyone concerned that GH might have sacrificed clinical quality for improved quality of life. © Health Research and Educational Trust.

Breaking Bad News: An Evidence-Based Review of Communication Models for Oncology Nurses.

PubMed

Bumb, Meridith; Keefe, Joanna; Miller, Lindsay; Overcash, Janine

2017-10-01

A diagnosis of cancer is a stressful, difficult, and life-altering event. Breaking bad news is distressing to patients and families and is often uncomfortable for the nurse delivering it. Evidence-based communication models have been developed and adapted for use in clinical practice to assist nurses with breaking bad news.

. The purpose of this article is to provide an overview on breaking bad news and to review the utility of the SPIKES and PEWTER evidence-based communication models for oncology nurses.
. Perceptions of breaking bad news from the nurse and patient perspectives, as well as barriers and consequences to effective communication, will be presented. Clinical examples of possible situations of breaking bad news will demonstrate how to use the SPIKES and PEWTER models of communication when disclosing bad news to patients and their families.
. By using the evidence-based communication strategies depicted in this article, oncology nurses can support the delivery of bad news and maintain communication with their patients and their patients' families in an effective and productive manner.

A human factors framework and study of the effect of nursing workload on patient safety and employee quality of working life.

PubMed

Holden, Richard J; Scanlon, Matthew C; Patel, Neal R; Kaushal, Rainu; Escoto, Kamisha Hamilton; Brown, Roger L; Alper, Samuel J; Arnold, Judi M; Shalaby, Theresa M; Murkowski, Kathleen; Karsh, Ben-Tzion

2011-01-01

Nursing workload is increasingly thought to contribute to both nurses' quality of working life and quality/safety of care. Prior studies lack a coherent model for conceptualising and measuring the effects of workload in healthcare. In contrast, we conceptualised a human factors model for workload specifying workload at three distinct levels of analysis and having multiple nurse and patient outcomes. To test this model, we analysed results from a cross-sectional survey of a volunteer sample of nurses in six units of two academic tertiary care paediatric hospitals. Workload measures were generally correlated with outcomes of interest. A multivariate structural model revealed that: the unit-level measure of staffing adequacy was significantly related to job dissatisfaction (path loading=0.31) and burnout (path loading=0.45); the task-level measure of mental workload related to interruptions, divided attention, and being rushed was associated with burnout (path loading=0.25) and medication error likelihood (path loading=1.04). Job-level workload was not uniquely and significantly associated with any outcomes. The human factors engineering model of nursing workload was supported by data from two paediatric hospitals. The findings provided a novel insight into specific ways that different types of workload could affect nurse and patient outcomes. These findings suggest further research and yield a number of human factors design suggestions.

Cost-effectiveness of a nurse practitioner-family physician model of care in a nursing home: controlled before and after study.

PubMed

Lacny, Sarah; Zarrabi, Mahmood; Martin-Misener, Ruth; Donald, Faith; Sketris, Ingrid; Murphy, Andrea L; DiCenso, Alba; Marshall, Deborah A

2016-09-01

To examine the cost-effectiveness of a nurse practitioner-family physician model of care compared with family physician-only care in a Canadian nursing home. As demand for long-term care increases, alternative care models including nurse practitioners are being explored. Cost-effectiveness analysis using a controlled before-after design. The study included an 18-month 'before' period (2005-2006) and a 21-month 'after' time period (2007-2009). Data were abstracted from charts from 2008-2010. We calculated incremental cost-effectiveness ratios comparing the intervention (nurse practitioner-family physician model; n = 45) to internal (n = 65), external (n = 70) and combined internal/external family physician-only control groups, measured as the change in healthcare costs divided by the change in emergency department transfers/person-month. We assessed joint uncertainty around costs and effects using non-parametric bootstrapping and cost-effectiveness acceptability curves. Point estimates of the incremental cost-effectiveness ratio demonstrated the nurse practitioner-family physician model dominated the internal and combined control groups (i.e. was associated with smaller increases in costs and emergency department transfers/person-month). Compared with the external control, the intervention resulted in a smaller increase in costs and larger increase in emergency department transfers. Using a willingness-to-pay threshold of $1000 CAD/emergency department transfer, the probability the intervention was cost-effective compared with the internal, external and combined control groups was 26%, 21% and 25%. Due to uncertainty around the distribution of costs and effects, we were unable to make a definitive conclusion regarding the cost-effectiveness of the nurse practitioner-family physician model; however, these results suggest benefits that could be confirmed in a larger study. © 2016 John Wiley & Sons Ltd.

Perceptions of leadership among final-year undergraduate nursing students.

PubMed

Francis-Shama, Jayne

2016-11-01

Aim The promotion of a distributed leadership model in health care means there is an expectation that undergraduate training should contribute to the development of nursing students' leadership capabilities. However, there is concern that the nursing degree programme is not sufficiently preparing students. This study explored nursing students' perceptions of leadership before qualifying, and how prepared they felt to take on leadership roles. Method Data were collected from 20 undergraduate nursing students, using a Straussian grounded theory approach, through three focus groups and six semi-structured interviews. Findings These suggest students are disengaged from the learning of leadership, and preparation for leadership in clinical areas is problematic, as students are exposed to flawed role modelling. Conclusion Discrepancies between nurse education and the realities of clinical practice mean that successfully preparing nursing students for leadership roles will be challenging within current provision.

Determining job satisfaction of nurses working in hospitals of Iran: A systematic review and meta-analysis.

PubMed

Amiresmaili, Mohammadreza; Moosazadeh, Mahmood

2013-09-01

Employees feeling and attitude to their job has a significant role on their performance. Present study sought to investigate documents related to nurses job satisfaction, using systematic review and meta-analysis to estimate nurses job satisfaction in Iran. Papers on nurses job satisfaction were identified by searching different data bases using appropriate key words. Seventeen studies were extracted using inclusuion criteria. Data were analyzed using Meta-analysis command in STATA 11. Considerable hetrogenecity is apparent in results of nurses job satisfaction studies. Although, according to random effect model, nurses total job satisfaction was estimated at 46.3 (CI: 32.1-60.4), this was estimated at 51.9 (CI = 51.1-52.8) using fixed effect model. Additionally, a reverse relationship was observed between nurses overall job satisfaction and their age. Nurses' job satisfaction in Iran is at a good level compared with other countries. The more satisfied the nurses are with their working conditions, the less is their intention to leave their job. Dissatisfaction is associated with higher resignment and turnover, paying deep attention to efficient factors on nurses dissatisfaction and trying to overcome them is important to improve nurses' working conditions.

Nurses' Satisfaction With Using Nursing Information Systems From Technology Acceptance Model and Information Systems Success Model Perspectives: A Reductionist Approach.

PubMed

Lin, Hsien-Cheng

2017-02-01

Nursing information systems can enhance nursing practice and the efficiency and quality of administrative affairs within the nursing department and thus have been widely considered for implementation. Close alignment of human-computer interaction can advance optimal clinical performance with the use of information systems. However, a lack of introduction of the concept of alignment between users' perceptions and technological functionality has caused dissatisfaction, as shown in the existing literature. This study provides insight into the alignment between nurses' perceptions and how technological functionality affects their satisfaction with Nursing Information System use through a reductionist perspective of alignment. This cross-sectional study collected data from 531 registered nurses in Taiwan. The results indicated that "perceived usefulness in system quality alignment," "perceived usefulness in information quality alignment," "perceived ease of use in system quality alignment," "perceived ease of use in information quality alignment," and "perceived ease of use in service quality alignment" have significantly affected nurses' satisfaction with Nursing Information System use. However, "perceived usefulness in service quality alignment" had no significant effect on nurses' satisfaction. This study also provides some meaningful implications for theoretical and practical aspects of design.

How SEIPS can be used as a model for macroergonomic approach in subunit healthcare (Case study: The nurse perception of fatigue in surgery ward unit)

NASA Astrophysics Data System (ADS)

Iftadi, Irwan; Astuti, Rahmaniyah Dwi; Pristiyana, Ardian Ade

2017-11-01

Occupational fatigue in healthcare nurses, which has multifaceted issues, is associated with decreased patient safety and the quality of nursing care. The aim of this study was to investigate the nurses fatigue problem in sub-unit healthcare based on their perceptual experience. Interviews were conducted and analyzed utilizing a direct qualitative content analysis approach using NVivo Software and guided by Model of System Engineering Initiative for Patient Safety (SEIPS). The findings of this research were a steering on what nurses perceive as contributing and preventing to fatigue which are likewise arranged in SEIPS model. It was shown that a macro ergonomic approach is valuable for understanding complexities of work systems, even though it is a small unit organization.

The mediating effect of self-reflection and learning effectiveness on clinical nursing performance in nursing students: A follow-up study.

PubMed

Pai, Hsiang-Chu; Ko, Hui-Ling; Eng, Cheng-Joo; Yen, Wen-Jiuan

The effectiveness of simulation learning and the effects of anxiety in the simulated situation have been understudied. In addition, research on the association between learning effectiveness and students' clinical care performance in the hospital setting is very limited in Taiwan. The aim of this study is to examine the mediating effect of self-reflection and simulation learning effectiveness on the clinical nursing performance of nursing students. A Prospective, longitudinal, and correlational design was used. The study was conducted from December 2014 to July 2015. Participants were 293 nursing students in southern Taiwan. A structural model was specified and tested using partial least squares structural equation modeling to examine the relationships between the variables. The results revealed that the model was robust in terms of its measurement quality (reliability, validity, and goodness of fit), with the data's explaining 38.3% of variance in nursing competence. As self-reflection and learning effectiveness were added into the structural model, the effect of anxiety on nursing competence was still significant, but the regression coefficient (β) estimate of -0.41 (p<0.05) changed to β=-0.15 (p<0.050),indicating that self-reflection and learning effectiveness mediated the relationship between anxiety and nursing competence. Nursing competence was negatively affected by anxiety and positively affected by self-reflection (β=0.49, p<0.05) and simulation learning effectiveness (β=0.10, p<0.05). The teacher's encouraging learning can have a positive influence on students' self-reflection and learning effectiveness, which then decreases the effect of anxiety on nursing competence and further promotes students' clinical care ability. Copyright © 2017 Elsevier Inc. All rights reserved.

[Loan of services developing palliative care skills based on the apprentice model].

PubMed

Dallaire, Clémence; Audet, Geneviève; L'Heureux, Michel; Saint-Laurent, Louise; Fillion, Lise; Morin, Diane; Dubé, Nathalie

2008-01-01

For over 25 years, the Maison Michel-Sarrazin, a private palliative care institution in the Quebec City region, has had an original agreement with other establishments in the healthcare network (hospitals, long-term residential centres and CLSCs), in the form of the loan of nursing services. Based on the findings of a study as part of a research program, this article describes the loan of nursing services and qualitatively assesses its effects on the development of nurses' palliative care skills. An evaluative descriptive approach based on two conceptual frameworks (Giddens; Patton) was used to compile the views of 79 players. The findings demonstrate the innovative nature of the loan of nursing services and its considerable influence on the development of nursing skills, thanks to training based on the apprenticeship model (learning through observation and imitation), and on nursing practice at the Maison Michel-Sarrazin. Nevertheless, the controversy surrounding training using the apprenticeship model and the lack of recognition of this training on the part of the lending institutions raise questions despite the general satisfaction with the loan of nursing services.

A multidisciplinary approach to team nursing within a low secure service: the team leader role.

PubMed

Nagi, Claire; Davies, Jason; Williams, Marie; Roberts, Catherine; Lewis, Roger

2012-01-01

This article critically examines the clinical utility of redesigning a nursing practice model within the Intensive Support and Intervention Service, a new low secure mental health facility in the United Kingdom. Specifically, the "team nursing" approach to care delivery has been adapted to consist of multidisciplinary team leaders as opposed to nursing team leaders. The authors describe the role, properties, and functions of the multidisciplinary team leader approach. The authors provide examples of the benefits and challenges posed to date and the ways in which potential barriers have been overcome. Nursing care leadership can be provided by multidisciplinary staff. An adapted model of team nursing can be implemented in a low secure setting. © 2011 Wiley Periodicals, Inc.

Nursing home queues and home health users.

PubMed

Swan, J H; Benjamin, A E

1993-01-01

Home health market growth suggests the need for models explaining home health utilization. We have previously explained state-level Medicare home health visits with reference to nursing home markets. Here we introduce a model whereby state-level Medicare home health use is a function of nursing home queues and other demand and supply factors. Medicare home health users per state population is negatively related to nursing home bed stock, positively to Medicaid eligibility levels and to Medicaid nursing home recipients per population, as well as to various other demand and supply measures. This explanation of home health users explains previously-reported findings for home health visits. The findings support the argument that home health use is explained by factors affecting lengths of nursing home queues.

Prediction of Nursing Workload in Hospital.

PubMed

Fiebig, Madlen; Hunstein, Dirk; Bartholomeyczik, Sabine

2018-01-01

A dissertation project at the Witten/Herdecke University [1] is investigating which (nursing sensitive) patient characteristics are suitable for predicting a higher or lower degree of nursing workload. For this research project four predictive modelling methods were selected. In a first step, SUPPORT VECTOR MACHINE, RANDOM FOREST, and GRADIENT BOOSTING were used to identify potential predictors from the nursing sensitive patient characteristics. The results were compared via FEATURE IMPORTANCE. To predict nursing workload the predictors identified in step 1 were modelled using MULTINOMIAL LOGISTIC REGRESSION. First results from the data mining process will be presented. A prognostic determination of nursing workload can be used not only as a basis for human resource planning in hospital, but also to respond to health policy issues.

Navy Nurse Corps manpower management model.

