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Aim: This concept analysis aims to distinguish the concept of nurse empowerment as an individual professional process rather than a job‐related process and to identify ways in which a clarified understanding of individual empowerment can impact the discipline. Background: The history of nursing as a gendered role has led to oppression in the profession as evidenced by lateral violence and attrition. Empowerment initiatives that focus on a nurse within an organization often provide false power. Design: Walker and Avant's method was used for this concept analysis. Data Source: Published literature from 1990 to 2019 was identified from electronic health profession‐related databases, and current definitions and uses of empowerment were pulled from empirical works and electronic databases. Review Methods: A review of abstracts and full text from articles relating to nurse empowerment was performed, and empirical studies used to provide an understanding of the concept as used today. Results: True empowerment entails a nurse controlling her practice and career. Elements of individual empowerment can be pulled from existing work on structural and psychological empowerment. Conclusions: Analyzing nurse empowerment from an individual perspective allows us to move beyond the oppressive history of nursing and move the profession forward to impact our communities. [ABSTRACT FROM AUTHOR]

The article offers information on the reorganization and restructuring of Registered Nurse (RN) training program at Virginia Mason Medical Center (VMMC). It promotes retention by creating a RN residency, which adds value to the new graduate's experience, injects a sense of loyalty and belonging, and ensures competence in a clinical specialty. It states that VMMC utilizes the Virginia Mason Production System (VMPS), which uses the lean principles from Toyota Production System, to decrease waste and efficiencies, reduce cost and increase safety and quality of care for patients. It mentions that using online didactic program allows them to increase the flexibility of the program, and adjust it with each individual's needs for both new graduates and experienced RNs.

Competing Interests: Competing interests: None declared.

Objective: To quantify the relationship between staffing characteristics and patient outcomes in acute care hospitals in Washington state., Methods: Retrospective cross-sectional time-series study of linked data from six sources on staffing and outcomes for Washington state hospitals. Key stakeholders provided input on data sources, measures, and outcomes in a four-phase participatory process. After data cleaning and linkage, we used a random effects Poisson regression model to examine the relationship between staffing levels or characteristics and adverse outcomes., Results: The study included 263 hospital-years from 80 distinct hospitals, with 162 hospital-years from general acute care hospitals (n=46) and 101 hospital-years from critical access hospitals (n=34). In general acute care hospitals, a higher ratio of patients to care team staff is associated with a higher number of adverse events (adjusted RR, 1.36 per one SD increase; 95% UI 1.13-1.63), and a lower proportion of RNs on the care team staff is likely associated with a higher number of adverse events (adjusted RR, 1.16 per one SD increase; 95% UI, 0.97-1.39). In critical access hospitals, a lower proportion of RNs on the care team is associated with a higher number of adverse events (adjusted RR, 3.28 per one SD increase; 95% UI, 1.20-7.75). A counterfactual analysis indicated that if all general acute care hospitals had no more than the median staffing ratio of 1.2 patient hours per staff hour, the number of adverse events would be reduced by 10% (95% UI 2.7-16.8)., Conclusion: RN staffing is an indisputable component of safe, high quality patient care, and other factors such as availability of care team staff, hospital features, and patient characteristics also impact patient outcomes. This study highlights the utility of merging diverse data sources to provide a comprehensive analysis of the relationships between staffing and patient outcomes., Competing Interests: Conflicts of interest: None to declare.

Background: Health systems have long been interested in the best practices for staffing in the acute care setting. Studies on staffing often focus on registered nurses and nurse-to-patient staffing ratios. There are fewer studies on the relationship between interprofessional team members or contextual factors such as hospital and community characteristics and patient outcomes. This qualitative study aimed to refine a causal model by soliciting hospital stakeholder feedback on staffing and patient outcomes., Methods: We conducted a qualitative study using semi-structured interviews and thematic analysis to understand hospital stakeholder perspectives and their experiences of factors that affect acute care inpatient outcomes. Interviews were conducted in 2022 with 38 hospital stakeholders representing 19 hospitals across Washington State., Results: Findings support a model of characteristics impacting patient outcomes to include the complex and interconnected relationships between community, hospital, patient, and staffing characteristics. Within the model, patient characteristics are nested into hospital characteristics, and in turn these were nested within community characteristics to highlight the importance of setting and context when evaluating outcomes. Together, these factors influenced both staff characteristics and patient outcomes, while these two categories also share a direct relationship., Conclusion: Findings can be applied to hospitals and health systems across the globe to examine how external factors such as community resource availability impact care delivery. Future research should expand on this work with specific attention to how staffing changes and interprofessional team composition can improve patient outcomes., Competing Interests: Competing Interests: None to declare