Findings from this project provide insight into factors that influence delegation effectiveness. These can guide CNOs and frontline nurse leaders to focus on implementing strategies to mitigate the consequence of missed care. Ineffective delegation of basic nursing care can result in poor patient outcomes, potentially impacting quality measures, satisfaction, and reimbursement for the institution.
Nurse leaders must focus on implementing strategies to mitigate factors and the consequences of care omissions, including poor patient outcomes. An analysis of point-of-care delivery system failures and ineffective processes is essential.
AIM The purpose of this project was to address factors contributing to the nurse faculty shortage. BACKGROUND There is a demonstrated need to sustain and stabilize faculty currently in the workforce to avoid exacerbating the current and future faculty shortage in nursing. Recommendations of previous studies focus on strategies for recruitment, retention, and ongoing faculty development. METHOD A survey was employed to identify and describe the workload of nurse faculty and identify the impact of retirement and other retention issues. RESULTS Findings showed an aging and nondiverse nursing faculty with increased and variable workload. There was no standard means of calculating workload. With identification of increased workload, faculty are considering retirement at a higher than projected rate. CONCLUSION Four primary areas to address the nursing faculty shortage include focus on diversity balance, development of collaborative positions (joint appointments), and clear identification of nursing faculty workload.
There has been a great deal of attention focused upon the professional and faculty nursing shortage. Retirement rates of seasoned nurse faculty, fewer nurses pursuing academic roles as nursing faculty, and insufficient numbers of nurses in doctoral programs hinder the ability to educate willing students to become professional nurses. The aim of this descriptive, quantitative study in the New England region was to determine barriers to job satisfaction as reported by nurse faculty. A 32-item survey was used with questions about workload, satisfaction, and identified barriers to satisfaction. Responses from 226 nurse faculty support findings regarding factors essential to job satisfaction, including work environment and workload. Implications for the study findings include the need for attention to the complexity of the academic work environment, specifically in nursing education.
Evidence points to the omission of required nursing care as a pervasive problem in acute care hospitals. Labor and material resource constraints, increasing patient complexity, ineffective delegation, and poor communication have been identified as contributing factors. Nurse executives should examine the degree and causes of missed care in their organizations. Action plans should be developed based on identification of issues contributing to this serious concern, thus promoting safe patient care.
Purpose/Objective: The Community-based Care Transitions Program (CCTP) defined a broad spectrum of interventions and services for elderly patients at high risk of hospital readmission. The purposes for a CCTP as developed by the Centers for Medicare & Medicaid Services are to improve transitions of beneficiaries from the inpatient hospital setting to other care settings, to improve quality of care, to reduce readmissions for high-risk beneficiaries, and to document measurable savings. The goals for this CCTP initiative were as follows: achievement of a 20% reduction in the 30-day all-cause readmission rate across all partner hospitals compared with baseline; reduction in the 30-day all-cause readmission rate among the high-risk cohort served; and achievement of the target volumes for full enrollment. Primary Practice Settings: The partnership included acute care institutions and community-based care organizations that have been involved with care transition programs for years and have a long history of working collaboratively to provide services to a largely low-income, underserved, and ethnically and racially diverse target population. Findings/Conclusions: The program successfully transitioned to full operation within the first year of inception. To date, the partnership of the acute hospital setting and the community-based organizations has reached and provided services to nearly 8,000 total individuals, surpassing our target enrollment goal. To date, the readmission rate has decreased to 12.5%, which is an 11% decline since inception of the program. Implications for Case Management Practice: The collaboration of health care providers, social workers, nurse practitioners, physicians, community pharmacists, and the visiting nurses is integral to a successful transition from hospital to home. Home visits by the transition facilitators allowed for the coordination of a multitude of services in the community, including those previously available to patients in the past that have rarely been accessed. Including a pharmacist on the team provided teaching regarding medication adherence, medication management, and pharmacy services, which added to interventions to decrease future hospitalizations.
The aim of this project was to evaluate the effectiveness and outcomes of a redesigned newly licensed nurse orientation program. A unique aspect of this program was an end-of-orientation simulated four-patient assignment that was designed to assess five categories of critical thinking: prioritization and delegation, problem recognition, clinical decision making, clinical implementation, and reflection. Newly licensed nurses' critical thinking was measured by the Advisory Board's Critical Thinking Diagnostic tool at 10 weeks, 6 months, and 12 months. Findings showed that in all five categories of critical thinking, a significant increase was found between the 10-week and 6-month evaluation. Two of the categories-prioritization and delegation, and problem recognition-were found to have a significant increase from the 6-month evaluation to the 12-month evaluation. In addition, newly licensed nurses reported improvement in their confidence and in their preparation to work independently. J Contin Educ Nurs. 2017;48(1):22-28.
Aim: The purpose of this study was to identify the impact of the dedicated education unit (DEU) on nursing students' critical thinking ability. Background: The DEU is an innovative approach to clinical education, which uses clinical nurses with expert practice consistently in a competency-based experience. Method: Participants (intervention and control groups) completed the Nursing Executive Center's Critical Thinking Diagnostic Assessment tool before and after clinical experience. Results: Participants included 243 students with 179 non-DEU and 64 DEU students. There were significant increases in total pretest and posttest score means (P < .05) for the DEU (intervention) group. A significant change (P < .0001) was seen in critical thinking scores by category for both groups and in the intervention group on pretest and posttest scores, even after controlling for pretest scores (P < .0001). Conclusions: Results support the efficacy of the DEU model in developing critical thinking. Prior DEU studies have focused on implementation and satisfaction with the model.
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