PubMed

Kinstler, Daniel P; Johnson, Raymond W; Richter, Anke; Kocher, Kathryn

2008-01-01

The Navy Nurse Corps is part of a team of professionals that provides high quality, economical health care to approximately 700,000 active duty Navy and Marine Corps members, as well as 2.6 million retired and family members. Navy Nurse Corps manpower management efficiency is critical to providing this care. This paper aims to focus on manpower planning in the Navy Nurse Corps. The Nurse Corps manages personnel primarily through the recruitment process, drawing on multiple hiring sources. Promotion rates at the lowest two ranks are mandated, but not at the higher ranks. Retention rates vary across pay grades. Using these promotion and attrition rates, a Markov model was constructed to model the personnel flow of junior nurse corps officers. Hiring sources were shown to have a statistically significant effect on promotion and retention rates. However, these effects were not found to be practically significant in the Markov model. Only small improvements in rank imbalances are possible given current recruiting guidelines. Allowing greater flexibility in recruiting practices, fewer recruits would generate a 25 percent reduction in rank imbalances, but result in understaffing. Recruiting different ranks at entry would generate a 65 percent reduction in rank imbalances without understaffing issues. Policies adjusting promotion and retention rates are more powerful in controlling personnel flows than adjusting hiring sources. These policies are the only means for addressing the fundamental sources of rank imbalances in the Navy Nurse Corps arising from current manpower guidelines. The paper shows that modeling to improve manpower management may enable the Navy Nurse Corps to more efficiently fulfill its mandate for high-quality healthcare.

The impact of the work environment of nurses on patient safety outcomes: a multi-level modelling approach.

PubMed

Kirwan, Marcia; Matthews, Anne; Scott, P Anne

2013-02-01

Patient safety is a priority for health services in all countries. The importance of the nurse's role in patient safety has been established. Effective nurse staffing levels, nurse education levels, and a positive work environment for nurses are factors which are known to impact on patient safety outcomes. This study sought to explore the relationship between the ward environment in which nurses practice and specific patient safety outcomes, using ward level variables as well as nurse level variables. The outcomes were nurse-reported patient safety levels in the wards in which they work, and numbers of formal adverse events reports submitted by nurses in the last year. This cross-sectional quantitative study was carried out within a European FP7 project: Nurse Forecasting: Human Resources Planning in Nursing (RN4CAST) project. 108 general medical and surgical wards in 30 hospitals throughout Ireland. All nurses in direct patient care in the study wards were invited to participate. Data from 1397 of these nurses were used in this analysis. A nurse survey was carried out using a questionnaire incorporating the Practice Environment Scale of the Nursing Work Index (PES-NWI). Ethical approval was obtained from the authors' institution and all ethics committees representing the 30 study hospitals. Multilevel modelling was carried out to examine the impact of ward level factors on patient safety. These included proportions of nurses on the ward educated to degree level, and aggregated ward-level mean for PES-NWI scores. The study results support other research findings indicating that a positive practice environment enhances patient safety outcomes. Specifically at ward level, factors such as the ward practice environment and the proportion of nurses with degrees were found to significantly impact safety outcomes. The models developed for this study predicted 76% and 51% of the between-ward variance of these outcomes. The results can be used to enhance patient safety within hospitals by demonstrating factors at ward-level which enable nurses to effectively carry out this aspect of their role. The importance of ward-level nurse factors such as nurse education level and the work environment should be recognised and manipulated as important influences on patient safety. Copyright © 2012 Elsevier Ltd. All rights reserved.

Nonlinear Analysis to Detect if Excellent Nursing Work Environments Have Highest Well-Being.

PubMed

Casalicchio, Giuseppe; Lesaffre, Emmanuel; Küchenhoff, Helmut; Bruyneel, Luk

2017-09-01

To detect potentially nonlinear associations between nurses' work environment and nurse staffing on the one hand and nurse burnout on the other hand. A cross-sectional multicountry study for which data collection using a survey of 33,731 registered nurses in 12 European countries took place during 2009 to 2010. A semiparametric latent variable model that describes both linear and potentially nonlinear associations between burnout (Maslach Burnout Inventory: emotional exhaustion, depersonalization, personal accomplishment) and work environment (Practice Environment Scale of the Nursing Work Index: managerial support for nursing, doctor-nurse collegial relations, promotion of care quality) and staffing (patient-to-nurse ratio). Similar conclusions are reached from linear and nonlinear models estimating the association between work environment and burnout. For staffing, an increase in the patient-to-nurse ratio is associated with an increase in emotional exhaustion. At about 15 patients per nurse, no further increase in emotional exhaustion is seen. Absence of evidence for diminishing returns of improving work environments suggests that continuous improvement and achieving excellence in nurse work environments pays off strongly in terms of lower nurse-reported burnout rates. Nurse staffing policy would benefit from a larger number of studies that identify specific minimum as well as maximum thresholds at which inputs affect nurse and patient outcomes. Nurse burnout is omnipresent and has previously been shown to be related to worse patient outcomes. Additional increments in characteristics of excellent work environments, up to the highest possible standard, correspond to lower nurse burnout. © 2017 Sigma Theta Tau International.

Predictors of hospital nurses' intent to stay: a cross-sectional questionnaire survey in Shanghai, China.

PubMed

Wang, L; Tao, H; Ellenbecker, C H; Liu, X H

2012-12-01

To investigate predictors of hospital nurses' intent to stay in the nursing profession. A cross-sectional survey design was adopted. Over 1000 nurses working in hospitals in Shanghai, China, were invited to complete a survey questionnaire between May and October 2009 and 919 nurses responded for an 82% response rate. Regression models explained 41.3% of variance in nurse intent to stay. Although the proposed model hypothesized 18 predictors of intent to stay, only seven were statistically significant factors of nurse intent to stay: normative commitment, economic costs commitment, age, limited alternatives commitment, praise/recognition, professional advancement opportunities and the hospital classification. Of these, the strongest predictors were normative commitment, economic costs commitment and age, which explained 37.3% of variance in nurse intent to stay. Possible strategies to improve nurses' intent to stay include employment practices that improve the work environment, increased wages and benefits, and greater professional opportunity for nurses' personal growth development and promotion. Healthcare organizations should establish an asserting and nurturing environment for nurses and improve nurses' normative commitment and economic costs commitment. Increased effort should be made to improve nurses' conditions in primary and secondary hospitals where nurses report a lower level of intent to stay in nursing. Participants came from a limited number of hospitals in Shanghai. A larger sample from different hospitals in Shanghai and other districts in Mainland China could have enhanced the generalizability of the results and increased the power of the study. © 2012 The Authors. International Nursing Review © 2012 International Council of Nurses.

Establishing a Measurement Tool for a Nursing Work Environment in Taiwan.

PubMed

Lin, Li-Chiu; Lee, Huan-Fang; Yen, Miaofen

2017-02-01

The nursing work environment is a critical global health care problem. Many health care providers are concerned about the associations between the nursing work environment and the outcomes of organizations, nurses, and patients. Nursing work environment instruments have been assessed in the West but have not been considered in Asia. However, different cultures will affect the factorial structure of the tool. Using a stratified nationwide random sample, we created a measurement tool for the nursing work environment in Taiwan. The Nursing Work Environment Index-Revised Scale and the Essentials of Magnetism scale were used to examine the factorial structure. Item analysis, exploratory factor analysis, and confirmatory factor analysis were used to examine the hypothesis model and generate a new factorial structure. The Taiwan Nursing Work Environment Index (TNWEI) was established to evaluate the nursing work environment in Taiwan. The four factors were labeled "Organizational Support" (7 items), "Nurse Staffing and Resources" (4 items), "Nurse-Physician Collaboration" (4 items), and "Support for Continuing Education" (4 items). The 19 items explained 58.5% of the variance. Confirmatory factor analysis showed a good fit to the model (x2/df = 5.99; p < .05, goodness of fit index [GFI] = .90; RMSEA = .07). The TNWEI provides a comprehensive and efficient method for measuring the nurses' work environment in Taiwan.

Enabling professional development in mental health nursing: the role of clinical leadership.

PubMed

Ennis, G; Happell, B; Reid-Searl, K

2015-10-01

Clinical leadership is acknowledged as important to the nursing profession. While studies continue to identify its significance in contributing to positive outcomes for consumers, the role that clinical leadership has in enabling and supporting professional development in mental health nursing is poorly understood. This study utilized a grounded theory methodology to explore the characteristics clinicians consider important for clinical leadership and its significance for mental health nursing in day-to-day clinical practice. Individual face-to-face, semi-structured interviews were conducted with nurses working in mental health settings. Participants described the important role that clinical leaders play in enabling professional development of others through role modelling and clinical teaching. They describe how nurses, whom they perceive as clinical leaders, use role modelling and clinical teaching to influence the professional development of nursing staff and undergraduate nursing students. Attributes such as professionalism and honesty were seen, by participants, as enablers for clinical leaders in effectively and positively supporting the professional development of junior staff and undergraduate nurses in mental health nursing. This paper examines clinical leadership from the perspective of mental health nurses delivering care, and highlights the important role of clinical leaders in supporting professional development in mental health nursing. © 2015 John Wiley & Sons Ltd.

Nursing Home Staffing and Quality under the Nursing Home Reform Act

ERIC Educational Resources Information Center

Zhang, Xinzhi; Grabowski, David C.

2004-01-01

Purpose: We examine whether the Nursing Home Reform Act (NHRA) improved nursing home staffing and quality. Design and Methods: Data from 5,092 nursing homes were linked across the 1987 Medicare/Medicaid Automated Certification System and the 1993 Online Survey, Certification and Reporting system. A dummy-year model was used to examine the effects…

Joinng the ranks: nurses as role models.

PubMed

Davidhizar, Ruth

2005-01-01

The average age of today's nurse is 45. The average age of today's nurse educator is 55. Not only is the mean age of nurses increasing, but the United States is also facing a national nursing shortage crisis--with fewer and fewer nurses both in the field and entering the profession. Massive advertising campaigns highlighting flexible nursing opportunities, increased incentives from health care agencies in need of nurses, and newly created flexible shift opportunities for nurses include strategies aimed at addressing this shortage. Fortunately, nursing education programs are seeing an increase in applicants, and many schools of nursing are filling their slots for new students to capacity. But this problem will not be solved by solely tempting new recruits.

Evaluation of a support worker role, within a nurse delegation and supervision model, for provision of medicines support for older people living at home: the Workforce Innovation for Safe and Effective (WISE) Medicines Care study.

PubMed

Lee, Cik Yin; Beanland, Christine; Goeman, Dianne; Johnson, Ann; Thorn, Juliet; Koch, Susan; Elliott, Rohan A

2015-10-06

Support with managing medicines at home is a common reason for older people to receive community nursing services. With population ageing and projected nurse shortages, reliance on nurses may not be sustainable. We developed and tested a new workforce model: 'Workforce Innovation for Safe and Effective (WISE) Medicines Care', which enabled nurses to delegate medicines support home visits for low-risk clients to support workers (known as community care aides [CCAs]). Primary study aims were to assess whether the model increased the number of medicines support home visits conducted by CCAs, explore nurses', CCAs' and consumers' experiences with the CCAs' expanded role, and identify enablers and barriers to delegation of medicines support. A prospective before-after mixed-methods study was conducted within a community nursing service that employed a small number of CCAs. The CCAs' main role prior to the WISE Medicines Care model was personal care, with a very limited role in medicines support. CCAs received training in medicines support, and nurses received training in assessment, delegation and supervision. Home visit data over two three-month periods were compared. Focus groups and interviews were conducted with purposive samples of nurses (n = 27), CCAs (n = 7) and consumers (n = 28). Medicines support visits by CCAs increased from 43/16,863 (0.25 %) to 714/21,552 (3.3 %) (p < 0.001). Nurses reported mostly positive experiences, and high levels of trust and confidence in CCAs. They reported that delegating to CCAs sometimes eliminated the need for duplicate nurse and CCA visits (for people requiring personal care plus medicines support) and enabled them to visit people with more complex needs. CCAs enjoyed their expanded role and were accepted by clients and/or carers. Nurses and CCAs reported effective communication when medicine-related problems occurred. No medication incidents involving CCAs were reported. Barriers to implementation included the limited number of CCAs employed in the organisation and reluctance from some nurses to delegate medicines support to CCAs. Enablers included training and support, existing relationships between CCAs and nurses, and positive staff attitudes. Appropriately trained and supervised support workers can be used to support community nurses with providing medicines management for older people in the home care setting, particularly for those who are at low risk of adverse medication events or errors. The model was acceptable to nurses, clients and carers, and may offer a sustainable and safe and effective future workforce solution to provision of medicines support for older people in the home care setting.

A new model in teaching undergraduate research: A collaborative approach and learning cooperatives.

PubMed

O'Neal, Pamela V; McClellan, Lynx Carlton; Jarosinski, Judith M

2016-05-01

Forming new, innovative collaborative approaches and cooperative learning methods between universities and hospitals maximize learning for undergraduate nursing students in a research course and provide professional development for nurses on the unit. The purpose of this Collaborative Approach and Learning Cooperatives (CALC) Model is to foster working relations between faculty and hospital administrators, maximize small group learning of undergraduate nursing students, and promote onsite knowledge of evidence based care for unit nurses. A quality improvement study using the CALC Model was implemented in an undergraduate nursing research course at a southern university. Hospital administrators provided a list of clinical concerns based on national performance outcome measures. Undergraduate junior nursing student teams chose a clinical question, gathered evidence from the literature, synthesized results, demonstrated practice application, and developed practice recommendations. The student teams developed posters, which were evaluated by hospital administrators. The administrators selected several posters to display on hospital units for continuing education opportunity. This CALC Model is a systematic, calculated approach and an economically feasible plan to maximize personnel and financial resources to optimize collaboration and cooperative learning. Universities and hospital administrators, nurses, and students benefit from working together and learning from each other. Copyright © 2016 Elsevier Ltd. All rights reserved.

An Integrative Review of Flipped Classroom Teaching Models in Nursing Education.

PubMed

Njie-Carr, Veronica P S; Ludeman, Emilie; Lee, Mei Ching; Dordunoo, Dzifa; Trocky, Nina M; Jenkins, Louise S

Nursing care is changing dramatically given the need for students to address complex and multiple patient comorbidities. Students experience difficulties applying knowledge gained from didactic instruction to make important clinical decisions for optimal patient care. To optimize nursing education pedagogy, innovative teaching strategies are required to prepare future nurses for practice. This integrative review synthesized the state of the science on flipped classroom models from 13 empirical studies published through May 2016. The purpose of the review was to evaluate studies conducted on flipped classroom models among nursing students using a validated framework by Whittemore and Knafl. Multiple academic databases were searched, ranging in scope including PubMed, Embase (Elsevier), CINAHL (Ebsco), Scopus, Web of Science, and Google Scholar, resulting in 95 unique records. After screening and full-text reviews, 82 papers were removed. Thirteen empirical studies were included in the final analysis and results provided (a) design and process information on flipped classroom models in nursing education, (b) a summary of the state of the evidence to inform the implementation of flipped classrooms, and (c) a foundation to build future research in this area of nursing education. To develop sound evidence-based teaching strategies, rigorous scientific methods are needed to inform the implementation of flipped classroom approaches. Copyright © 2016 Elsevier Inc. All rights reserved.

