Online Journal of Issues in Nursing

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Nurse scholars and clinicians seek to publish their research and scholarly findings to strengthen both nursing science and clinical practice. Traditionally subscription-based publications have been the mainstay of knowledge dissemination. However, subscription costs have tended to restrict access to many journals to a small, specialized, academic community, a limitation that has contributed to the development of open access (OA) publications. OA journals have a powerful appeal as they allow greater access to scholars and consumers on a global level...

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As nurses, we seek to better understand how to gain nursing ‘wisdom’ and apply this wisdom in our daily practice. Yet the concept and experience of ‘wisdom in nursing practice’ has not been well defined. This article addresses wisdom-in-action for nursing practice. We briefly describe nursing theory, review the wisdom literature as presented in various disciplines, and identify characteristics of wisdom by analyzing four models of wisdom from other disciplines. We also present the ten antecedents of wisdom and the ten characteristics of wisdom identified in our analysis of the wisdom literature, discuss and summarize these antecedents, and conclude that understanding these ten antecedents and the ten characteristics of wisdom-in-action can both help nurses demonstrate wisdom as they provide nursing care and teach new nurses the process of becoming wise in nursing practice...

The Affordable Care Act requires nonprofit hospitals to collaborate with public health agencies and community stakeholders to identify and address community health needs. As a rural organization, Wabash County (Indiana) Hospital pursued new approaches to achieve these revised requirements of the community benefit mandate. Using a case study approach, the authors provide a historical review of governmental relationships with nonprofit community hospitals, offer a case study application for implementing legislative mandates and community benefit requirements, share the insights they garnered on their journey to meet the mandates, and conclude that drawing upon the existing resources in the community and using current community assets in novel ways can help conserve time, and also financial, material, and human resources in meeting legislative mandates...

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Care transitions between settings are a well-known cause of medical errors. A key component of transition is information exchange, especially in long-term care (LTC). However, LTC is behind other settings in adoption of health information technologies (HIT). In this article, we provide some brief background information about care transitions in LTC and concerns related to technology. We describe a pilot project using HIT and secure messaging in LTC to facilitate electronic information exchange during care transitions...

The concept of care coordination is often touted as the preferred way to streamline care for complex patients. Care coordination is even more popular with the mention of it in the Affordable Care Act of 2010 and with new Medicare payment models. The purpose of this article is to define care coordination, briefly describe trends for older adults and care coordination, and explore roles for registered nurses. We describe elder-appropriate models of care coordination useful for older adults with multimorbidity...

A fundamental component of the medical home model is care coordination. In Minnesota, this model informed design and implementation of the state's health care home (HCH) model, a key element of statewide healthcare reform legislation. Children with medical complexity (CMC) often require care from multiple specialists and community resources. Coordinating this multi-faceted care within the HCH is challenging. This article describes the need for specialized models of care coordination for CMC. Two models of care coordination for CMC were developed to address this challenge...

The 2013 addition of the Care Transition Measures to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey; enactment of the Patient Protection and Affordable Care Act (2010); and a greater focus on population health have brought a heightened awareness and need for action with patient transitions. Data are emerging from the additional Care Transition Measures and benchmarks have been developed. This article briefly describes the context of care transition. We describe the journey of Indiana University Health North Hospital to overcome patient care transition obstacles, ultimately achieving designation as a top performer...

Older adults with multiple chronic conditions complicated by other risk factors, such as deficits in activities of daily living or social barriers, experience multiple challenges in managing their healthcare needs, especially during episodes of acute illness. Identifying effective strategies to improve care transitions and outcomes for this population is essential. One rigorously tested model that has consistently demonstrated effectiveness in addressing the needs of this complex population while reducing healthcare costs is the Transitional Care Model (TCM)...

Both safety and quality of care patients receive depend upon the quality of the practice environment where care is provided. In this article, the authors review relevant literature, and describe their study that identified how nurses and physicians define respectful behavior; examined perceptions of the relationship between nurses and physicians in clinical settings in which they practice together; and analyzed the impact of nurse-physician relationships on nursing care decisions. Perceptions of nurse-physician relationships were assessed using the Professional Practice Environment Assessment Scale and perceptions of respectful behavior and the effect of physician behavior on nursing practice were assessed with single, forced-choice items...

Sixty nurses from five countries (Canada, India, Ireland, Japan, and Korea) took part in 11 focus groups that discussed the question: Do you consider your work meaningful? Fostering meaning and mentorship as part of the institutional culture was a central theme that emerged from the discussions. In this article, we begin with a background discussion of meaning and meaningful work as presented in the literature related to existentialism and hardiness. Next, we describe the method and analysis processes we used in our qualitative study asking how nurses find meaning in their very challenging work and report our findings of four themes that emerged from the comments shared by nurses, specifically relationships, compassionate caring, identity, and a mentoring culture...

Discrimination against internationally educated nurses (IENs) remains a seldom-explored topic in the United States. Yet, the literature describing experiences of IENs indicates that some do experience workplace discrimination as an additional workplace stressor. IENs view this discrimination as an obstacle to career advancement and professional recognition. Consequences of workplace discrimination affect IENs' physical and psychological well being, the quality of patient care, and healthcare organizational costs...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.