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Nursing Leadership

Sarah Lopez, Michelle Freeman
The nursing profession has long acknowledged the importance of leadership and like many other professions has been criticized as "leader-centric." The role of leadership is to influence followers towards a common goal. Leaders, therefore, must have a clear understanding of followership, including the factors that promote followers' effectiveness and engagement. They must be able to identify following and non-following behaviours, and they must practice leadership styles that support effective followership...
September 2018: Nursing Leadership
Vanessa M D'Sa, Jenny Ploeg, Anita Fisher, Noori Akhtar-Danesh, Gladys Peachey
Around the world, registered nurses are working increasing amounts of overtime. This is particularly true in critical care environments, which experience unpredictable fluctuations in patient volume and acuity combined with a need for greater numbers of specialized nurses. Although it is commonplace, little consensus exists surrounding the effects of overtime on nursing sick time and patient outcomes. Using data from 11 different critical care units nestled within three major academic health science centres in Southern Ontario, a multilevel-model Poisson regression analysis was used to evaluate the association between nursing overtime and nursing sick time, patient mortality and patient infection incidents...
September 2018: Nursing Leadership
Shannon Landry, Kathy Bisson, Colleen Cook, Linda Morrison
Aware of the evidence demonstrating how important employee engagement is to patient experience, outcomes and cost containment, leadership at Bluewater Health, Sarnia, was looking for strategic solutions to improve engagement. Work with compassion fatigue and resilience specialists suggested focusing on kindness. This article shares the hospital's experience designing and implementing their campaign - from a core committee that empowers and encourages teams to find their own creative ways to promote kindness, through to leadership's commitment to changing organizational culture...
September 2018: Nursing Leadership
Barbara Mildon
Against the backdrop of Ontario's "Inquiry into the Safety and Security of Residents in the Long-Term Care Homes System," this commentary offers personal reflections about nursing regulation and the profession. The evolution of the three pillars of nursing is briefly described, and emerging changes in regulatory structures and professional associations are identified. The nature of the relationship between the regulator and the registrant is commented on, and the lived experiences of regulation from the perspective of an employer and a chief nursing executive are discussed...
September 2018: Nursing Leadership
Susan M Duncan, Nora B Whyte
Nursing organizations including regulatory colleges are undergoing transitions that fundamentally alter the face of Canadian nursing. As British Columbia regulatory and professional organizational transitions are held up as a potential model for the rest of Canada, we offer a critical commentary on a most recent transition to the One Nursing Regulator of all nursing role designations in the formation of the British Columbia College of Nursing Professionals in 2018. We draw attention to amalgamation processes - professional regulation and governance, the preservation of nursing history, allocation of nurses' fees and resources and the role distinctions and identities of registrant groups - Registered Nurses, Nurse Practitioners, Licensed Practical Nurses and Registered Psychiatric Nurses...
September 2018: Nursing Leadership
Roxanne Tarjan
Public expectations of safety are a given in all aspects of our daily lives and certainly in the delivery of health services. Can enhanced legislation and regulatory requirements strengthen the very systems established to support safe care and safe practice by those professionals delivering this care? The delivery of health services is a complex matrix of public and private systems and care providers. Individual regulated health professionals play a key role in ensuring safe care as do legislators, employers, regulators and unions...
September 2018: Nursing Leadership
Kathleen Leslie, Sioban Nelson
Identifying poor or unsafe practice is an important aspect of professional regulation. One way that health profession regulators access this information is through legislated mandatory reporting of incompetence or incapacity. Australia's mandatory reporting provisions are far-reaching and have become a touchstone issue in Australia's regulatory framework. In Ontario, mandatory reporting of health professionals is more limited. In this article, we compare the mandatory reporting regimes in these two jurisdictions through a historical and legal analysis examining the development and reform of mandatory reporting...
September 2018: Nursing Leadership
Lynn M Nagle
A registered nurse of questionable professional competence, with a dodgy employment record, a history of mental illness and substance abuse, remains employed and ultimately murders eight vulnerable seniors, attempts to murder four others, and assaults another two over the course of a decade. At least those are the ones for which Elizabeth Wettlaufer offered a confession. Like most nurses and citizens, I was horrified by the revelation of multiple homicides at the hand of one of us. How could such a confluence of incompetence, mental illness and addiction, and willful murder go undetected for so long by so many?...
September 2018: Nursing Leadership
Julia Lukewich, Samantha Taylor, Marie-Eve Poitras, Ruth Martin-Misener
Family practice nurses (also known as primary care nurses) are registered nurses who practice in primary healthcare and function as generalists who provide a broad range of health services, including preventative screening, health education, chronic disease management, care coordination, and system navigation. This paper reports on the current state of family practice nursing in Canada and findings from an environmental scan of literature focused on family practice nursing competency development internationally...