Development of an International School Nurse Asthma Care Coordination Model

PubMed Central

Garwick, Ann W.; Svavarsdóttir, Erla Kolbrun; Seppelt, Ann M.; Looman, Wendy S.; Anderson, Lori S.; Örlygsdóttir, Brynja

2015-01-01

Aim To identify and compare how school nurses in Reykjavik, Iceland and St. Paul, Minnesota coordinated care for youth with asthma (ages 10–18) and to develop an asthma school nurse care coordination model. Background Little is known about how school nurses coordinate care for youth with asthma in different countries. Design A qualitative descriptive study design using focus group data. Methods Six focus groups with 32 school nurses were conducted in Reykjavik (n=17) and St. Paul (n=15) using the same protocol between September 2008 – January 2009. Descriptive content analytic and constant comparison strategies were used to categorize and compare how school nurses coordinated care, which resulted in the development of an International School Nurse Asthma Care Coordination Model. Findings Participants in both countries spontaneously described a similar asthma care coordination process that involved information gathering, assessing risk for asthma episodes, prioritizing health care needs and anticipating and planning for student needs at the individual and school levels. This process informed how they individualized symptom management, case management and/or asthma education. School nurses played a pivotal part in collaborating with families, school and health care professionals to ensure quality care for youth with asthma. Conclusions Results indicate a high level of complexity in school nurses’ approaches to asthma care coordination that were responsive to the diverse and changing needs of students in school settings. The conceptual model derived provides a framework for investigators to use in examining the asthma care coordination process of school nurses in other geographic locations. PMID:25223389

Hospital explores winning balance in perioperative education.

PubMed

Onstott, A T

1998-09-01

Although there are a number of education models used today that expose bachelor of nursing degree students to perioperative nursing, producing nursing graduates who have the education and experience needed to work in the demanding perioperative arena is a challenge for education facilities. The University of Colorado Health Sciences Center, Denver, has developed a perioperative education model that interfaces with one of the university's clinical sites, University Hospital, Denver, to achieve a winning balance between perioperative education and employment. The model provides nursing students with a realistic perspective of the OR and gives the employer an opportunity to thoroughly evaluate potential employees--beyond a resume and references.

Emergency room nurses' pathway to turnover intention: a moderated serial mediation analysis.

PubMed

Bruyneel, Luk; Thoelen, Tom; Adriaenssens, Jef; Sermeus, Walter

2017-04-01

The aim of this study was to explore the association between the quality of the work environment, job characteristics, demographic characteristics and a pathway of job satisfaction, emotional exhaustion and turnover intention among nurses in emergency departments and perform subgroup analyses. Turnover intention among nurses is high. Multiple causes have been described, mostly in large studies of nurses working on general wards, often without considering complementarity of conceptual models and showing scant interest in the consistency of associations across subgroups of nurses. Cross-sectional multicentre survey. Convenience sample of 294 nurses in 11 Belgian emergency departments during 2014-2015. Indirect effects in the form of mediation and serial mediation were estimated to assess the association between work environment (Magnet model), job characteristics (Job Demand Control Support model) and turnover intention via job satisfaction and emotional exhaustion. Consistency of these indirect effects across subgroups of nurses was examined using moderated mediation analysis (conditional indirect effects). Several Magnet and Job Demand Control Support dimensions were related to turnover intention, either via job dissatisfaction (mediation) or via job satisfaction and emotional exhaustion (serial mediation). In the case of social support from supervisor, these indirect effects were only significant for female nurses, among whom turnover intention was higher. Last, nurses with more years of experience were less likely to indicate turnover intention. To maximize prevention of turnover intention at emergency departments, interventions could target early career nurses, work environment and job characteristics. Female nurses in particular may also benefit from improved social support from their supervisor. © 2016 John Wiley & Sons Ltd.

Service and education share responsibility for nurses' value development.

PubMed

Schank, M J; Weis, D

2001-01-01

This article examines professional values of senior baccalaureate nursing students and practicing nurses. An important finding was that practicing nurses rated behaviors reflecting values in the American Nurses Association (ANA) Code for Nurses as more important than did senior students, thereby supporting the notion that practice contributes to value formation. The ongoing development and internalization of the nursing professions' values requires active involvement by staff development educators. The phenomena of value formation and development of professional values appear to mirror the novice to expert model.

Building a Culture of Authentic Partnership: One Academic Health Center Model for Nursing Leadership.

PubMed

Heath, Janie; Swartz, Colleen

2017-09-01

Senior nursing leaders from the University of Kentucky (UK) College of Nursing and UK HealthCare have explored the meaning of an authentic partnership. This article quantifies the tangible benefits and outcomes from this maturing academic nursing and clinical practice partnership. Benefits include inaugural academic nursing participation in health system governance, expanded integration of nursing research programs both in the college and in the health science center, and the development of collaborative strategies to address nursing workforce needs.

Thoughts About Nursing Curricula: Dark Clouds and Bright Lights.

PubMed

Turkel, Marian C; Fawcett, Jacqueline; Amankwaa, Linda; Clarke, Pamela N; Dee, Vivien; Eustace, Rosemary; Hansell, Phyllis Shanley; Jones, Dorothy A; Smith, Marlaine C; Zahourek, Rothlyn

2018-04-01

In this essay, several nurse scholars who are particularly concerned about the contemporary state of nursing science present their concerns about the inclusion of nursing conceptual models and theories in the curricula of nursing programs (dark clouds) and ways in which the concerns have been addressed (bright lights). This essay is the second of two essays that were catalyzed by Barrett's paper, "Again, What Is Nursing Science?" The first essay was published in the previous issue of Nursing Science Quarterly.

Examination of a cognitive model of stress, burnout, and intention to resign for Japanese nurses.

PubMed

Ohue, Takashi; Moriyama, Michiko; Nakaya, Takashi

2011-06-01

A reduction in burnout is required to decrease the voluntary turnover of nurses. This study was carried out with the aim of establishing a cognitive model of stress, burnout, and intention to resign for nurses. A questionnaire survey was administered to 336 nurses (27 male and 309 female) who had worked for ≤5 years at a hospital with multiple departments. The survey included an evaluation of burnout (Maslach Burnout Inventory), stress (Nursing Job Stressor Scale), automatic thoughts (Automatic Thoughts Questionnaire-Revised), and irrational beliefs (Japanese Irrational Belief Test), in addition to the intention to resign. The stressors that affected burnout in the nurses included conflict with other nursing staff, nursing role conflict, qualitative workload, quantitative workload, and conflict with patients. The irrational beliefs that were related to burnout included dependence, problem avoidance, and helplessness. In order to examine the automatic thoughts affecting burnout, groups with low and high negative automatic thoughts and low and high positive automatic thoughts were established. A two-way ANOVA showed a significant interaction of these factors with emotional exhaustion, but no significant interaction with depersonalization and a personal sense of accomplishment. Only the major effect was significant. The final model showed a process of "stressor → irrational beliefs → negative automatic thoughts/positive automatic thoughts → burnout". In addition, a relationship between burnout and an intention to resign was shown. These results suggest that stress and burnout in nurses might be prevented and that the number of nurses who leave their position could be decreased by changing irrational beliefs to rational beliefs, decreasing negative automatic thoughts, and facilitating positive automatic thoughts. © 2010 The Authors. Japan Journal of Nursing Science © 2010 Japan Academy of Nursing Science.

Design of an Intelligent Nursing Clinical Pathway and Nursing Order Support System for Traditional Chinese Medicine.

PubMed

Ding, Bao-Fen; Chang, Polun; Wang, Ping; Li, Hai-Ting; Kuo, Ming-Chuan

2017-01-01

With an in-depth analysis of nursing work in 14 hospitals over a period of two years, one unique total nursing information system framework was established where the nursing clinical pathways are used as the main frame and the nursing orders as the nodes on the frame. We used the nursing order concept with the principles of nursing process. A closed-loop management model composed of the nursing orders was set up to solve nursing problems. Based on the principles of traditional Chinese medicine, we further designed an intelligent support module to automatically deduct clinical nursing pathways to promote standardized management and improve the quality of nursing care. The system has successfully been implemented in some facilities since 2015.

Latent Growth Modeling of nursing care dependency of acute neurological inpatients.

PubMed

Piredda, M; Ghezzi, V; De Marinis, M G; Palese, A

2015-01-01

Longitudinal three-time point study, addressing how neurological adult patient care dependency varies from the admission time to the 3rd day of acute hospitalization. Nursing care dependency was measured with the Care Dependency Scale (CDS) and a Latent Growth Modeling approach was used to analyse the CDS trend in 124 neurosurgical and stroke inpatients. Care dependence followed a decreasing linear trend. Results can help nurse-managers planning an appropriate amount of nursing care for acute neurological patients during their initial stage of hospitalization. Further studies are needed aimed at investigating the determinants of nursing care dependence during the entire in-hospital stay.

Allocation of nursing care hours in a combined ophthalmic nursing unit.

PubMed

Navarro, V B; Stout, W A; Tolley, F M

1995-04-01

Traditional service configuration with separate nursing units for outpatient and inpatient care is becoming ineffective for new patient care delivery models. With the new configuration of a combined nursing unit, it was necessary to rethink traditional reporting methodologies and calculation of hours of care. This project management plan is an initial attempt to develop a standard costing/productivity model for a combined unit. The methodology developed from this plan measures nursing care hours for each patient population to determine the number of full time equivalents (FTEs) for a combined unit and allocates FTEs based on inpatient (IP), outpatient (OP), and emergency room (ER) volumes.

The Peace and Power Conceptual Model: An Assessment Guide for School Nurses Regarding Commercial Sexual Exploitation of Children.

PubMed

Fraley, Hannah E; Aronowitz, Teri

2017-10-01

Human trafficking is a global problem; more than half of all victims are children. In the United States (US), at-risk youth continue to attend school. School nurses are on the frontlines, presenting a window of opportunity to identify and prevent exploitation. Available papers targeting school nurses report that school nurses may lack awareness of commercial sexual exploitation and may have attitudes and misperceptions about behaviors of school children at risk. This is a theoretical paper applying the Peace and Power Conceptual Model to understand the role of school nurses in commercial sexual exploitation of children.

[Application of an improved model of a job-matching platform for nurses].

PubMed

Huang, Way-Ren; Lin, Chiou-Fen

2015-04-01

The three-month attrition rate for new nurses in Taiwan remains high. Many hospitals rely on traditional recruitment methods to find new nurses, yet it appears that their efficacy is less than ideal. To effectively solve this manpower shortage, a nursing resource platform is a project worth developing in the future. This study aimed to utilize a quality-improvement model to establish communication between hospitals and nursing students and create a customized employee-employer information-matching platform to help nursing students enter the workforce. This study was structured around a quality-improvement model and used current situation analysis, literature review, focus-group discussions, and process re-engineering to formulate necessary content for a job-matching platform for nursing. The concept of an academia-industry strategic alliance helped connect supply and demand within the same supply chain. The nurse job-matching platform created in this study provided job flexibility as well as job suitability assessments and continued follow-up and services for nurses after entering the workforce to provide more accurate matching of employers and employees. The academia-industry strategic alliance, job suitability, and long-term follow-up designed in this study are all new features in Taiwan's human resource service systems. The proposed human resource process re-engineering provides nursing students facing graduation with a professionally managed human resources platform. Allowing students to find an appropriate job prior to graduation will improve willingness to work and employee retention.

The nursing contribution to chronic disease management: a case of public expectation? Qualitative findings from a multiple case study design in England and Wales.

PubMed

Wilson, Patricia Mary; Brooks, Fiona; Procter, Susan; Kendall, Sally

2012-01-01

The global response to the rise in prevalence of chronic disease is a focus on the way services are managed and delivered, in which nurses are seen as central in shaping patient experience. However, there is relatively little known on how patients perceive the changes to service delivery envisaged by chronic care models. The PEARLE project aimed to explore, identify and characterise the origins, processes and outcomes of effective chronic disease management models and the nursing contributions to the models. Design, settings and participants Case study design of seven sites in England and Wales ensuring a range of chronic disease management models. Participants included over ninety patients and family carers ranging in age from children to older people with conditions such as diabetes, respiratory disease, epilepsy, or coronary heart disease. Semi-structured interviews with patients and family carers. Focus groups were conducted with adolescents and children. A whole systems approach guided data collection and data were thematically analysed. Despite nurses' role and skill development and the shift away from the acute care model, the results suggested that patients had a persisting belief in the monopoly of expertise continuing to exist in the acute care setting. Patients were more satisfied if they saw the nurse as diagnostician, prescriber and medical manager of the condition. Patients were less satisfied when they had been transferred from an established doctor-led to nurse-led service. While nurses within the study were highly skilled, patient perception was guided by the familiar rather than most appropriate service delivery. Most patients saw chronic disease management as a medicalised approach and the nursing contribution was most valued when emulating it. Patients' preferences and expectations of chronic disease management were framed by a strongly biomedical discourse. Perceptions of nurse-led chronic disease management were often shaped by what was previously familiar to the patient. At a strategic level, autonomous nursing practice requires support and further promotion to wider society if there is to be a shift in societal expectation and trust in the nurse's role in chronic disease management. Copyright © 2011 Elsevier Ltd. All rights reserved.

Filipino Nursing Students' Behavioral Intentions toward Geriatric Care: A Structural Equation Model (SEM)

ERIC Educational Resources Information Center

de Guzman, Allan B.; Jimenez, Benito Christian B.; Jocson, Kathlyn P.; Junio, Aileen R.; Junio, Drazen E.; Jurado, Jasper Benjamin N.; Justiniano, Angela Bianca F.

