Moral distress is increasingly recognized as a problem affecting healthcare professionals. If not addressed, it may create job dissatisfaction, withdrawal from the moral dimensions of patient care, or even leaving the profession. Using the 21-Moral Distress Scale-Revised to assess moral distress, 323 surveys were received from 5 healthcare disciplines. The overall results showed that all disciplines experienced moderate to high actual moral distress, related to similar and/or different patient care situations.

Shared governance is considered an innovative management process model that includes shared decision-making between all members of the healthcare workforce and focuses on nurses' control over their practice and accountability of care. One specific tool that measures shared governance perceptions of nurses is the RN-focused Index of Professional Governance (IPNG). The objective of this study was to assess reliability and add to the validity of the IPNG by further establishing the construct validity and correlating the scale scores to measures of satisfaction obtained from the National Database of Nursing Quality Indicators (or NDNQI) survey. There were 76 respondents representing six units in one hospital. We reported high reliability for each one of the six subscale scores as well as for the total score (Cronbach alphas of 0.94 and higher). Construct validity was supported by the invariance of the scores across age groups along with schooling and Downloaded from experience levels. Concurrent validity was supported by a correlation of the IPNG score with job enjoyment (r ¼ 0.437, p ¼ 0.002) and the desire to recommend the hospital as a place of employment (r ¼ 0.442, p ¼ 0.001). The IPNG should also be tested in other healthcare professionals as its scoring ability can compare management, units and departments.

This article describes the ethical principles of autonomy, beneficence, and justice within the nurse researcher-participant relationship as these principles relate to the informed consent process for research. Within this process, the nurse is confronted with a dual role. This article describes how nurses, who are in the dual role of care provider and researcher, can apply these ethical principles to their practice in conjunction with the American Nurses Association's code of ethics for nurses. This article also describes, as an element of ethical practice, the importance of using participant-centered quality measures to aid informed decision making of participants in research. In addition, the article provides strategies for improving the informed consent process in nursing research. Finally, case scenarios are discussed, along with the application of ethical principles within the awareness of the dual role of the nurse as care provider and researcher.

The MSPM allows organizations to retain a quality nursing work force focused on safety patient care by transitioning new graduate RNs into the practice setting.

The American Nurses Association mandates nursing informaticists to evaluate clinical system implementation processes. When implementing electronic documentation systems, the use of an evaluation tool aids in the identification of end-user concerns and recommendations, which leads to process improvement. At two community hospitals in South Florida, a Clinical Information System Implementation Evaluation Scale was used to evaluate nursing perceptions during the implementation of a new pediatric electronic documentation system (eDocumentation). The goals were to identify barriers and resistance, as well as opportunities to improve the implementation process, and thus gain acceptance among end users.