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OBJECTIVE: The aim of this study was to examine the relationship between various factors and self-perceived transformational leadership among a sample of Filipino nurse managers (NMs). BACKGROUND: Transformational leadership plays a crucial role in promoting positive outcomes in healthcare settings, particularly for NMs. Understanding the factors that influence NMs' self-perceived transformational leadership is essential for improving leadership practices and enhancing organizational effectiveness. METHODS: A cross-sectional research design was used to collect data from 260 NMs using standardized measures. RESULTS: Employment status, the number of units managed, the type of hospital employment, psychological distress, and job satisfaction were factors that significantly influenced their leadership perceptions. CONCLUSION: By addressing the identified factors, nursing organizations can create an environment that promotes effective leadership practices, ultimately enhancing patient outcomes, staff satisfaction, and overall organizational performance. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To examine the association between organizational safety climate (OSC), in-hospital mortality (IM), and failure to rescue (FTR) in 2 hospitals, 1 with and 1 without crew-resource-management training. BACKGROUND: OSC is 1 of the most important organizational factors that promotes safety at work; however, there is a lack of research examining the relationship between OSC and patient deaths in hospitals. METHODS: We utilized a matched 2-group comparison of surgical patients and surveyed surgical staff to assess the relationship between OSC, FTR, and IM. RESULTS: The OSC assessment was completed by 261 surgical team members. A total of 1764 patients had at least 1 FTR complication; however, there was no association between OSC with FTR or IM for either hospital. CONCLUSIONS: Nurse leaders should remain vigilant in building work teams with strong hospital safety climates. More research is needed to explore the relationship between OSC and patient outcomes. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to examine the effect of nurses' mobility plan use on patients' length of stay, discharge destination, falls, physical therapy consults, and nurses' knowledge, attitudes, and beliefs regarding patient mobility. BACKGROUND: Functional decline due to decreased mobility during hospitalization results in diminished quality of life. Sixty-five percent of older inpatients lose the ability to ambulate during hospitalization and 30% do not regain that capability. METHODS: Using a quasi-experimental design, nurses' use of a mobility assessment on 4 patient outcome variables was examined before (n = 2,259) and after (n = 3,649) use. Nurses' attitudes, knowledge, and beliefs regarding mobility were also examined. RESULTS: Positive changes in patient variables occurred. Limited change occurred relative to nurses' knowledge, attitudes, and beliefs. CONCLUSIONS: Implementing a nurse-led mobility plan enhances therapy resource utilization through identification of appropriate consults and improves patients' discharge home. In addition, nurses' knowledge, attitudes, and beliefs toward patient mobility planning can be positively influenced. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine a just and consistent practice for creating nursing assignments. BACKGROUND: Traditional methods of assigning patients to nurses may lead to unbalanced nursing workload. This article describes the ongoing, hospital-wide effort to evaluate and implement a nursing assignment tool based on electronic health record (EHR) functionality and auto-calculated nursing workload scores. METHODS: EHR records of individual patient workload scores from all hospital units were collected from August 2017 to June 2018. A nurse-specific total workload score was summed for each staff. Then, each hospital unit's mean nurse workload score and standard deviation, along with the unit's nurse-to-patient ratio, were used to calculate levels of high, medium, and low nursing workload measurement (NWM). RESULTS: Mean patient-specific workload scores varied greatly across hospital units. Unit-specific nurse-to-patient ratios were factored into NWM scores to create ranges for assignments that were relatively consistent across the institution. CONCLUSION: The use of objective, electronically generated nursing workload scores, combined with traditional nurse-to-patient ratios, provides accurate real-time nurse staffing needs that can inform best practice in staffing. The confirmation of individual patient workload scores and an appreciation for the complexity of EHR vendor rules are necessary for successful implementation. Automation ensures patient safety, staff satisfaction, and optimal resource allocation. [ABSTRACT FROM AUTHOR]

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

The article offers information on transformational leadership is identified as being critical for achieving superior nursing performance in healthcare organizations. Topic include the American Nurses Credentialing Center (ANCC) defines transformational leaders as "those who stimulate and inspire followers to both achieve extraordinary outcomes and, in the process, develop their own leadership capacity".