2013-01-01

Anchored on the key constucts of Ajzen's Theory of Planned Behavior (1985), this paper seeks to test a model that explores the influence of knowledge, attitude, and caring behavior on nursing students' behavioral intention toward geriatric care. A five-part survey-questionnaire was administered to 839 third and fourth year nursing students from a…

Using clinical nurses as preceptors to teach leadership and management to senior nursing students: a qualitative descriptive study.

PubMed

Lillibridge, Jennifer

2007-01-01

The preceptor model of clinical education uses nurses to fulfill the role of 'teacher' in a one-on-one relationship with students. The current nursing shortage, however, places increased demands on nurses and threatens their continuation in this role. The purpose of this qualitative descriptive study was to gain a better understanding of the nurse preceptor's experience. Five themes evolved during data analysis: (1) making it worthwhile for the nurse, (2) making a difference, (3) engaging in the process, (4) "I love being a preceptor, but..., and (5) accepting the role, taking responsibility. Making it worthwhile for the nurse included how nurses saw personal and professional rewards and benefits in precepting. Making a difference described how nurses felt they made a difference in student learning. Engaging in the process described how nurses created learning opportunities for students by being a good role model and protecting students from negative experiences. "I love being a preceptor, but..." identified aspects of the precepting role that were difficult. Accepting the role, taking responsibility identified the different people involved in the complex precepting experience; the preceptor, nursing faculty, students, and the nurse manager that all had to work together if students were to have a good experience. Findings can be used to develop better support for preceptors as well as more structured and consistent orientation to the role.

The Study of Nursing Care project: back to the future for contemporary nursing research?

PubMed

Smith, Kylie M; Crookes, Patrick A

2012-11-01

  To discuss the Study of Nursing Care project, an initiative from the late 1970s in the UK. The article explores the impact of the Study of Nursing Care on nursing research, and considers to what extent it presents a useful model for contemporary nursing research.   It is acknowledged internationally that the nursing academic workforce is ageing and dwindling. Many possible solutions are being debated with all agreeing that the next generation of evidence based nurse leaders is urgently required.   In this article, the authors survey existing workforce schemes, describe the Study of Nursing Care series, published in the 1970s, and draw on interviews and correspondence conducted in 2009 with four of the original Study of Nursing Care research assistants.   The Study of Nursing Care project poses a potential response to academic workforce issues. This article discusses the evolution of the project, its methods and operation and considers its possible implications for contemporary practice. Implications for nursing.  The Study of Nursing Care model demonstrates the clear benefits of fully committed funding, a programmatic approach towards research development, and the importance of selecting the right kind of people for the work, in a national scheme.   The authors argue that although the clinical outcomes it set out to achieve remain elusive, the project produced a cohort of nurse researchers who went on to give important leadership in nursing, including in nursing academia/research. A contemporary version of the Study of Nursing Care has important potential to generate the next generation of nurse researchers, and leaders, into the twenty-first century. © 2012 Blackwell Publishing Ltd.

[Is It Time to Implement a 12-Hour Shift for Nurses in Taiwan?

PubMed

Lin, Yi-Fung; Chang, Shiow-Ru; Wang, Li-Ting

2017-04-01

The twelve-hour shift system, first introduced in the U.S. in 1967 to address a nursing shortage, is now the main system of shift rotation used in numerous countries. In recent years, several hospitals in Taiwan have implemented the 12-hour shift model as one initiative to improve the problems of overtime and high turnover rate among nursing staff. Under this model, nurses work only three to four days per week for 12-hour shifts per day. Despite the increase in numbers of days off, there is growing concern that long shift hours may harm both the safety of patients and the well being of the nurses. The aim of the present article is to explain the application of the 12-hour shift system and to review the potential impacts of this model. Benefits of the 12-hour shift system include improving quality of life for nursing staff, reducing the turnover rate, and increasing job satisfaction. Primary concerns regarding this system include patient safety, nurse fatigue, and the potential negative effects on the sleep quality of nurses. These findings may be referenced by policymakers considering the development / implementation of flexible work schedules in Taiwan. The government must set a ceiling on work hours allowed per week and impose limits on overtime in order to prevent burnout in nursing staff.

The relationship between educational stress, stress coping, self-esteem, social support, and health status among nursing students in Turkey: A structural equation modeling approach.

PubMed

Yıldırım, N; Karaca, A; Cangur, S; Acıkgoz, F; Akkus, D

2017-01-01

Nursing education can be a stressful experience. To fully benefit from this experience and develop a positive professional identity, it is essential for nursing students to effectively cope with education-related stress. The aim of the study was to investigate the relationships between nursing students' education-related stress and stress coping, self-esteem, social support, and health status. This study utilized a cross-sectional, descriptive, and correlational design. The sample consisted 517 nursing students from a bachelor program in Turkey during the 2014-2015 academic year. Participants provided data on sociodemographic characteristics as well as completing the following instruments: Nursing Education Stress Scale, Coping Behavior Inventory for Nursing Students, Multidimensional Scale of Perceived Social Support, Rosenberg Self-Esteem Scale, and General Health Questionnaire. Relationships were examined using multivariate structural equation modeling. Results indicated that nursing students' stress coping levels were affected by self-esteem and social support. Additionally, this interaction appears to affect general health status. Although the direct effect of stress on coping was non-significant, its overall effect was significant within the model. It is necessary to conduct further intervention studies examining the role of self-esteem and social support in facilitating nursing students' stress-related coping during their education. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Monitoring of nursing service context factors: first descriptive results of a cross-sectional Swiss study prior the introduction of SwissDRG].

PubMed

Kleinknecht-Dolf, Michael; Spichiger, Elisabeth; Frei, Irena Anna; Müller, Marianne; Martin, Jacqueline S; Spirig, Rebecca

2015-04-01

The adoption of DRG-based payment systems has narrowed hospitals' financial margins, necessitating streamlining and process optimization. The experience of other countries shows that this restructuring can influence context factors essential to the delivery of nursing care. As a result, nursing care quality and patient safety may be impacted. The Sinergia Project aims to develop a monitoring model and related instruments to continuously monitor the impact of DRG-based reimbursement on central nursing service context factors. The descriptive, quantitative results were collected within the framework of a study with a mixed methods design by means of an online survey in which nurses from five hospitals participated. The results show that the nursing service context factors examined (nursing care complexity, quality of the work environment, management, moral distress and job satisfaction), have relevance in all practice areas as regards practice setting and nursing care delivery. Patterns can be recognized that are consistent with those found in the literature and which could be an indication of the relationships between the context factors above, as was hypothesized in the model. The study has provided the participating hospitals with useful data upon which to base discussions on ensuring quality of nursing care and practice development, in addition to information important to the further development of the model and the instruments employed.

Individual and contextual antecedents of workplace aggression in aged care nurses and certified nursing assistants.

PubMed

Rodwell, John; Demir, Defne; Gulyas, Andre

2015-08-01

Employees in aged care are at high risk of workplace aggression. Research rarely examines the individual and contextual antecedents of aggression for specific types of workers within these settings, such as nurses and certified nursing assistants (CNAs). The study aimed to explore characteristics of the job demands-resources model (JD-R), negative affectivity (NA) and demographics related to workplace aggression for aged care workers. The survey study was based on 208 nurses and 83 CNAs working within aged care. Data from each group were analysed separately using ordinal regressions. Both aged care nurses and CNAs reported high rates of bullying, external emotional abuse, threat of assault and physical assault. Elements of the JD-R model and individual characteristics were related to aggression types for both groups. Characteristics of the JD-R model, NA and demographics are important in understanding the antecedents of aggression observed among aged care workers. © 2015 Wiley Publishing Asia Pty Ltd.

Analysis of the Nursing Documentation in Use in Portugal - Building a Clinical Data Model of Nursing Centered on the Management of Treatment Regimen.

PubMed

Cruz, Inês; Bastos, Fernanda; Pereira, Filipe; Silva, Abel; Sousa, Paulino

2016-01-01

The use of technology to support information produced by nurses, especially information and communication technologies, is a current reality, but the proliferation of different statements of nursing diagnosis has made it more difficult for the production of indicators, hindering semantic interoperability of data. This study analyzed all statements of diagnosis focused on the management of medication regimen, customized to the Nursing Practice Support System (SAPE®) that was being used in Portugal in 2013. A total of 598 statements of nursing diagnoses about the phenomenon under study were analyzed, through an a priori analysis model - the ISO 18104 standard: 2003. The purpose was to identify terms used by nurses to describe the range of diagnoses, thus avoiding conceptual redundancy. After a content analysis process conducted by researchers and a broader group of experts, and when excluded all conceptual redundancy, 30 statements of nursing diagnosis were identified.

A multidimensional analysis of the epistemic origins of nursing theories, models, and frameworks.

PubMed

Beckstead, Jason W; Beckstead, Laura Grace

2006-01-01

The purpose of this article is to introduce our notion of epistemic space and to demonstrate its utility for understanding the origins and trajectories of nursing theory in the 20th century using multidimensional scaling (MDS). A literature review was conducted on primary and secondary sources written by and about 20 nurse theorists to investigate whether or not they cited 129 different scholars in the fields of anthropology, biology, nursing, philosophy, psychology, and sociology. Seventy-four scholars were identified as having been cited by at least two nurse theorists (319 citations total). Proximity scores, quantifying the similarity among nurse theorists based on proportions of shared citations, were calculated and analyzed using MDS. The emergent model of epistemic space that accommodated these similarities among nurse theorists revealed the systematic influence of scholars from various fields, notably psychology, biology, and philosophy. We believe that this schema and resulting taxonomy will prove useful for furthering our understanding of the relationships among nursing theories and theories in other fields of science.

Making difficult decisions: the role of quality of care in choosing a nursing home.

PubMed

Pesis-Katz, Irena; Phelps, Charles E; Temkin-Greener, Helena; Spector, William D; Veazie, Peter; Mukamel, Dana B

2013-05-01

We investigated how quality of care affects choosing a nursing home. We examined nursing home choice in California, Ohio, New York, and Texas in 2001, a period before the federal Nursing Home Compare report card was published. Thus, consumers were less able to observe clinical quality or clinical quality was masked. We modeled nursing home choice by estimating a conditional multinomial logit model. In all states, consumers were more likely to choose nursing homes of high hotel services quality but not clinical care quality. Nursing home choice was also significantly associated with shorter distance from prior residence, not-for-profit status, and larger facility size. In the absence of quality report cards, consumers choose a nursing home on the basis of the quality dimensions that are easy for them to observe, evaluate, and apply to their situation. Future research should focus on identifying the quality information that offers the most value added to consumers.

Nursing Philosophy of community mental health nurses in Japan: A qualitative, descriptive study.

PubMed

Tanaka, Koji; Hasegawa, Masami; Nagayama, Yutaka; Oe, Masato

2018-04-01

The present study reports the findings of a qualitative, descriptive study that sought to clarify nursing philosophy for community mental health nurses (CMHN) working at independent psychiatric home-visit nursing agencies in Japan. We carried out participant observation and semistructured interviews with 13 CMHN in rural and urban areas. We identified eight subthemes and three higher-order themes based on these subthemes. CMHN embraced a nursing philosophy in which they: (i) have respect for consumers' ways of life and their self-realization; (ii) find harmony between view of life and work; and (iii) build communities where residents support each other beyond their roles. Together, these themes constitute a valuable nursing philosophy that supports the recovery of people with mental illness. The themes could also help educate professionals about principles and meanings relevant to recovery, which are regarded as key to changing the professional's care paradigm from a biomedical model to a recovery model. © 2017 Australian College of Mental Health Nurses Inc.

Making Difficult Decisions: The Role of Quality of Care in Choosing a Nursing Home

PubMed Central

Phelps, Charles E.; Temkin-Greener, Helena; Spector, William D.; Veazie, Peter; Mukamel, Dana B.

2013-01-01

Objectives. We investigated how quality of care affects choosing a nursing home. Methods. We examined nursing home choice in California, Ohio, New York, and Texas in 2001, a period before the federal Nursing Home Compare report card was published. Thus, consumers were less able to observe clinical quality or clinical quality was masked. We modeled nursing home choice by estimating a conditional multinomial logit model. Results. In all states, consumers were more likely to choose nursing homes of high hotel services quality but not clinical care quality. Nursing home choice was also significantly associated with shorter distance from prior residence, not-for-profit status, and larger facility size. Conclusions. In the absence of quality report cards, consumers choose a nursing home on the basis of the quality dimensions that are easy for them to observe, evaluate, and apply to their situation. Future research should focus on identifying the quality information that offers the most value added to consumers. PMID:23488519

Role-modelling and the hidden curriculum: New graduate nurses' professional socialisation.

PubMed

Hunter, Kiri; Cook, Catherine

2018-05-12

To explore new graduate nurses' experiences of professional socialisation by registered nurses in hospital-based practice settings, and identify strategies that support professional identity development. Professionalism is reinforced and stabilised in the clinical environment through the 'hidden curriculum', with major learning coming from practice role-models. New graduates observe attitudes, behaviours, decision-making and skills, and gain feedback from registered nurses, which they translate into their own practice. Professional socialisation occurs through encounters with desirable and undesirable role-modelling; both are significant in professional identity formation. Qualitative descriptive design. Data collection was undertaken through semi-structured interviews with five new graduate nurse participants. A general inductive approach guided analysis. The meaningful descriptions gained provided insight into their experiences. Three main themes identified from the data include: 'Lessons from the wilderness'; 'Life in the wild'; and 'Belonging to a wolf pack'. The data set highlighted the major transitional process from student identity to registered nurse. New graduates' rethinking of beliefs and professional nursing identities were influenced by organisational pressures and experienced nurses role-modelling practices contrary to professional values. Despite encountering a range of professional behaviours, attitudes and dilemmas, new graduates were capable of moral agency and critical thinking. However, they rapidly acculturated and described compromises to cope. To promote high morale and a sense of belonging, a concerted effort is required by all nurses to facilitate the socialisation process to encourage self-authorship. A well-developed professional identity enhances nursing as a profession, contributing towards better healthcare delivery and outcomes. It is critically important how professional values are learnt within the culture of nursing. Tensions in clinical practice need to be understood better to avoid moral distress caused by dissonance between expectation and experience. It is advantageous to increase early positive socialisation. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Nursing curriculums may hinder a career in gerontological nursing: An integrative review.

