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- All Subjects: Nursing
- Creators: Lamb, Gerri
- Creators: Augusta, Dawn
The goal of this qualitative study was to explore and understand the way critical care nurses navigate within the patient room and interact with its features. The study of critical care nurses interacting with the patient room environment was conducted in five critical care units at three tertiary care institutions in the Eastern United States, along with another unit in the pilot study at a community hospital in the Southwest United States. Nurses were observed in their typical work environment as they performed normal tasks and patient care activities for entire day and night shifts. The study involved ethnographic field observations, individual semi-structured participant interviews, and examination of photographs and floor plans.
The exploratory study resulted in a comprehensive model for nurse navigation that includes both cognitive and action components, along with a conceptual framework for nurse behavioral activity. Repetitive patterns of nurse movement were identified and named. The findings produced recommendations for nurses’ effective use of space and architectural design of ICU patient rooms to improve patient outcomes.
This study sought to determine the nursing leadership competencies clinical managers expect of new nurses in an acute care setting and to identify gaps between end-of-program nursing leadership competencies, as outlined in The Essentials of Baccalaureate Education for Professional Nursing Practice, with leadership competencies identified by clinical managers in an acute-care setting.
A single, bounded case study approach was used to collect data from nurse managers and assistant nurse managers at one acute care hospital. Data from intensive interviews, focus groups, and archival records were analyzed. Seven major themes related to clinical leadership emerged, including intentional learning, communication, professional practice, advocacy, teamwork, influencing practice, and systems thinking. Traits, mentoring, and generational differences emerged as secondary themes.
Data from this study revealed a developmental sequence for clinical leadership. Certain expectations identified as antecedent to clinical leadership emerged initially, whereas other aspects of clinical leadership, developed later in the career trajectory. It was clear that accomplishing nursing care tasks was a fundamental expectation for professional nursing practice. Communication, teamwork and advocacy are crucial leadership competencies which help the new nurse to effectively manage time and provide safe, high-quality nursing care. As the new nurse continues to develop, systems thinking and influencing nursing practice emerge as significant expectations. Nurse managers have clear expectations for how new nurses should be prepared for clinical leadership. The degree to which clinical practice partners employing new nurses and academic nursing programs educating future nurses collaborate to establish expected outcomes is variable; however, academic-practice collaborations are crucial in developing educational standards for entry to practice in complex healthcare delivery systems.
The study sample consisted of 10 adult-medical surgical units, five home care agencies and six long-term care facilities. A total of 273 hospital nursing and discharge planning staff and 69 post-acute staff participated. Hospital staff completed a survey about communication patterns for patient care and patient discharge and about communication quality on the unit. Hospital and post-acute care staff completed surveys about relationship quality and demographic characteristics. Evidence-based practice adherence rates for risk assessment, medication reconciliation, and discharge summary were measured as documented in the electronic medical record.
Social network analysis was used to analyze the communication patterns for patient care communication at the unit. These findings were correlated with (1) aggregate responses for communication quality, (2) aggregate responses for relationship quality, and (3) EBP adherence. Statistically significant relationships were found between communication patterns, and communication quality and relationship quality. There were
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two significant relationships between communication quality, and EBP adherence. Limitations in response rates and missing data prevented the analysis of all of the hypothesized relationships.
The findings from this study provide empirical support for the role of social networks and relationships among staff in adoption of, and adherence to, EBP. Social network theory and social network analysis, especially the concept of knowledge sharing, provide ways to understand and leverage the influence of peer relationships. Future studies are needed to better understand the contribution that relationships among staff (social networks) have in the adoption of and adherence to EBP among nursing staff. Further model development and multilevel studies are
It is often a passion for caring for others that drives people towards the profession of nursing in the first place. At some point, however, this desire to care for other people takes over, and nurses soon forget how to properly care for themselves. It was asked: If students are better prepared with and more encouraged to use healthy coping mechanisms and integrative modalities to deal with their daily lives, are they more likely to continue to care for themselves properly as time goes on? Ample research was conducted illuminating the prevalence of this worldwide problem and highlighting potential solutions noted by credible sources. An initiative was formed with the goal of improving the self care practices of nursing students at Arizona State University (ASU) with the greater intent of promoting a healthier work environment as these students advance into their future careers. The Arizona Student Chapter of the American Holistic Nurses Association (AHNA) at ASU was formed, and it serves as the vessel for this self-care health-care mission.