OBJECTIVE: The purpose of this study was to describe current practices for onboarding travel nurses (TRNs) and identify TRNs' specific onboarding needs. BACKGROUND: Onboarding must be streamlined and organized for TRNs to provide safe patient care. METHODS: Cross-sectional descriptive survey was used with 306 TRNs throughout United States who were recruited electronically from a closed social media group page. RESULTS: The TRNs identified critical information, including unit patient ratios, onboarding schedule 7 to 14 days before travel assignment start, and login IDs/accesses on day 1. Travel nurse onboarding and competency assessment checklists should be specific to the unit/facility where they will work. CONCLUSION: Findings from this study have the potential to support hospitals in the development of streamlined and tailored TRN onboarding to support regulatory compliance and patient safety as well as realize significant cost savings for TRN onboarding. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To examine whether healthcare-associated infections (HAIs) and nurse staffing are associated using unit-level staffing data. BACKGROUND: Previous studies of the association between HAIs and nurse staffing are inconsistent and limited by methodological weaknesses. METHODS: Cross-sectional data between 2007 and 2012 from a large urban hospital system were analyzed. HAIs were diagnosed using the Centers for Disease Control and Prevention's National Healthcare Safety Network definitions. We used Cox proportional-hazards regression model to examine the association of nurse staffing (2 days before HAI onset) with HAIs after adjusting for individual risks. RESULTS: Fifteen percent of patient-days had 1 shift understaffed, defined as staffing below 80% of the unit median for a shift, and 6.2% had both day and night shifts understaffed. Patients on units with both shifts understaffed were significantly more likely to develop HAIs 2 days later. CONCLUSIONS: Understaffing is associated with increased risk of HAIs. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study explored the types of decisions and differences in decision making that nurses made in different types of hospital units. BACKGROUND: The relationship between nurses' participation in decision making and the different types of hospital units where they work is not well understood. METHODS: Nurses' participation in decision making was explored using the Participation in Decision Activities Questionnaire. The final sample included 307 nurses in 24 nursing units in 6 hospitals. RESULTS: Nurses overall participated more in clinical than administrative decisions, and there were significant differences based on unit type. Critical care nurses had the highest and general care units the lowest levels of participation in decision making. CONCLUSIONS: Nurses in critical care units participated in higher amounts and at higher levels of clinical decisions overall than either intermediate or general care units. Nurse leaders should determine barriers to decision making in general care units and explore mechanisms to increase participation by clinical nurses. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to examine nurses' perceptions regarding the resources needed during floating. BACKGROUND: Most studies report on patterns of floating and the characteristics of float pool nurses. No studies exist regarding staff nurses' views of the types of resources needed to support floating. METHODS: Staff nurses in a pediatric hospital (N = 220) completed an electronic survey of both open- and close-ended questions. Close-ended data were analyzed with frequencies and percentages. Open-ended data were content-analyzed and then frequencies and percentages of categories of responses were performed. χ 2 Analyses were used to examine relationships between the variables. RESULTS: There were no significant relationships between resources and years at the institution and number of times floated in past year. The top 3 categories of resources needed to float by nurse participants included having an assigned a resource/buddy, mini-orientation, and electronic updates about the units they are floating to. CONCLUSIONS: These findings underscore common frustrations nurses experience during floating and ways that nurse executives can create a more satisfactory floating environment and increase nursing satisfaction. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to compare information sharing and advice networks' relationships with patient safety outcomes. BACKGROUND: Communication contributes to medical errors, but rarely is it clear what elements of communication are key. METHODS: We investigated relationships of information-sharing and advice networks to patient safety outcomes in 24 patient care units from 3 hospitals over 7 months. Web-based questionnaires completed via Android tablets provided data to create 2 networks using ORA, a social network analysis application. Each hospital provided nurse-sensitive patient safety outcomes. RESULTS: In both networks, medication errors correlated positively with node count and average distance and negatively with clustering coefficient. Density and weighted density negatively correlated with medication errors and falls in both networks. Eigenvector and total degree centrality correlated negatively with both safety outcomes, whereas betweenness centrality positively related to falls in the information-sharing network. CONCLUSION: Technology-enabled social network analysis data collection is feasible and can provide managers actionable system-level information. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to understand how nurses in a 25-bed critical-access hospital (CAH) led change to become the 1st to achieve Magnet® . BACKGROUND: Approximately 21% of the US population lives in rural areas served by CAHs. Rural nurse executives are particularly challenged with limited resources. METHODS: Staff nurses, nurse managers, interprofessional care providers, the chief nursing officer, and board of directors (n = 27) were interviewed. Observations of hospital units and administrative meetings were done, and hospital reports were analyzed. RESULTS: Nine themes emerged to support a conceptual model of leading change. The CAH spent 3 years of its 6-year journey establishing organizational readiness. Nurses overcame complex challenges by balancing operational support and fostering relationships. The Magnet journey led to significantly improved nurse and patient outcomes. A new organizational culture centered on shared governance, evidence-based practice, and higher education emerged. CONCLUSIONS: The journey to Magnet leads to improved nurse, patient, and organization outcomes. [ABSTRACT FROM AUTHOR]