PubMed

Garbrah, William; Välimäki, Tarja; Palovaara, Marjo; Kankkunen, Päivi

2017-09-01

To investigate what prevents undergraduate nursing students from choosing gerontological nursing as a career option. This study utilised an integrative literature review, which allows the inclusion of previous studies with diverse research designs to gain a broader view of the reasons why nursing students do not choose a gerontological nursing career. An electronic database search of CINAHL (Ebsco), Scopus and Eric elicited 251 scientific peer-reviewed empirical studies, published from 2006 to March 2016 in English. After meeting the inclusion criteria, 97 qualified for closer examination. Following exclusion, the final analysis and synthesis included 21 articles. Four main themes described nursing students' contributing reasons for not selecting gerontological nursing as a career option: socio-demographic factors; experiences, perceptions and knowledge about ageing; perceptions concerning the nature or status of gerontological nursing; and theoretical studies and practical education of nursing curriculum. Lack of positive experiences with older people before and during nursing students' studies led to their disinterest in gerontological nursing as a career option. The nursing curriculum also reinforces the perception of modern nursing as technical, with more emphasis on acute and critical care. The findings emphasise the need to implement an age-friendly curriculum and have nurses that specialise in gerontology to serve as mentors and role models. It is important to assist nursing students in identifying the potentials for career advancement in terms of gerontological nursing. There is also a need for nursing faculties to liaise with other stakeholders to develop or improve upon the clinical atmosphere for nursing students during gerontological nursing placement. Nursing faculties must review their curriculum to ensure that there is sufficient focus on the needs of older people within the curriculum for every student. Furthermore, respected role models who are knowledgeable and enthusiastic about issues related to older people must teach gerontological nursing courses. © 2017 John Wiley & Sons Ltd.

Developing a nursing personnel policy to address body art using an evidence-based model.

PubMed

Dorwart, Shawna D; Kuntz, Sandra W; Armstrong, Myrna L

2010-12-01

An increase in the prevalence of body art as a form of self-expression has motivated health care organizations to develop policies addressing nursing personnel's body art. A systematic review of literature on body art was completed and a telephone survey of 15 hospitals was conducted to query existing policy statements addressing nursing personnel's body art. The literature established no prevalence of body art among nurses or effect of nurses' body art. Of the 13 hospitals (86%) that shared their policy on body art, none provided a rationale or references to support their existing policies. A lack of published evidence identifying the effect of body art among nurses shifts the burden of determining care outcomes to the leadership of individual hospitals. Further research on patients' perception of nursing personnel with visible body art, using an evidence-based model, is recommended. Copyright 2010, SLACK Incorporated.

Factoring consumers' perspectives into policy decisions for nursing competence.

PubMed

Lazarus, Jean B; Lee, N Genell

2006-08-01

Health care delivery competence and accountability have typically been defined from providers' perspectives, rather than those of consumers as purchasers of services. In 1999, in the face of broad public concern about nursing competence the Alabama Board of Nursing developed an accountability model that established consumers at the center of the model and placed accountability for competent nursing practice at all levels of providers including regulatory agencies, health care organizations, educators, and licensees. The Board then authorized two research projects involving first, consumers perceptions on nursing competence and regulation, and second, comparing their perceptions with those of licensees, nurse educators, and organizational leaders (N = 1,127). Comparative data evidenced significant differences between consumers' and other participants' perceptions. This article highlights how policy implications derived from research resulted in regulatory changes for nursing competence. Five years of progress in policy changes made in the interest of public safety are summarized.

Internal marketing and the antecedents of nurse satisfaction and loyalty.

PubMed

Peltier, James W; Pointer, Lucille; Schibrowsky, John A

2008-01-01

Employee satisfaction and retention are critical issues that influence the success of any organization. Yet, one of the most critical problems facing the worldwide health care industry is the shortage of qualified nurses. Recent calls have been made within the traditional nursing literature for research that utilizes marketing and business models to better understand nurse satisfaction and retention. The purpose of this study is to develop scales that can be used to empirically test a model of the proposed antecedents of nurse job satisfaction and loyalty which have been used widely in the internal marketing and the relationship-marketing literature. Specifically, the study will investigate the degree to which structural bonding, social bonding, financial bonding activities, and quality of care impact how well nurses are satisfied with their job and their commitment to the organization. The results show that quality of care most impacted nurse satisfaction and loyalty, followed by structural, social, and financial bonds.

Nursing education at Western Governors University: a modern, disruptive approach.

PubMed

Jones-Schenk, Jan

2014-01-01

Over 1 million working registered nurses (RNs) currently do not have a bachelor's degree in nursing and comprise the critical group needing to return to school in order to achieve the Institute of Medicine's goal of 80% bachelors of science in nursing (BSNs) by 2020. Western Governors University (WGU) has developed a transformative educational model, incorporating 4 operational pillars (competency-based learning, technology, disaggregated faculty roles, and a student-centric management system), to revolutionize RN-BSN education. This article describes a successful contemporary model, disrupting most all of the traditional aspects of university education for professional nursing practice. The program design is of particular value to working adults and addresses the flexibility they need to accommodate academic advancement. The WGU nursing program currently serves over 5,000 students seeking BSN and Master of Science in Nursing degrees in all 50 states. © 2014.

The impact of nurses' spiritual health on their attitudes toward spiritual care, professional commitment, and caring.

PubMed

Chiang, Yi-Chien; Lee, Hsiang-Chun; Chu, Tsung-Lan; Han, Chin-Yen; Hsiao, Ya-Chu

2016-01-01

The personal spiritual health of nurses may play an important role in improving their attitudes toward spiritual care and their professional commitment and caring capabilities. The purpose of this study was to explore the impact of nurses' personal spiritual health on their attitudes toward spiritual care, professional commitment, and caring. A total of 619 clinical nurses were included in this cross-sectional survey. The measurements included the spiritual health scale-short form, the spiritual care attitude scale, the nurses' professional commitment scale, and the caring behaviors scale. Structural equation modeling was used to establish associations between the main research variables. The hypothetical model provided a good fit with the data. Nurses' spiritual health had a positive effect on nurses' professional commitment and caring. Nurses' attitudes toward spiritual care could therefore mediate their personal spiritual health, professional commitment, and caring. The findings indicated that nurses' personal spiritual health is an important value and belief system and can influence their attitudes toward spiritual care, professional commitment, and caring. Copyright © 2015 Elsevier Inc. All rights reserved.

The Lived Experiences of Nurses Caring For Dying Pediatric Patients.

PubMed

Curcio, Danna L

2017-01-01

Nurses and healthcare professionals may have difficulty adjusting to and comprehending their experiences when a patient’s life ends. This has the potential to interfere with patient care. Reflection on past events and actions enables critical discovery of strategies to benefit both nurses and patients. This qualitative phenomenological study explores the lived experiences of nurses caring for dying pediatric patients. The philosophical underpinning of Merleau-Ponty (2008), in combination with the research method of van Manen (1990), was used for this study. The Roy Adaptation Model (RAM) (Roy, 2009; Roy & Andrews, 1991) was the nursing model that guided the study to help understand that nurses are an adaptive system, using censoring as a compensatory adaptive process to help function for a purposeful cause. Nine female nurse participants with one to four years of experience were interviewed. The context of the experiences told by nurses caring for dying pediatric patents uncovered seven essential themes of empathy, feelings of ambivalence, inevitability, inspiration, relationship, self-preservation, and sorrow, and these themes demonstrated a connection formed between the nurse and the patient.

Exploring the impact of mentoring functions on job satisfaction and organizational commitment of new staff nurses

PubMed Central

2010-01-01

Background Although previous studies proved that the implementation of mentoring program is beneficial for enhancing the nursing skills and attitudes, few researchers devoted to exploring the impact of mentoring functions on job satisfaction and organizational commitment of new nurses. In this research we aimed at examining the effects of mentoring functions on the job satisfaction and organizational commitment of new nurses in Taiwan's hospitals. Methods We employed self-administered questionnaires to collect research data and select new nurses from three regional hospitals as samples in Taiwan. In all, 306 nurse samples were obtained. We adopted a multiple regression analysis to test the impact of the mentoring functions. Results Results revealed that career development and role modeling functions have positive effects on the job satisfaction and organizational commitment of new nurses; however, the psychosocial support function was incapable of providing adequate explanation for these work outcomes. Conclusion It is suggested in this study that nurse managers should improve the career development and role modeling functions of mentoring in order to enhance the job satisfaction and organizational commitment of new nurses. PMID:20712873

Concept Analysis: Health-Promoting Behaviors Related to Human Papilloma Virus (HPV) Infection.

PubMed

McCutcheon, Tonna; Schaar, Gina; Parker, Karen L

2015-01-01

The concept of health-promoting behaviors incorporates ideas presented in the Ottawa Charter of Public Health and the nursing-based Health Promotion Model. Despite the fact that the concept of health-promoting behaviors has a nursing influence, literature suggests nursing has inadequately developed and used this concept within nursing practice. A further review of literature regarding health promotion behaviors and the human papilloma virus suggest a distinct gap in nursing literature. This article presents a concept analysis of health-promoting behaviors related to the human papilloma virus in order to encourage the application of the concept into nursing practice, promote continued nursing research regarding this concept, and further expand the application of health-promoting behaviors to other situations and populations within the nursing discipline. Attributes of health-promoting behaviors are presented and include empowerment, participation, community, and a positive concept of health. Antecedents, consequences, and empirical referents are also presented, as are model, borderline, and contrary cases to help clarify the concept. Recommendations for human papilloma virus health-promoting behaviors within the nursing practice are also provided. © 2014 Wiley Periodicals, Inc.

Development and Psychometric Examination of the Inclusive Teaching Strategies in Nursing Education Instrument.

PubMed

Levey, Janet A

2017-08-01

Nurse educators might be unknowingly excluding learners secondary to teaching practices. Universal design for instruction (UDI) prepares and delivers accessible content and learning environments for diverse learners; however, it is not well known in nursing education. The aim of the study was to examine the psychometric properties of the Inclusive Teaching Strategies in Nursing Education (ITSinNE) 55-item instrument. Confirmatory factor analysis was performed on a sample of 311 educators in prelicensure programs. The ITSinNE scales had good to adequate estimates of reliability. The exogenous model fit the sample and model-implied covariance matrix; however, the endogenous model was not a good fit. Further instrument development is required. Measuring factors influencing nurse educators' willingness to adopt UDI will enable intervention research to enhance professional development fostering content and environmental access for all learners.

Models for predicting turnover of residential aged care nurses: a structural equation modelling analysis of secondary data.

PubMed

Gao, Fengsong; Newcombe, Peter; Tilse, Cheryl; Wilson, Jill; Tuckett, Anthony

2014-09-01

Nurse turnover in the residential aged care industry is a pressing issue. Researchers have shown ongoing interest in exploring how the factors that are amendable to change in aged care policy, regulation and funding and in organizational procedures (e.g. job demands, coping resources and psychological health of nurses) impact on turnover. However, the findings are mixed. This study tested two theoretical models of turnover to examine the structural relationships among job demands, coping resources, psychological health and turnover of residential aged care nurses. Although many previous studies operationalized turnover as intention to leave, the present study investigated actual turnover by following up with the same individuals over time, and thus provided more accurate predictive models of turnover behaviour. The sample, 239 Australian residential aged care nurses, came from the Nurses and Midwives e-cohort Study. Job demands, coping resources, and psychological health were measured using standardized instruments. Structural equation modelling was used to test the measurement and structural models. Controlling for a number of workforce and individual characteristics, coping resources (measured by job control, supervisor support, and co-worker support) were negatively and directly associated with turnover. Additionally, the findings supported the Job Demand-Control-Support model in that higher coping resources and lower job demands (indicated by psychological demands, physical demands, and effort) were related to better psychological health (measured by vitality, social functioning, role emotional, and mental health), and higher job demands were related to lower coping resources. Findings suggest that aged care policy makers and service providers might consider increasing coping resources available to nurses and minimizing job demands of care work to reduce turnover and improve nurses' psychological health. Moreover, findings from this Australian study may provide valuable practical and policy implications for other developed countries. Copyright © 2014 Elsevier Ltd. All rights reserved.

The impact of the psychological contract, justice and individual differences: nurses take it personally when employers break promises.

PubMed

Rodwell, John; Gulyas, Andre

2013-12-01

To explore affective and attitudinal outcomes of aspects of the psychological contract, organizational justice and negative affectivity in nursing. Job satisfaction, mental health and commitment to organizations and the nursing profession is important for nurse retention. The psychological contract and organizational justice are related constructs that have been linked to these outcomes, as has the characteristic of negative affectivity. Rarely have the relationships between these concepts and outcomes been examined. Cross-sectional data were collected during November, 2007. Survey data collected on Registered Nurses and midwives from a large metropolitan hospital in Australia (n = 193, after removing missing cases and outliers) were analysed using structural equation modelling. The model used self-report measures of psychological contract obligations, fulfilment and breach, organizational justice and negative affectivity as predictors of job satisfaction, organizational commitment, career commitment and psychological distress. Goodness-of-fit statistics confirmed a well-fitting model. The model explained 49%, 29%, 60% and 47% of the variance in psychological distress, job satisfaction, organizational commitment and career commitment respectively. Findings support the influence of the psychological contract, fairness and individual differences on outcomes important to nurse retention. Keeping promises is more important than making promises that cannot be kept. The results support a discrepancy mechanism underlying fulfilment and breach. The impact of breach suggests that nurses take breach personally, whereas fulfilment may represent a global evaluation of discrepancies. Ultimately, fulfilling, rather than making promises, keeps nurses happy. © 2013 John Wiley & Sons Ltd.

A Roy model study of adapting to being HIV positive.

PubMed

Perrett, Stephanie E; Biley, Francis C

2013-10-01

Roy's adaptation model outlines a generic process of adaptation useful to nurses in any situation where a patient is facing change. To advance nursing practice, nursing theories and frameworks must be constantly tested and developed through research. This article describes how the results of a qualitative grounded theory study have been used to test components of the Roy adaptation model. A framework for "negotiating uncertainty" was the result of a grounded theory study exploring adaptation to HIV. This framework has been compared to the Roy adaptation model, strengthening concepts such as focal and contextual stimuli, Roy's definition of adaptation and her description of adaptive modes, while suggesting areas for further development including the role of perception. The comparison described in this article demonstrates the usefulness of qualitative research in developing nursing models, specifically highlighting opportunities to continue refining Roy's work.

