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Managerial coaching may be an effective strategy to reduce role ambiguity among nurses. Although the benefits of coaching relationships have been demonstrated outside of nursing, there is a lack of evidence about this career development relationship in nursing. A cross-sectional design was used to determine the relationship between managerial coaching and role ambiguity among military and civilian nurses who work in the Military Health System (MHS). Nurses who worked at a large academic medical center in San Antonio, Texas were asked to participate by completing a survey to examine the variables of interest. Among the 382 nurses that responded, perceived role ambiguity was low and managerial coaching was seldom perceived from first-line supervisors. However, there was a significant negative relationship between managerial coaching and role ambiguity. This study provides foundational knowledge about the relationship between managerial coaching and role ambiguity for nurses working in the MHS. • There is a lack of nursing literature on whether managerial coaching reduces role ambiguity. • Nurses seldom received coaching from their first-line supervisors in this study. • Despite low levels of role ambiguity reported by nurses, any experience could be important. • Perceptions of managerial coaching correlate with decreased role ambiguity perceptions. • Managerial coaching should be an expected part of performance management to reduce role ambiguity. [ABSTRACT FROM AUTHOR]

Objectives The Practice Environment Scale of the Nursing Work Index (PES-NWI) is an instrument, which measures the nursing practice environment – defined as factors that enhance or attenuate a nurse’s ability to practice nursing skillfully and deliver high quality care. The purpose of this paper is to provide an updated review of the Practice Environment Scale of the Nursing Work Index’s use to date and provide recommendations that may be helpful to nursing leaders and researchers who plan to use this instrument. Design A narrative review of quantitative studies. Data sources PubMed, EMBASE, and the Cumulative Index to Nursing & Allied Health Literature were searched to identify relevant literature using the search terms, Practice Environment Scale of the Nursing Work Index and PES-NWI . Review methods Studies were included if they were published in English between 2010 and 2016 and focused on the relationship between the Practice Environment Scale of the Nursing Work Index and patient, nurse, or organizational outcomes. Data extraction focused on the reported survey scores and the significance and strength of the reported associations. Results Forty-six articles, from 28 countries, were included in this review. The majority reported significant findings between the nursing practice environment and outcomes. Although some modifications have been made, the instrument has remained primarily unchanged since its development. Most often, the scores regarding staffing and resource adequacy remained the lowest. Conclusion The frequency of use of this instrument has remained high. Many researchers advocate for a move beyond the study of the connection between the Practice Environment Scale and nurse, patient, and organizational outcomes. Research should shift toward identifying interventions that improve the environment in which nurses practice and determining if changing the environment results in improved care quality. [ABSTRACT FROM AUTHOR]

• Recent federal law change modified the management of military treatment facilities. • Rigorous literature review guided the creation of a nursing model for the military. • The joint professional practice model may guide other organizations to create their own practice model. By 2022 the Defense Health Agency became responsible for administration of all military treatment facilities (MTFs), which were previously managed by their respective military services. However, three different service-specific nursing professional practice models currently govern nursing practice in MTFs. To describe the literature search, review, and synthesis of evidence which informed the JPPM and provide some of the most actionable findings. A team of tri-service nurses developed the JPPM by conducting six rigorous systematic reviews to synthesize evidence pertaining to relevant model components. A total of 51,360 titles and abstracts were initially screened. Data were extracted from 540 included articles. The team then developed standards for five JPPM components: evidence-based practice, safety and quality, leadership development, healthy work environment, and operational readiness. The JPPM is a meaningful framework that will help create a mutual professional identity and shared vision to promote a unified nursing force in U.S. military settings. [ABSTRACT FROM AUTHOR]

Background A pressing need in the field of nursing is the identification of optimal staffing levels to ensure patient safety. Effective staffing requires comprehensive measurement of nursing workload to determine staffing needs. Issues surrounding nursing workload are complex, and the volume of workload is growing; however, many workload systems do not consider the numerous workload factors that impact nursing today. Purpose The purpose of this concept analysis was to better understand and define nursing workload as it relates to the acute-care setting. Methods Rogers' evolutionary method was used for this literature-based concept analysis. Discussion Nursing workload is influenced by more than patient care. The proposed definition of nursing workload may help leaders identify workload that is unnoticed and unmeasured. Conclusion These findings could help leaders consider and identify workload that is unnecessary, redundant, or more appropriate for assignment to other members of the health care team. [ABSTRACT FROM AUTHOR]

Background The Patient CaringTouch System (PCTS) is an innovative, strategic and patient-centric framework developed by the Army Nurse Corps for nursing care delivery that is designed to reduce nursing care variation and improve patient and nurse outcomes. Purpose This manuscript describes a program evaluation of the PCTS. Methods A pre and post design was used to describe changes in patient and nursing measures following PCTS implementation. Discussion Overall there was a good uptake of the PCTS; however, concurrent with initiation of the PCTS, declines in staffing levels and increases in patient acuity were noted. Medication administration error rates declined, but fall with injury rates increased. Pain reassessment following pain medication administration improved, as did several aspects of the nursing practice environment. Nurses’ job dissatisfaction and intent to leave increased; however, potentially preventable losses decreased. Conclusions The program evaluation results will be used to target areas for improvement so that the PCTS may be sustained. [ABSTRACT FROM AUTHOR]

Background Two decades ago, findings from an Institute of Medicine (IOM) report sparked the urgent need for evidence supporting relationships between nurse staffing and patient outcomes. Purpose This article provides an overview of nurse staffing, practice environment, and patient outcomes research, with an emphasis on findings from military studies. Lessons learned also are enumerated. Method This study is a review of the entire Military Nursing Outcomes Database (MilNOD) program of research. Discussion The MilNOD, in combination with evidence from other health care studies, provides nurses and leaders with information about the associations between staffing, patient outcomes, and the professional practice environment of nursing in the military. Leaders, therefore, have useful empirical evidence to make data-driven decisions. The MilNOD studies are the basis for the current Army nursing dashboard, and care delivery framework, called the Patent CaringTouch System. Conclusion Future research is needed to identify ideal staffing based on workload demands, and provide leaders with factors to consider when operationalizing staffing recommendations. [ABSTRACT FROM AUTHOR]