This article discusses how a group of directors and nursing staff in a rural hospital created an innovative unit meeting model using electronic technology to communicate with staff in a more meaningful manner and still comply with regulatory requirements and 2-way information needs. [ABSTRACT FROM AUTHOR]

To explore how relational coordination, known to enhance quality and efficiency outcomes for patients and hospitals, impacts direct care nurse outcomes such as burnout, work engagement, and job satisfaction, addressing the "Quadruple Aim," to improve the experience of providing care. BACKGROUND: Hospitals are complex organizations in which multiple providers work interdependently, under conditions of uncertainty and time constraints, to deliver safe quality care despite differences in specialization, training, and status. Relational coordination-communicating and relating for the purpose of task integration-is known to improve quality, safety, and efficiency under these conditions, but less is known about its impact on the well-being of direct care providers themselves. METHODS: Surveys measuring relational coordination among nurses and other types of providers as well as job-related outcomes in 5 acute care community hospitals were completed by direct care RNs. RESULTS: Relational coordination was significantly related to increased job satisfaction, increased work engagement, and reduced burnout. CONCLUSIONS: Relational coordination contributes to the well-being of direct care nurses, addressing the Quadruple Aim by improving the experience of providing care. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study is to examine characteristics of the nursing practice environment associated with lower RN turnover. BACKGROUND: Identifying characteristics of the practice environment that contribute to lower RN turnover is important for meeting the national quality strategy priority of reducing healthcare costs. METHODS: Data from 1002 adult care units in 162 National Database of Nursing Quality Indicators participating hospitals were analyzed using multivariate linear regression. The Practice Environment Scale of the Nursing Work Index was used to measure practice environment characteristics. RN turnover was measured at the unit level. RESULTS: Nursing units with higher overall ratings of the nursing practice environment had lower rates of RN turnover. Units with higher RN perceived staffing and resource adequacy experienced significantly lower RN turnover. CONCLUSIONS: Unit managers and hospital administrators should consider RN perception of staffing and resource adequacy and the overall practice environment when developing targeted strategies for decreasing RN turnover. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to identify processes, outcomes, and lessons learned from designing a new evidence-based unit. A research study was conducted simultaneously to rigorously measure changes in patient and staff outcomes. BACKGROUND: Nursing leadership and frontline nursing engagement are critical in evidence-based design to promote positive outcomes and workflow. METHODS: Quality indicators were tracked premove and postmove. Nursing workflow was tracked, and teamwork was examined. RESULTS: The incidence of falls and methicillin-resistant Staphylococcus aureus decreased on the new unit. Patient satisfaction improved; the greatest improvement was noise reduction. Teamwork remained stable. Nurses spent significantly more time in the patient rooms on the new unit. CONCLUSIONS: This hospital found nursing engagement in the unit design process to be imperative to promote positive patient outcomes and stable or improved teamwork. Nursing leaders should be involved at the onset of the design process to facilitate optimal outcomes. [ABSTRACT FROM AUTHOR]