Development of a Nurse Preceptor Competency Assessment Tool: A Mixed-Methods Approach

ERIC Educational Resources Information Center

Hoot, Tracy A. T.

2017-01-01

Clinical nurse preceptors are often assigned a nursing student based on their availability and not necessarily on their expertise. The preceptor, as role model and clinical teacher, is instrumental in guiding a nursing student in his or her transition into the role of a new graduate nurse. When a preceptor lacks the knowledge to meet the…

Achieving graduate outcomes in undergraduate nursing education: following the Yellow Brick Road.

PubMed

Baldwin, Adele; Bentley, Karyn; Langtree, Tanya; Mills, Jane

2014-01-01

Nursing practice is a dynamic and constantly changing field within healthcare, with well-documented challenges to maintaining a suitably skilled workforce to meet the needs of the community it serves. Undergraduate nursing education provides the mandatory minimum requirements for professional registration. Each nursing program has clearly stated graduate attributes, qualities that their graduates will possess on graduation. The aim of this paper is to stimulate discussion about graduate attributes for nurses, a transferrable set of specific attributes that make nursing graduates work ready. This paper focuses on identifying specific attributes, the embedding of those attributes in nursing education, particularly through role modelling, with the aim of producing a future workforce that is knowledgeable, compassionate and confident. The graduate attributes are likened to the qualities sought by the characters in 'The Wizard of Oz'; brains, heart and courage and the learning process as the 'Yellow Brick Road'. There is a relative lack of discussion about role modelling by nurse educators for nursing students, a potentially undervalued learning experience that we believe must be brought to the forefront of discussions pertaining to undergraduate nursing education and achieving graduate outcomes. Copyright © 2013 Elsevier Ltd. All rights reserved.

Effects of perceived workplace politics in hospitals on nurses' behavioural intentions in Ghana.

PubMed

Atinga, Roger A; Domfeh, Kwame A; Kayi, Esinam; Abuosi, Aaron; Dzansi, Gladys

2014-03-01

To examine the effects of perceived workplace politics in hospitals on nurses' job satisfaction, commitment, exit intention, job neglect, absenteeism and performance. One of the factors contributing to nurses' poor advancement in clinical practice is the existence of petty politics, which has given rise to competing self-interest. However, little evidence exists to inform policy direction on the implication of politics on nurses' behaviour. A total of 610 nurses comprising associate and nursing professionals completed a structured questionnaire modelled on workplace politics and its outcome variables. Descriptive statistics and mean comparisons were used to analyse data. A multivariate regression model was computed to examine association between perceived politics and nurses' behavioural intentions. Perceived politics potentially leads to decline in job satisfaction, commitment and work performance. However, perceived workplace politics is associated with high intention to leave, negligent behaviour and absenteeism. Measures aimed at improving nursing management and health-care delivery should be directed at minimising the use of politics to promote self-interest. Evidence-based best practices in nursing management centred on the creation of an enabling environment for nurses to participate in decision-making should be given critical attention. © 2013 John Wiley & Sons Ltd.

The impact of emotional intelligent leadership on staff nurse empowerment: the moderating effect of span of control.

PubMed

Lucas, Victoria; Laschinger, Heather K Spence; Wong, Carol A

2008-11-01

To test a model linking nurses' perceptions of their nurse manager's emotionally intelligent leadership style and nurses' structural empowerment, and the impact of nurse manager span of control (number of direct reports) on the emotional intelligence/empowerment relationship. Hospital restructuring in the 1990s resulted in a dramatic reduction in nurse manager positions, yet nurse managers are critical to empowering nurses for professional practice. A descriptive correlational survey design was used to test the hypothesized model in two community hospitals in Ontario. Two hundred and three nurses from two hospitals returned useable questionnaires (68% response rate). Span of control was a significant moderator of the relationship between nurses perceptions of their managers' emotionally intelligent behaviour and feelings of workplace empowerment. The results suggest that even managers with strong emotional intelligence may not be able to empower their staff if their span of control is large. Every effort must be made to ensure that managers have reasonable spans of control that allow them to develop and use the leadership skill necessary for empowering their staff to practice to the full scope of their professional role.

Mental Health of Muslim Nursing Students in Thailand

PubMed Central

Ratanasiripong, Paul

2012-01-01

The purpose of this research was to explore the mental health and well-being of Muslim nursing students in Thailand. Specifically, the study investigated the factors that impact anxiety and depression among Muslim nursing students. This cross-sectional research was conducted with a half sampling method of Muslim undergraduate students who were studying at a public nursing college in Thailand. From the 220 self-identified Muslim nursing students, 110 were sampled for this study, representing 14% of the total nursing students at this college. Results indicated a moderate prevalence of anxiety and high prevalence of depression among Muslim nursing students. Stress (β = .42) was positively associated with anxiety, while self-esteem (β = -.42) was negatively associated with anxiety; together this model accounted for 46% of the variance in anxiety. Self-esteem (β = -.41) and social support (β = -.17) were negatively associated with depression, while stress (β = .37) was positively correlated with depression; together this model accounted for 57% of the variance in depression. Recommendations were given to help train Muslim nursing students to be competent nurses with good mental health and well-being who will succeed and contribute to the nursing profession. PMID:22792481

Educating the educators at Hue Medical College, Hue, Viet Nam.

PubMed

Pron, A L; Zygmont, D; Bender, P; Black, K

2008-06-01

In June 2005, four faculty members from Temple University, Philadelphia, USA, conducted a nursing educator workshop in Hue, Viet Nam. Didactic and clinical instruction addressed paediatric, maternity, psychiatric and surgical nursing content as well as instructional methods and student evaluation techniques. This educator workshop was requested as means of increasing the professionalization of nursing in Viet Nam. Student nurses in Viet Nam are taught by physician-faculty. Between the cultural and economic factors that contribute to the current status and practice of nursing in Viet Nam and the lack of nurse educator role models, the nursing profession has many obstacles to overcome in their quest for increased autonomy. During the workshop, in addition to modelling interactive teaching methods as they taught the classroom and clinical content, these authors also demonstrated the level of knowledge expected of nurses in the USA. Despite much advance planning for this workshop, there were many challenges for the USA faculty. Some of the lessons learned which might help others included having a sense of humour, maintaining flexibility in teaching styles and content, being prepared for the cultural and religious influences on health care, and utilizing all of one's nursing skills to find creative solutions when teaching nursing in another country.

From scientific discovery to health outcomes: A synergistic model of doctoral nursing education.

PubMed

Michael, Melanie J; Clochesy, John M

2016-05-01

Across the globe, health system leaders and stakeholder are calling for system-level reforms in education, research, and practice to accelerate the uptake and application of new knowledge in practice and to improve health care delivery and health outcomes. An evolving bi-dimensional research-practice focused model of doctoral nursing education in the U.S. is creating unprecedented opportunities for collaborative translational and investigative efforts for nurse researchers and practitioners. The nursing academy must commit to a shared goal of preparing future generations of nurse scientists and practitioners with the capacity and motivation to work together to accelerate the translation of evidence into practice in order to place nursing at the forefront of health system improvement efforts and advance the profession. Copyright © 2016 Elsevier Ltd. All rights reserved.

Elements of a Nursing Professional Practice Model.

ERIC Educational Resources Information Center

Hoffart, Nancy; Woods, Cynthia Q.

1996-01-01

A professional practice model is a system that supports control over nursing care. It has five subsystems: values, professional relationships, delivery model, management approach, and compensation and rewards. Comparison of five health facilities provides guidelines for planning, implementing and evaluating a professional practice model. (SK)

Authentic leadership and nurse-assessed adverse patient outcomes.

PubMed

Wong, Carol A; Giallonardo, Lisa M

2013-07-01

Our purpose was to test a model examining relationships among authentic leadership, nurses' trust in their manager, areas of work life and nurse-assessed adverse patient outcomes. Although several work environment factors have been cited as critical to patient outcomes, studies linking nursing leadership styles with patient outcomes are limited suggesting the need for additional research to investigate the mechanisms by which leadership may influence patient outcomes. Secondary analysis of data collected in a cross-sectional survey of 280 (48% response rate) registered nurses working in acute care hospitals in Ontario was conducted using structural equation modelling. The final model fit the data acceptably (χ(2) = 1.30, df = 2, P = 0.52, IFI = 0.99, CFI = 1.00, RMSEA = 0.00). Authentic leadership was significantly associated with decreased adverse patient outcomes through trust in the manager and areas of work life. The findings suggest that nurses who see their managers as demonstrating high levels of authentic leadership report increased trust, greater congruence in the areas of work life and lower frequencies of adverse patient outcomes. Managers who emphasize transparency, balanced processing, self-awareness and high ethical standards in their interactions with nurses may contribute to safer work environments for patients and nurses. © 2013 John Wiley & Sons Ltd.

The impact of organisational factors on horizontal bullying and turnover intentions in the nursing workplace.

PubMed

Blackstock, Sheila; Harlos, Karen; Macleod, Martha L P; Hardy, Cindy L

2015-11-01

To examine the impact of organisational factors on bullying among peers (i.e. horizontal) and its effect on turnover intentions among Canadian registered nurses (RNs). Bullying among nurses is an international problem. Few studies have examined factors specific to nursing work environments that may increase exposure to bullying. An Australian model of nurse bullying was tested among Canadian registered nurse coworkers using a web-based survey (n = 103). Three factors - misuse of organisational processes/procedures, organisational tolerance and reward of bullying, and informal organisational alliances - were examined as predictors of horizontal bullying, which in turn was examined as a predictor of turnover intentions. The construct validity of model measures was explored. Informal organisational alliances and misuse of organisational processes/procedures predicted increased horizontal bullying that, in turn, predicted increased turnover intentions. Construct validity of model measures was supported. Negative informal alliances and misuse of organisational processes are antecedents to bullying, which adversely affects employment relationship stability. The results suggest that reforming flawed organisational processes that contribute to registered nurses' bullying experiences may help to reduce chronically high turnover. Nurse leaders and managers need to create workplace processes that foster positive networks, fairness and respect through more transparent and accountable practices. © 2014 John Wiley & Sons Ltd.

Solving work-related ethical problems.

PubMed

Laukkanen, Laura; Suhonen, Riitta; Leino-Kilpi, Helena

2016-12-01

Nurse managers are responsible for solving work-related ethical problems to promote a positive ethical culture in healthcare organizations. The aim of this study was to describe the activities that nurse managers use to solve work-related ethical problems. The ultimate aim was to enhance the ethical awareness of all nurse managers. The data for this descriptive cross-sectional survey were analyzed through inductive content analysis and quantification. Participants and research context: The data were collected in 2011 using a questionnaire that included an open-ended question and background factors. Participants were nurse managers working in Finnish healthcare organizations (n = 122). Ethical considerations: Permission for the study was given by the Finnish Association of Academic Managers and Experts of Health Sciences. Nurse managers identified a variety of activities they use to solve work-related ethical problems: discussion (30%), cooperation (25%), work organization (17%), intervention (10%), personal values (9%), operational models (4%), statistics and feedback (4%), and personal examples (1%). However, these activities did not follow any common or systematic model. In the future, nurse managers need a more systematic approach to solve ethical problems. It is important to establish new kinds of ethics structures in organizations, such as a common, systematic ethical decision-making model and an ethics club for nurse manager problems, to support nurse managers in solving work-related ethical problems.

Organizational culture shapes the adoption and incorporation of simulation into nursing curricula: a grounded theory study.

PubMed

Taplay, Karyn; Jack, Susan M; Baxter, Pamela; Eva, Kevin; Martin, Lynn

2014-01-01

Purpose. To create a substantive mid-range theory explaining how the organizational cultures of undergraduate nursing programs shape the adoption and incorporation of mid-to high-level technical fidelity simulators as a teaching strategy within curricula. Method. A constructivist grounded theory was used to guide this study which was conducted in Ontario, Canada, during 2011-12. Semistructured interviews (n = 43) with participants that included nursing administrators, nursing faculty, and simulation leaders across multiple programs (n = 13) informed this study. Additionally, key documents (n = 67) were reviewed. Purposeful and theoretical sampling was used and data were collected and analyzed simultaneously. Data were compared among and between sites. Findings. The organizational elements that shape simulation in nursing (OESSN) model depicts five key organizational factors at the nursing program level that shaped the adoption and incorporation of simulation: (1) leaders working in tandem, (2) information exchange, (3) physical locale, (4) shared motivators, and (5) scaffolding to manage change. Conclusions. The OESSN model provides an explanation of the organizational factors that contributed to the adoption and incorporation of simulation into nursing curricula. Nursing programs that use the OESSN model may experience a more rapid or broad uptake of simulation when organizational factors that impact adoption and incorporation are considered and planned for.

Organizational Culture Shapes the Adoption and Incorporation of Simulation into Nursing Curricula: A Grounded Theory Study

PubMed Central

Jack, Susan M.; Eva, Kevin; Martin, Lynn

2014-01-01

Purpose. To create a substantive mid-range theory explaining how the organizational cultures of undergraduate nursing programs shape the adoption and incorporation of mid-to high-level technical fidelity simulators as a teaching strategy within curricula. Method. A constructivist grounded theory was used to guide this study which was conducted in Ontario, Canada, during 2011-12. Semistructured interviews (n = 43) with participants that included nursing administrators, nursing faculty, and simulation leaders across multiple programs (n = 13) informed this study. Additionally, key documents (n = 67) were reviewed. Purposeful and theoretical sampling was used and data were collected and analyzed simultaneously. Data were compared among and between sites. Findings. The organizational elements that shape simulation in nursing (OESSN) model depicts five key organizational factors at the nursing program level that shaped the adoption and incorporation of simulation: (1) leaders working in tandem, (2) information exchange, (3) physical locale, (4) shared motivators, and (5) scaffolding to manage change. Conclusions. The OESSN model provides an explanation of the organizational factors that contributed to the adoption and incorporation of simulation into nursing curricula. Nursing programs that use the OESSN model may experience a more rapid or broad uptake of simulation when organizational factors that impact adoption and incorporation are considered and planned for. PMID:24818018

Cardiovascular health promotion and consumers with mental illness in Australia.