An ultrasound-guided peripheral intravenous (UGPIV) quality improvement project occurred in an 849-bed tertiary care hospital with a goal to reduce the use of central lines, in particular, peripherally inserted central catheters (PICCs). Since implementation, PICCs have decreased by 46.7% overall, and 59 nurses in hospital are competent in placing UGPIVs. Placement of UGPIVs by the bedside nurse is a key initiative in decreasing PICC use and, potentially, infections. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The purpose of this study was to examine the importance of factors related to nurse retention. BACKGROUND: Retaining nurses within the healthcare system is a challenge for hospital administrators. Understanding factors important to nurse retention is essential. METHODS: Responses of nurses (n = 279) to the Baptist Health Nurse Retention Questionnaire (BHNRQ) at a 391-bed Magnet® redesignated community hospital were analyzed to explore differences in importance scores of bedside nurses. RESULTS: The results demonstrate that each of the 12 items on the BHNRQ was moderately to highly important. A multivariate analysis of variance based on generation, degree, unit, and experience revealed no significant differences on subscale scores (nursing practice, management, and staffing). Themes derived from the comment section on the BHNRQ were consistent with quantitative findings. CONCLUSION: Clinical and managerial competence, engagement with their employees, and presence on the unit are keys to retaining a satisfied nursing workforce. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The purpose is to examine the psychometric properties of the professional practice work environment inventory (PPWEI). BACKGROUND: Derived from the Professional Practice Environment (PPE) and the Revised PPE scales, the PPWEIwas designed tomeasure 8 components of the PPE that can be used to assist nurse administrators in decision-making. METHODS: A psychometric evaluation was undertaken with 874 nurses who were providing direct care to patients at theMassachusetts GeneralHospital and who provided no missing data on the newly developed 72-item PPWEI. RESULTS: Cronbach's α internal consistency reliability of the total score was .93, with 61 items having factor loadings more than .50, the factor loading cutoff used to define the component subscales. Principal component analyses with varimax rotation and Kaiser normalization demonstrated 8 components, explaining 64.6%of variance. Cronbach's α reliability coefficients of the PPWEI subscales ranged from .82 to .93. CONCLUSION: The multidimensional PPWEI is a psychometrically sound measure of several components of the PPE in the acute care setting and sufficiently reliable and valid for use as independent subscales in healthcare research. [ABSTRACT FROM AUTHOR]

OBJECTIVE: 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. BACKGROUND: 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. METHODS: 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. RESULTS: Nursing leader's behavioral integrity was positively related to nurses' intention to remain (b = 0.34, < G.001). This relationship was enhanced when the level of intragroup relationship conflict was high (b = 0.21, P < .05). CONCLUSIONS: Nursing leaders assigned to units with a high level of intragroup relationship conflict OBJECTIVE: 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. BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The purposes of this study were to develop and test the Baptist Health Nurse Retention Questionnaire (BHNRQ) and examine the importance of nurse retention factors. BACKGROUND: Multiple factors, including increasing patient acuity levels, have led to concerns regarding nurse retention. An understanding of current factors related to retention is limited. METHODS: To establish the psychometric properties of the BHNRQ, data were collected from 279 bedside nurses at a 391-bed, Magnet® redesignated community hospital. A principal component analysis was conducted to determine the subscale structure of the BHNRQ. Additional analyses were conducted related to content validity and test-retest reliability. RESULTS: The results of the principal components analysis revealed 3 subscales: nursing practice, management, and staffing. Analyses demonstrate that the BHNRQ is a reliable and valid instrument for measuring nurse retention factors. CONCLUSION: The BHNRQ was found to be a clinically useful instrument for measuring important factors related to nurse retention. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to explore RNs and nurse directors' (NDs') perceptions of leadership on units with high RN satisfaction scores. BACKGROUND: Identifying the characteristics of NDs that contribute to RN satisfaction is important in the recruitment and retention of RNs and in the selection and role development of NDs. METHODS: This study used a qualitative design using appreciative inquiry-guided data collection. RESULTS: Nine RNs and 9 NDs met the inclusion criteria. Each group identified 4 themes. CONCLUSIONS: Registered nurse and ND participants identified similar themes representative of leadership attributes and behaviors that contribute to RN satisfaction. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The purposes of this study are to determine the level of emotional intelligence (EI) among nurse managers (NMs) in an academic medical center and determine the relationship of EI and demographic variables. BACKGROUND: Emotional intelligence is a concept that warrants further research in nursing because there is a huge gap in knowledge about nurse leaders' EI. METHODS: Data were collected from 38 NMs recruited from a large academic medical center in the Northeast. RESULTS: Mean EI scores among NMs were average. Nurse managers with less than 2 years of experience had statistically significant lower "using emotions" branch score and strategic EI. Nurse managers with a masters' degree in nursing scored significantly higher in using emotions branch score than did those with a masters' degree in a related field. CONCLUSION: Opportunities exist to enhance the EI of NMs. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study is to increase nurses' time for direct patient care and improve safety via a novel human factors framework for nursing worksystem improvement. BACKGROUND: Time available for direct patient care influences outcomes, yet worksystem barriers prevent nurses adequate time at the bedside. METHODS: A novel human factors framework was developed for worksystem improvement in 3 units at 2 facilities. Objectives included improving nurse efficiency as measured by time-and-motion studies, reducing missing medications and subsequent trips to medication rooms and improving medication safety. RESULTS: Worksystem improvement resulted in time savings of 16% to 32%per nurse per 12-hour shift. Requests for missing medications dropped from 3.2 to 1.3 per day. Nurse medication room trips were reduced by 30% and nurse-reported medication errors fell from a range of 1.2 to 0.8 and 6.3 to 4.0 per month. CONCLUSIONS: An innovative human factors framework for nursing worksystem improvement provided practical and high priority targets for interventions that significantly improved the nursing worksystem. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The objective of this project was to use an interdisciplinary approach to analyze strategies through simulation technology for improving patient flow in a pediatric hospital. BACKGROUND: Various statistics have been offered on the number of children admitted annually to hospitals. For administrators, particularly in smaller systems, the financial burden of equipping and staffing pediatric units often outweighs the moral desire to maintain a pediatric unit as a viable option for patients and pediatricians. METHODS: Discrete event simulation was used to model current operations of a pediatric unit. Cost analysis was conducted using simulation reflecting various percentages of patients being referred to a discharge holding area (DHA) upon discharge and of the use of all private rooms. RESULTS: Both DHA and private rooms resulted in increased patient volumes. CONCLUSIONS: Administrators should consider the use of a DHA and/or private rooms to ease the census strains of pediatric units and the resultant revenue of this service. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The objective of this evidence-based investigation is to determine the efficacy of a quiet-time intervention to reduce noise in the hospital setting. BACKGROUND: For many reasons, noise continues to increase in the hospital setting. METHODS: In a descriptive comparative design, using a convenience sample of hospitalized patients, 80 patients were assessed on their perceptions of noise using the Patient Survey on Noise During Hospital Stay. RESULTS: Data revealed favorable responses to quiet time, with 70% of subjects reporting quiet-time intervention to be effective in reducing noise. Sixty percent of participants felt that 1 hour of quiet time helped to facilitate a quieter, more restful environment for the whole day. CONCLUSION: A quiet-time intervention is effective in addressing patient perception of noise while in the acute care hospital setting. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to test the reliability and validity of the Psychological Conditions Scale (PCS), a measure of drivers of engagement in hospital-based nurses. BACKGROUND: Research suggests drivers of engagement are positive links to patient, employee, and hospital outcomes. Although this scale has been used in other occupations, it has not been tested in nursing. METHODS: A cross-sectional, methodological study using a convenience sample of 200 nurses in a large Magnet® hospital in New Jersey. RESULTS: Cronbach's α's ranged from .64 to .95. Principal components exploratory factor analysis with oblique rotation revealed that 13 items loaded unambiguously in 3 domains and explained 76% of the variance. Mean PCS scores ranged from 3.62 to 4.68 on a 5-point Likert scale. CONCLUSIONS: The scale is an adequate measure of drivers of engagement in hospital-based nurses. Leadership efforts to promote the facilitators of engagement are recommended. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study examined the influence of authentic leadership, person-job fit with 6 areas of worklife, and civility norms on coworker incivility and burnout among new graduate nurses. BACKGROUND: New graduate nurses report experiencing high levels of workplace incivility from co-workers, which has been found to negatively impact their job and career satisfaction and increase their intention to leave. The role of civility norms in preventing burnout and subsequent exposure to incivility from coworkers has yet to be examined among new graduate nurses. METHODS: A cross-sectional mail survey of 993 new graduate nurses across Canada was conducted. RESULTS: The results supported the hypothesized relationships between study variables. CONCLUSIONS: Civility norms play a key role in preventing early career burnout and coworker incivility experienced by new graduate nurses. Leaders can influence civility norms by engaging in authentic leadership behaviors and optimizing person-job fit. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to investigate the perceptions of RNs on the implementation of safe patient handling and mobility (SPHM) programs in states with and without SPHM legislation. BACKGROUND: Despite numerous strategies developed to reduce caregiver injuries, nurses are still experiencing work-related musculoskeletal injuries. A comprehensive SPHM program has been found to be effective in reducing patient handling injuries among nurses. METHODS: By using data from 143 480 RNs working in 321 acute care hospitals in 44 US states, RNs' perceptions on 6 key aspects of SPHM programs were compared between states with and without SPHM legislation and among 11 unit types. RESULTS: Registered nurses in states with SPHM legislation are more likely to report the implementation of SPHM programs in contrast with those in comparison states. This finding was found for each of the 11 unit types. CONCLUSIONS: This study provides evidence to support the positive effect of state-based efforts for legislative actions on the development and implementation of SPHM programs. [ABSTRACT FROM AUTHOR]