PubMed

Happell, Brenda; Platania-Phung, Chris

2015-04-01

People with serious mental illness (SMI) have increased risk of cardiovascular disease and premature death, yet research on nurse-provided health promotion in mental health services remains under-developed. This paper informs efforts to improve the nursing role in physical health of consumers with SMI by establishing what nurse perceptions and background influence their care. Members of the Australian College of Mental Health Nursing were invited to participate in an online survey on their views on physical health care in mental health services. Survey questions included: (a) nurse-consumer collaboration in preventative care and (b) sub-sections of the Robson and Haddad Physical Health Attitude Scale to measure nurse perceived barriers to encouraging lifestyle change of consumers with SMI and frequency of nurse physical healthcare practices. Structural equation modelling was applied to investigate antecedents to physical health care, as well as relationships between antecedents. A national sample of 643 nurses reported regular engagement in health promotion (e.g. advice on diet). There was statistical support for a model depicting perceived consumer-nurse collaboration as a dual-determinant of nurse perceived barriers and self-reported health promotion to consumers with SMI. Perceived barriers to consumer lifestyle change did not predict health promotion. The effects of nurse-consumer collaboration were significant, but small. Perceived consumer-nurse collaboration in preventative care may positively influence the amount of health promotion by nurses in mental health. Perceived barriers to consumer adherence with a healthy lifestyle did not have an impact on nurse-delivered health promotion.

The impact of undergraduate clinical teaching models on the perceptions of work-readiness among new graduate nurses: A cross sectional study.

PubMed

Patterson, Emma E B; Boyd, Leanne; Mnatzaganian, George

2017-08-01

Clinical Placements are an essential component of bridging the gap between academic theory and nursing practice. There are multiple clinical models designed to ease the transition from student to professional, yet there has been little exploration of such models and their impact on graduates' perceptions of work-readiness. This cross sectional study examined perceptions of work-readiness of new graduate nurses who attended one of the following clinical teaching models: the University Fellowship Program (UFP), the Traditional Multi-facility Clinical Model (TMCPM), and the Mixed Program (MP). Three groups of first year graduate nurses (UFP, TMCPM, and MP) were compared using the Work-readiness Scale, a validated and reliable tool, which assessed nurses' perceptions of work-readiness in four domains: organizational acumen, personal work characteristics, social intelligence, and work competence. A multivariable Generalized Estimating Equations regression investigated socio-demographic and teaching-modelrelated factors associated with work-readiness. Of 43 nurses approached, 28 completed the survey (65% response rate) of whom 6 were UFP attendants, 8 attended the TMCPM and 14 the MP. Those who had attended the UFP scored higher than the other two in all four domains; however, the crude between-group comparisons did not yield statistically significant results. Only after accounting for age, gender, teaching setting and prior work experience, the multivariable model showed that undertaking the UFP was likely to increase perceptions of work-readiness by 1.4 points (95% CI 0.11-2.69), P=0.03). The UFP was superior to the other two placement models. The study suggests that the UFP may enhance graduate nurses' perceptions of work readiness. Copyright © 2017 Elsevier Ltd. All rights reserved.

Exploratory Study of Factors Influencing Job-Related Stress in Japanese Psychiatric Nurses

PubMed Central

Yada, Hironori; Lu, Xi; Omori, Hisamitsu; Abe, Hiroshi; Matsuo, Hisae; Ishida, Yasushi; Katoh, Takahiko

2015-01-01

This study explored the factor structure of psychiatric nurses' job-related stress and examined the specificity of the related stressors using the job stressor scale of the Brief Job Stress Questionnaire (BJSQ). The stressor scale of the BJSQ was administered to 296 nurses and assistant nurses. Answers were examined statistically. Exploratory factor analysis was performed to identify factor structures; two factors (overload and job environment) were valid. Confirmatory factor analysis was conducted to examine the two-factor structure and found 11 items with factor loadings of >0.40 (model 1), 13 items with factor loadings from 0.30 to <0.40 (model 2), and 17 items with factor loadings from 0.20 to <0.30 (model 3) for one factor; model 1 demonstrated the highest goodness of fit. Then, we observed that the two-factor structure (model 1) showed a higher goodness of fit than the original six-factor structure. This differed from subscales based on general workers' job-related stressors, suggesting that the factor structure of psychiatric nurses' job-related stressors is specific. Further steps may be necessary to reduce job-related stress specifically related to overload including attention to many needs of patients and job environment including complex ethical dilemmas in psychiatric nursing. PMID:25922763

Exploratory study of factors influencing job-related stress in Japanese psychiatric nurses.

PubMed

Yada, Hironori; Lu, Xi; Omori, Hisamitsu; Abe, Hiroshi; Matsuo, Hisae; Ishida, Yasushi; Katoh, Takahiko

2015-01-01

This study explored the factor structure of psychiatric nurses' job-related stress and examined the specificity of the related stressors using the job stressor scale of the Brief Job Stress Questionnaire (BJSQ). The stressor scale of the BJSQ was administered to 296 nurses and assistant nurses. Answers were examined statistically. Exploratory factor analysis was performed to identify factor structures; two factors (overload and job environment) were valid. Confirmatory factor analysis was conducted to examine the two-factor structure and found 11 items with factor loadings of >0.40 (model 1), 13 items with factor loadings from 0.30 to <0.40 (model 2), and 17 items with factor loadings from 0.20 to <0.30 (model 3) for one factor; model 1 demonstrated the highest goodness of fit. Then, we observed that the two-factor structure (model 1) showed a higher goodness of fit than the original six-factor structure. This differed from subscales based on general workers' job-related stressors, suggesting that the factor structure of psychiatric nurses' job-related stressors is specific. Further steps may be necessary to reduce job-related stress specifically related to overload including attention to many needs of patients and job environment including complex ethical dilemmas in psychiatric nursing.

The practice of certified community health CNSs.

PubMed

Logan, Leanne

2005-01-01

This study explored the practice of clinical nurse specialists (CNSs) certified in Community Health nursing in the United States and described demographic and employment characteristics and perspectives about professional practice. The survey method was used. Of the 209 Community Health CNSs certified by American Nurses Credentialing Center (ANCC) invited to complete the investigator-designed mail questionnaire, 111 (53%) returned a completed questionnaire. The questionnaire contained 27 items about employment, income, years in practice, certification, career satisfaction, and educational preparation, and asked participants to indicate the fit between the Community Health CNS role and the traditional CNS subroles model described by the American Nurses Association (ANA) (The Role of the Clinical Nurse Specialist, 1986) and the updated National Association of Clinical Nurse Specialists (NACNS) CNS practice model (Statement on Clinical Nurse Specialist Practice and Education, 1998). Content validity was established by Community Health CNS reviewer feedback. Quantifiable data were tallied and analyzed using standard spreadsheet computer software. Qualitative data were summarized for content themes. The majority of participants were white, middle-aged females who reported being satisfied with their careers as Community Health CNSs. Most indicated that they were respected by colleagues, that they had been adequately prepared by their education, and that their current work made good use of their education and expertise. When asked to identify, by percentage of effort, the fit between their job responsibilities and the traditional subroles model of practice, the mean of reported fit was as follows: educator, 35%; administrator/leader, 22%; clinician, 21%; consultant, 14%; and researcher, 8%. The fit between job responsibilities and the spheres of influence in the NACNS model of practice was reported to average 39% for patient/client, 35% for organization/network, and 25% for nurses/ nursing practice. Community Health CNS is a viable specialty practice with long-term career options. The subrole functions-described by ANA-of clinician, educator, administrator/leader, consultant, and to a lesser extent researcher apply to the role. The more intergraded updated model offered by NACNS also fits Community Health CNS practice with more emphasis on patient/client and organization/ network spheres than on nurses/nursing practice sphere. Schools of nursing should continue to offer the Community Health CNS programs and incorporate both the traditional functions and newer practice model into their curricula, with a greater emphasis on diversity of students to help ensure a more diverse CNS population. Further research is needed to explore the outcomes of Community Health CNS practice and the factors that contribute to role satisfaction.

The relationship between supervisor support and registered nurse outcomes in nursing care units.

PubMed

Hall, Debra S

2007-01-01

Workplace social support is a major characteristic related to the Job Demand-Control model of job stress. Organizational and managerial support have an effect on nurse satisfaction and burnout. The relationships between perceived supervisor support and measures of nurse occupation-related outcomes were investigated in 3 nursing units within an academic medical center. Nurses with greater levels of perceived supervisor support experienced more positive job outcomes and less negative outcomes, including less occupational stress, than nurses with less perceived supervisor support. Implications for refocusing the role of the nurse supervisor and its effect on multiple nursing occupation-related outcomes are discussed.

Influence of work-family-school role conflicts and social support on psychological wellbeing among registered nurses pursuing advanced degree.

PubMed

Xu, Lijuan; Song, Rhayun

2016-08-01

The purpose of the study was to determine how work-family-school role conflict and social support influence psychological well-being among registered nurses pursuing an advanced degree. A cross-sectional, correlational study design was used. Convenience sampling was used to recruit 320 registered nurses pursuing an advanced nursing degree at 13 hospitals in Korea, from June to October 2011. Data were analyzed using structural equation modeling with the AMOS program. Confirmatory factor analyses were conducted to evaluate the measurement model prior to the testing of study hypotheses before and after controlling for extraneous variables. The fit parameters of the modified model (χ(2)/df=2.01, GFI=0.91, AGFI=0.89, CFI=0.92, SRMR=0.068, and RMSEA=0.065) indicated its suitability as the research model. This model explained 45% of the variance in work-related psychological well-being and 52% of the variance in general psychological well-being. Both social support and work-family-school role conflict exerted significant effects on work-related psychological well-being and general psychological well-being. The findings of the present study imply that work-family-school role conflict influences the psychological well-being of registered nurses pursuing an advanced degree. It is necessary for nursing administrators to develop strategies to help registered nurses to manage their multiple roles and improve both their work-related psychological well-being and their general psychological well-being. Copyright © 2015 Elsevier Inc. All rights reserved.

Nursing education in Bangladesh: a social business model.

PubMed

Parfitt, Barbara; Nahar, Niru Shamsun

2016-06-01

The aim of this project was to develop a quality nurse education programme in Bangladesh. A sustainable social business financial model was used. The project is a collaboration between Glasgow Caledonian University and the Grameen Health Care Trust. It contributes to the UN development agenda, eradication of poverty, sustainability and the development of global partnerships. There is an acute shortage of nurses in Bangladesh but many young women who wish to become nurses are unable to do so. Women are discriminated against, have few leadership opportunities and poverty affects large proportions of rural society. The collaboration between the University and the Trust provides the necessary input to ensure a quality nursing programme. A business plan was developed, competency-based teaching introduced, infrastructure and financial management processes were set-up and an evaluation framework was put in place. The systems evaluation framework monitors the financial status of the College and the effects of the programme on students. The social business model, providing access to educational loans, has enabled 118 students to graduate into employment. The College is currently on target to be financially sustainable by 2016. This project outlines a business model that tackles poverty, gender equality and contributes to the human resource deficit. Young women are equipped as change agents and leaders. The social business model provides a mechanism for releasing funds for education to those who are impoverished. It provides a viable option for increasing the number of well-educated nurse leaders in developing countries. © 2016 International Council of Nurses.

The Impact of Green House Adoption on Medicare Spending and Utilization.

PubMed

Grabowski, David C; Afendulis, Christopher C; Caudry, Daryl J; O'Malley, A James; Kemper, Peter

2016-02-01

To evaluate the impact of the Green House (GH) model of nursing home care on Medicare acute hospital, other hospital, skilled nursing facility, and hospice spending and utilization. Medicare claims and enrollment data from 2005 through 2010 merged with resident-level minimum data set (MDS) assessments. Using a difference-in-differences framework, we compared Medicare Part A and hospice expenditures and utilization in 15 nursing homes that adopted the GH model relative to changes over the same time period in 223 matched nonadopting nursing homes. We applied the same method for residents of GH homes and for residents of "legacy" homes, the original nursing homes that stay open alongside the GH home(s). The adoption of GH had no detectable impact on Medicare Part A (plus hospice) spending and utilization across all residents living in the nursing home. When we analyzed residents living in GH homes and legacy units separately, however, we found that the adoption of the GH model reduced overall annual Medicare Part A spending by $7,746 per resident, although this appeared to be partially offset by an increase in spending in legacy homes. To the extent that the GH model reduces Medicare spending, adopting nursing homes do not receive any of the related Medicare savings under traditional payment mechanisms. New approaches that are currently being developed and piloted, which better align financial incentives for providers and payers, could incentivize greater adoption of the GH model. © Health Research and Educational Trust.

Effects of nurse staffing, work environments, and education on patient mortality: An observational study

PubMed Central

Cho, Eunhee; Sloane, Douglas M.; Kim, Eun-Young; Kim, Sera; Choi, Miyoung; Yoo, Il Young; Lee, Hye Sun; Aiken, Linda H.

2014-01-01

Background While considerable evidence has been produced showing a link between nursing characteristics and patient outcomes in the U.S. and Europe, little is known about whether similar associations are present in South Korea. Objective To examine the effects of nurse staffing, work environment, and education on patient mortality. Methods This study linked hospital facility data with staff nurse survey data (N=1,024) and surgical patient discharge data (N = 76,036) from 14 high-technology teaching hospitals with 700 or more beds in South Korea, collected between January 1, 2008 and December 31, 2008. Logistic regression models that corrected for the clustering of patients in hospitals were used to estimate the effects of the three nursing characteristics on risk-adjusted patient mortality within 30 days of admission. Results Risk-adjusted models reveal that nurse staffing, nurse work environments, and nurse education were significantly associated with patient mortality (OR 1.05, 95% CI 1.00–1.10; OR 0.52, 95% CI 0.31–0.88; and OR 0.91, CI 0.83–0.99; respectively). These odds ratios imply that each additional patient per nurse is associated with an 5% increase in the odds of patient death within 30 days of admission, that the odds of patient mortality are nearly 50% lower in the hospitals with better nurse work environments than in hospitals with mixed or poor nurse work environments, and that each 10% increase in BSN nurse is associated with a 9% decrease in patient deaths. Conclusions Nurse staffing, nurse work environments, and percentages of BSN nurses in South Korea are associated with patient mortality. Improving hospital nurse staffing and work environments and increasing the percentages of BSN nurses would help reduce the number of preventable in-hospital deaths. PMID:25213091

The NURSING-Positive Recruitment Arabic Model (NURS-P.R.A.M.): A Mixed Methods Study.