This study, implemented on 2 medical-surgical units, evaluated the impact of a standardized, evidence-based new medication education program. Outcomes evaluated included patient postdischarge knowledge of new medication purpose and side effects, patient satisfaction with new medication, and Medicare reimbursement earn-back potential. As a result, knowledge scores for new medication purpose and side effects were high post intervention. Patient satisfaction with new medication education increased. Value-based purchasing reimbursement earn-back potential improved. [ABSTRACT FROM AUTHOR]

Fatigue negatively affects healthcare workers' health and well-being, decreases patient safety, and negatively impacts the work environment. Although individual lifestyle choices influence fatigue levels, much responsibility lies with nursing administrators to prevent situations that may result in sleep deprivation or overwork. This article, the 2nd in a 2-part series, describes the results that were achieved from a fatigue reduction intervention. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The objective of this study is to identify the effects of unit collaboration and nursing leadership on nurse outcomes and quality of care. BACKGROUND: Along with the current healthcare reform, collaboration of care providers and nursing leadership has been underscored; however, empirical evidence of the impact on outcomes and quality of care has been limited. METHODS: Data from 29742 nurses in 1228 units of 200 acute care hospitals in 41 states were analyzed using multilevel linear regressions. Collaboration (nursenurse collaboration and nurse-physician collaboration) and nursing leadership were measured at the unit level. Outcomes included nurse job satisfaction, intent to leave, and nurse-reported quality of care. RESULTS: Nurses reported lower intent to leave, higher job satisfaction, and better quality of care in units with better collaboration and stronger nursing leadership. CONCLUSION: Creating a care environment of strong collaboration among care providers and nursing leadership can help hospitals maintain a competitive nursing workforce supporting high quality of care. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This pilot study examined differences in RN perception of the professional practice environment and financial indicators between salary-wage and hourly-wage compensation models. BACKGROUND: There is a dearth of current information regarding use of salary-wage models for compensation for direct care nurses. METHODS: A descriptive, comparative design was used to examine the Revised Professional Practice Environment Scale (RPPE) and financial indicators of nurses in a nonprofit healthcare system over a 6-month period. RESULTS: Mean scores on the RPPE were significantly lower for hourly-wage RNs, and the hourly-wage model resulted in a 1.2% additional cost for overtime hours compared with the fixed cost of the salary-wage model. CONCLUSIONS: Nurses in an hourly-wage unit reported a significantly lower perception of the clinical practice environment than did their peers in a salary-wage unit, indicating that professional practice perceptions in a salary-wage unit may provide a more effective professional practice environment. Financial analysis resulted in a budget-neutral impact. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The objectives of this study were to examine the quality of unit-level nurse turnover data collection among the National Database of Nursing Quality Indicators hospitals and to identify the burdens of collecting such data .BACKGROUND : Tracking and managing nurse turnover at the unit level are critical for administrators who determine managerial strategies. Little is known about the quality of and burdens of unit-level turnover data collection. METHODS: Surveys from 178 hospitals were analyzed descriptively. RESULTS: Most hospitals strongly agreed or agreed with the quality of unit-level turnover data collection. Hospitals identified the burdens of additional time and resources needed for unit-level turnover data collection and the difficulty of obtaining specific reasons for turnover CONCLUSIONS: Collecting unit-level nurse turnover data can be important and useful for administrators to improve nurse retention, workforce stability, and quality of care. We suggest that the advantages of unitlevel nurse turnover data and reports can overcome the identified burdens. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The objective of this study was to investigate the impact of The Productive Ward-Releasing Time to Care™ program implemented in a hospital transformation process on nurse perception related to practice environment, burnout, quality of care, and job outcomes. BACKGROUND: To address the continuously evolving complex challenges of patient care, high-performance nursing care is necessary. METHODS: A longitudinal survey design was used to conduct a study in a 600-bed acute care university hospital with 3 measurement periods: TO: base line in 2006, T1 in 2011, and T2 in 2013. As part of the hospital transformation process, the productive ward program was introduced between T1 and T2. RESULTS: Relevant impact on nurse-physician relations, nurse management, hospital management-organizational support, nurse-reported quality of care, and job outcomes were identified. CONCLUSION: Hospital strategies and policies should be aligned with daily practices so that engaged and committed staff can promote excellent outcomes. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study tested a multilevel model examining the effects of work-unit structural empowerment and social capital on perceptions of unit effectiveness and nurses' ratings of patient care quality. BACKGROUND: Structural empowerment and social capital are valuable resources for staff nurses that promote work effectiveness and high-quality patient care. No studies have examined social capital in nursing at the group level. METHODS: A cross-sectional survey of 525 nurses in 49 nursing units in 25 acute care hospitals in Ontario was conducted to test the hypothesized multilevel model using structural equation modeling. RESULTS: Both unit-level structural empowerment and social capital had significant effects on unit effectiveness (β = .05 and β = .29, P < .05, respectively). Unit-level predictors explained 87.5% of level 2 variance in individual nurses' ratings of patient care quality. CONCLUSIONS: This study provides a better understanding of how unit-level structural empowerment [ABSTRACT FROM AUTHOR]