PubMed

Tawash, Eman; Cowman, Seamus

2018-06-12

To identify factors influencing high school students' choice of nursing and explore strategic interventions to promote nursing as a career in the Arab region. This study forms part of a PhD thesis, conducted in Bahrain, in a healthcare environment with a high dependence on expatriate nurses to maintain nursing services. However, in attracting local candidates to study nursing, the public image of nursing in the Middle East must be improved by implementing strategies that are sensitive to the Arabic culture. A mixed methods approach incorporating quantitative and qualitative dimensions. Data were collected between 2012-2015 using self-administered questionnaires, semi-structured interviews, focus groups and written narratives. The study sample included high school students, parents, career guidance counsellors and nursing students. A one-group pre-test post-test design was used to introduce a nursing recruitment intervention to high school students. SPSS was used to analyse quantitative data. Colaizzi's (1978) and Krueger's (1994) frameworks were applied to analyse the qualitative data. It is proposed that the public perceptions of Arab people about nursing may be grounded in strong cultural influences and any efforts to improve the enrolment and retention of local nurses should consider enhancing the social values of the nursing profession. The NURSING-Positive Recruitment Arabic Model incorporates essential elements which will guide nursing recruitment in the Arabic cultures. The study findings reflect certain issues similar to the core international literature on nursing recruitment, however there are fundamental issues particular to the Arab region, which must be included in the development of a nursing recruitment strategy for Arabic nursing. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Determinants of nursing competence of nursing students in Taiwan: the role of self-reflection and insight.

PubMed

Eng, Cheng-Joo; Pai, Hsiang-Chu

2015-03-01

A nursing practicum course is critical to strengthening the nursing competence of nursing students. Research has found that practice stress and coping behaviors can have either a negative or positive influence on the learning and practice performance of nursing students. Nevertheless, there are few evidence-based studies related to the relationship between self-reflection and insight and nursing competence in Taiwanese nursing students. To test the determinants and the effect of self-reflection and insight on nursing competence in nursing students during the first 2 months of their practice experience. Cross-sectional and correlational research designs were employed. From September to November 2013, a total of 312 nursing students at a junior college in southern Taiwan served as participants in this study. Four questionnaires were used to collect data: Self-reflection and Insight Scale (SRIS), Perceived Stress Scale (PSS), Coping Behavior Inventory (CBI), and Holistic Nursing Competence Scale (HNCS). The research model was evaluated through structural equation modeling (SEM), with the use of the partial least squares (PLS) method. Results indicated that self-reflection and insight, practice stress, and practice coping behavior were statistically significantly associated with nursing competence. In addition, self-reflection and insight were significantly and positively associated with practice coping behavior and negatively associated with practice stress. Students' coping behavior partially mediates the effect of self-reflection and stress on nursing competence. Overall, these variables explained 39.4% of the variance in these students' nursing competence. Self-reflection and insight affected nursing competence during the practice period. These variables have not only had a direct influence on nursing competence but also an indirect effect through the mediating effect of coping behavior and stress. Copyright © 2014 Elsevier Ltd. All rights reserved.

Exploring the cross-level impact of market orientation on nursing innovation in hospitals.

PubMed

Weng, Rhay-Hung; Huang, Ching-Yuan; Lin, Tzu-En

2013-01-01

Recently, many hospitals have been enthusiastically encouraging nurses to pursue nursing innovation to improve health care quality and increase nursing productivity by proposing innovative training methods, products, services, care skills, and care methods. This study tried to explore the cross-level impact of market orientation on nursing innovation. In our study, 3 to 7 nurses and 1 manager were selected from each nursing team to act as respondents. The questionnaire survey began after the managers of each nursing team and the nurses had been anonymously coded and paired up in Taiwan in 2009-2010. A total of 808 valid questionnaires were collected, including 172 valid teams. Hierarchical linear modeling was used for the analysis. Nursing innovation is the sum of knowledge creation, innovation behavior, and innovation diffusion displayed by the nurses during nursing care. The level of knowledge creation, as perceived by the nurses, was the highest, whereas the level of innovation diffusion was the lowest. Results of hierarchical linear modeling showed that only competitor orientation yielded a significant positive influence on knowledge creation, innovation behavior, or innovation diffusion. The r values were 0.53, 0.49, and 0.61, respectively. Customer orientation and interfunctional coordination did not have significant effects on nursing innovation. Hospital nurses exhibited better performance in knowledge creation than in innovation behavior and diffusion. Only competitor orientation had a significantly positive and cross-level influence on nursing innovation. However, competitor orientation was observed to be the lowest dimension of market orientation, which indicates that this factor should be the focus when improving nursing innovations in the future. Therefore, managers should continually understand the strategies, advantages, and methods of their competitors.

The influence of personal and workplace resources on new graduate nurses' job satisfaction.

PubMed

Pineau Stam, Lisa M; Spence Laschinger, Heather K; Regan, Sandra; Wong, Carol A

2015-03-01

This study examined the influence of new graduate nurses' personal resources (psychological capital) and access to structural resources (empowerment and staffing) on their job satisfaction. Reports suggest that new graduate nurses are experiencing stressful work environments, low job satisfaction, and high turnover intentions. These nurses are a health human resource that must be retained for the replacement of retiring nurses, and to address impending shortages. Supportive workplaces that promote new graduate nurses' job satisfaction may play an important role in the retention of new nurses. A secondary analysis of data from a larger study of new graduate nurses was conducted. Data collection was completed using self-reported questionnaires. Hierarchical multiple regression was used to test the hypothesised model. Psychological capital, structural empowerment and perceived staffing adequacy were significant independent predictors of job satisfaction. The final model explained 38% of the variance in job satisfaction. Both personal and structural workplace factors are important to new graduate nurses' job satisfaction. Managers should ensure empowerment structures are in place to support new graduate nurses' job satisfaction. Orientation processes and ongoing management support to build psychological capital in new graduate nurses will help create positive perceptions of the workplace, enhancing job satisfaction. © 2013 John Wiley & Sons Ltd.

Linking nurses' perceptions of patient care quality to job satisfaction: the role of authentic leadership and empowering professional practice environments.

PubMed

Spence Laschinger, Heather K; Fida, Roberta

2015-05-01

A model linking authentic leadership, structural empowerment, and supportive professional practice environments to nurses' perceptions of patient care quality and job satisfaction was tested. Positive work environment characteristics are important for nurses' perceptions of patient care quality and job satisfaction (significant factors for retention). Few studies have examined the mechanism by which these characteristics operate to influence perceptions of patient care quality or job satisfaction. A cross-sectional provincial survey of 723 Canadian nurses was used to test the hypothesized models using structural equation modeling. The model was an acceptable fit and all paths were significant. Authentic leadership had a positive effect on structural empowerment, which had a positive effect on perceived support for professional practice and a negative effect on nurses' perceptions that inadequate unit staffing prevented them from providing high-quality patient care. These workplace conditions predicted job satisfaction. Authentic leaders play an important role in creating empowering professional practice environments that foster high-quality care and job satisfaction.

A Concept Analysis of Holistic Care by Hybrid Model.

PubMed

Jasemi, Madineh; Valizadeh, Leila; Zamanzadeh, Vahid; Keogh, Brian

2017-01-01

Even though holistic care has been widely discussed in the health care and professional nursing literature, there is no comprehensive definition of it. Therefore, the aim of this article is to present a concept analysis of holistic care which was developed using the hybrid model. The hybrid model comprises three phases. In the theoretical phase, characteristics of holistic care were identified through a review of the literature from CINAHL, MEDLINE, PubMed, OVID, and Google Scholar databases. During the fieldwork phase, in-depth interviews were conducted with eight nurses who were purposely selected. Finally, following an analysis of the literature and the qualitative interviews, a theoretical description of the concept of holistic care was extracted. Two main themes were extracted of analytical phase: "Holistic care for offering a comprehensive model for caring" and "holistic care for improving patients' and nurses' conditions." By undertaking a conceptual analysis of holistic care, its meaning can be clarified which will encourage nursing educators to include holistic care in nursing syllabi, and consequently facilitate its provision in practice.

The technology acceptance model: predicting nurses' intention to use telemedicine technology (eICU).

PubMed

Kowitlawakul, Yanika

2011-07-01

The purposes of this study were to determine factors and predictors that influence nurses' intention to use the eICU technology, to examine the applicability of the Technology Acceptance Model in explaining nurses' intention to use the eICU technology in healthcare settings, and to provide psychometric evidence of the measurement scales used in the study. The study involved 117 participants from two healthcare systems. The Telemedicine Technology Acceptance Model was developed based on the original Technology Acceptance Model that was initially developed by Fred Davis in 1986. The eICU Acceptance Survey was used as an instrument for the study. Content validity was examined, and the reliability of the instrument was tested. The results show that perceived usefulness is the most influential factor that influences nurses' intention to use the eICU technology. The principal factors that influence perceived usefulness are perceived ease of use, support from physicians, and years working in the hospital. The model fit was reasonably adequate and able to explain 58% of the variance (R = 0.58) in intention to use the eICU technology with the nursing sample.

The mediating effect of emotional intelligence between emotional labour, job stress, burnout and nurses' turnover intention.

PubMed

Hong, Eunyoung; Lee, Young Sook

2016-12-01

This study was designed to construct and test the structural equation modelling on nurses' turnover intention including emotional labour, job stress, emotional intelligence and burnout in order to identify the mediating effect of emotional intelligence between those variables. Emotional labour, job stress and burnout increase turnover intention of nurses. However, emotional intelligence is negatively correlated with emotional labour and reduces job stress, burnout and turnover intention. Structural equation modelling was used to analyse the goodness of fit of the hypothetical model of nurses' turnover intention. Research data were collected via questionnaires from 4 to 22 August 2014 and analysed using SPSS version 18.0 and AMOS version 20.0. The model fit indices for the hypothetical model were suitable for recommended. Emotional intelligence has decreasing effect on turnover intention through burnout, although its direct effect on turnover intention is not significant. Emotional intelligence has mediation effect between emotional labour and burnout. This study's results suggest that increasing emotional intelligence might critically decrease nurses' turnover intention by reducing the effect of emotional labour on burnout. © 2016 John Wiley & Sons Australia, Ltd.

Structural empowerment and burnout among Portuguese nursing staff: An explicative model.

PubMed

Orgambídez-Ramos, Alejandro; Borrego-Alés, Yolanda; Vázquez-Aguado, Octavio; March-Amegual, Jaume

2017-11-01

Kanter's structural empowerment model was used to assess the influence of access to opportunities, resources, information and support on core burnout through global empowerment in a nursing sample in Portugal. The empowerment experience increases the levels of nursing professionals' satisfaction and performance preventing the emergence of burnout. However, the relationship between structural empowerment and burnout has been scarcely studied in Portugal. We conducted a cross-sectional correlational study assessing a final sample of 297 participants (62.13% response rate, 63.64% women). Model fit and mediation test were examined using structural equation modelling (path analysis). Access to opportunities and access to support had direct impact, through global empowerment, on core burnout, whereas access to resources had both direct and indirect impact on core burnout. The results validated the structural empowerment model and its application in nursing staff in Portugal. Professional training plans, the development of formal and informal support networks, and the availability of resources increase the levels of empowerment and decrease the likelihood of experiencing burnout in nursing professionals. © 2017 John Wiley & Sons Ltd.

Implementation of a model of emergency care in an Australian hospital.

PubMed

Millichamp, Tracey; Bakon, Shannon; Christensen, Martin; Stock, Kate; Howarth, Sarah

2017-11-10

Emergency departments are characterised by a fast-paced, quick turnover and high acuity workload, therefore appropriate staffing is vital to ensure positive patient outcomes. Models of care are frameworks in which safe and effective patient-to-nurse ratios can be ensured. The aim of this study was to implement a supportive and transparent model of emergency nursing care that provides structure - regardless of nursing staff profile, business or other demands; improvement to nursing workloads; and promotes individual responsibility and accountability for patient care. A convergent parallel mixed-method approach was used. Quantitative data were analysed using descriptive statistics and the qualitative data used a thematic analysis to identify recurrent themes. Data post-implementation of the model of emergency nursing care indicate improved staff satisfaction in relation to workload, patient care and support structures. The development and implementation of a model of care in an emergency department improved staff workload and staff's perception of their ability to provide care. ©2017 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

Empowering Education: A New Model for In-service Training of Nursing Staff

PubMed Central

CHAGHARI, MAHMUD; SAFFARI, MOHSEN; EBADI, ABBAS; AMERYOUN, AHMAD

2017-01-01

Introduction: In-service training of nurses plays an indispensable role in improving the quality of inpatient care. Need to enhance the effectiveness of in-service training of nurses is an inevitable requirement. This study attempted to design a new optimal model for in-service training of nurses. Methods: This qualitative study was conducted in two stages during 2015-2016. In the first stage, the Grounded Theory was adopted to explore the process of training 35 participating nurses. The sampling was initially purposeful and then theoretically based on emerging concept. Data were collected through interview, observation and field notes. Moreover, the data were analyzed through Corbin-Strauss method and the data were coded through MAXQDA-10. In the second stage, the findings were employed through ’Walker and Avants strategy for theory construction so as to design an optimal model for in-service training of nursing staff. Results: In the first stage, there were five major themes including unsuccessful mandatory education, empowering education, organizational challenges of education, poor educational management, and educational-occupational resiliency. Empowering education was the core variable derived from the research, based on which a grounded theory was proposed. The new empowering education model was composed of self-directed learning and practical learning. There are several strategies to achieve empowering education, including the fostering of searching skills, clinical performance monitoring, motivational factors, participation in the design and implementation, and problem-solving approach. Conclusion: Empowering education is a new model for in-service training of nurses, which matches the training programs with andragogical needs and desirability of learning among the staff. Owing to its practical nature, the empowering education can facilitate occupational tasks and achieving greater mastery of professional skills among the nurses. PMID:28180130