A medical/surgical unit at the University of Michigan Health System implemented a pod nursing model of care to improve efficiency and patient and staff satisfaction. One centralized station was replaced with 4 satellites and supplies were relocated next to patient rooms. Patients were assigned to 2 nurses who worked as partners. Three patient (satisfaction, call lights, and falls) and nurse (satisfaction and overtime) outcomes improved after implementation. Efforts should be focused on addressing patient acuity imbalances across assignments and strengthening communication among the healthcare team. Studies are needed to test the model in larger and more diverse settings. [ABSTRACT FROM AUTHOR]

The article discusses a study which sought to identify the impact that ratios have on nursing workforce and the work environment of nurses. A search of news articles between 1998 and 2006 was conducted to identify stakeholders' concerns and/or benefits related to nurse-to-patient ratios. The various measures of nurse-level outcomes in the categories of workforce and work environment are discussed.

The article presents an analysis of Nursing Speciality certification by Magnet® Status and unit type. It examined the trends by Magnet status hospitals and patient care unit types. Magnet recognition is assigned to organizations which offer higher levels of health care facilities. Unit rates of speciality certification increased in all pediatric units and adult critical care and declined for psychiatric unit types for magnet designated organizations.

The article discusses a study examining the impact of decentralization of support spaces on reduction of the time wasted by registered nurses (RNs) in walking, using a simulation-based experimental method. Results showed that the total walking time can be reduced up to 67.9 percent, depending on the decentralization level used. It suggests that appropriate levels of decentralization may contribute to care quality and efficacy, although extreme levels may reduce the opportunities for several activities in areas of peer support, socialization and mentoring that contribute to care quality.

The article discusses about the acute care hospitals in creating work environments and develop the operating system where patient safety should be an essential institutional priority in health care literature. The purpose of the study is to describe the quality and strength of the patient on medical-surgical units associated with the climate. Nursing workgroup and managerial commitment to safety were two most strongly positive attributes of the patient safety climate. Nurses on smaller units were also committed to patients for safety and solving their problems.