June 2018: Nursing Leadership
Kristin Cleverley, Christina Bartha, Gillian Strudwick, Rebecca Chakraborty, Rani Srivastava
This paper presents the development of a mental health and addictions settings-specific Client Care Needs Assessment (CCNA) tool. The process of tool development was completed using a modified Delphi approach. During Round One, indicators reflecting the unique needs of patients with mental illness and addictions issues were identified through meetings with interprofessional teams. During Round Two, an interprofessional mental health practice expert panel further refined the tool via online survey. Round Three consisted of refining and finalizing the tool...
June 2018: Nursing Leadership
Dipti Purbhoo, Anne Wojtak
As jurisdictions around the world transform their healthcare systems, the home and community care sector represents both a significant challenge and a critical opportunity for the future. One of the biggest challenges is that home and community care lags behind hospitals and primary care in most health systems in funding, policy, and infrastructure. At the same time, home and community care is an ideal foundation for a health system which is patient and family-centred and provides care options that are delivered closer to home...
June 2018: Nursing Leadership
Lianne Jeffs
As part of the special focus on nursing leadership and quality improvement, I had the privilege of interviewing Chris Power (CP) chief executive officer of Canadian Patient Safety Institute (CPSI); Michael Villeneuve (MV) chief executive officer of the Canadian Nurses Association (CNA) and Judith Shamian (JS) past president International Council of Nurses (ICN) and former CNA president around their perspectives of our current context and their collective wisdom on key actions for nurse leaders to undertake to advance the quality and safety agenda in Canada and globally...
June 2018: Nursing Leadership
Lianne Jeffs, G Ross Baker, Ru Taggar, Pam Hubley, Joy Richards, Jane Merkley, Judy Shearer, Hailey Webster, Melissa Dizon, Jessie Ho Fong
To lead effectively within their organizations, nurse executives must possess quality and safety literacy and be able to engage and motivate clinicians to participate in safety and quality initiatives. Given the paucity of research in Canada, a study was undertaken to explore nurse executives' understanding of the key concepts and strategies associated with patient safety and quality improvement, and their engagement with patient safety and quality improvement in their hospitals and healthcare systems. This study used an exploratory qualitative design with a content analysis approach on 20 nurse executives working in hospitals in Ontario...
June 2018: Nursing Leadership
Lianne Jeffs
Now more than ever with the increasing complexity of care needs and the aging nursing workforce, nurse executives need to embrace the opportunity to acquire and enhance their transformation leadership competencies to advance and accelerate patient safety and quality improvement in healthcare. This paper calls for nurse leaders to engage in authentic, complex and resilient leadership to meet the evolving challenges and advances in technology in healthcare amidst achieving the quadruple aim of improving the care experience, improving population health, reducing the cost of care and improving the provider experience...
June 2018: Nursing Leadership
Lynn M Nagle
The editor-in-chief discusses the central theme of this issue of the Canadian Journal of Nursing Leadership - advancing quality and safety in healthcare. As she explains, authors in this issue represent a range of perspectives and highlight nursing leadership strategies, competencies, and obligations to ensure quality and safety in Canadian healthcare organizations.
June 2018: Nursing Leadership
Ross Graham, Rosanne Beuthin
Background: While multisource feedback and coaching have shown promise as effective professional development strategies for physicians, the effectiveness of these interventions with nurse practitioners - a growing profession in Canada - remains unknown. Despite this knowledge gap, multiple nursing colleges in Canada require their nurse practitioner members to participate in multisource feedback processes. Methods: An exploratory study was performed with twelve nurse practitioners using an online multisource feedback process (based on the CanMEDS Framework) and an in-person coaching session (using the R2C2 Model)...
2018: Nursing Leadership
Heather Hunt-Smith, Mollie Butler
Newfoundland and Labrador (NL) has the highest prevalence of diabetes in Canada. In 2011, Eastern Health (EH) selected diabetes as its chronic disease management focus in response to national statistics on the disease. In 2012, EH partnered with Saint Elizabeth (SE) to offer a free e-learning module on diabetes management to its healthcare providers. In this paper, the Engage Others domain of the LEADS in a Caring Environment Framework is used to describe the EH-SE partnership for this e-learning including strategies used to engage nursing and allied health staff...
2018: Nursing Leadership
Stephanie Gilbert, E Kevin Kelloway
LEADS in a Caring Environment has been adopted as the primary leadership framework by the Canadian Health Leadership Network. This study developed and validated a 20-item behaviourally anchored rating scale to assess the twenty LEADS capabilities. Canadian healthcare employees and support staff (N = 156) were asked to rate their managers using the scale and also completed measures of transformational leadership, job-related affective well-being, and intent to stay for validation purposes. Exploratory factor analysis suggested that the scale was best represented by a single factor structure...
2018: Nursing Leadership
Lea Bill, Leila Gillis
Nurse leaders, educators and employers work to address the challenges of providing optimal care to Indigenous people and communities in Canada, which is often further complicated by geography and isolation. The Canadian Indigenous Nurses Association (CINA) has responded to the Calls to Action of the Truth and Reconciliation Commission of Canada through partnerships with various levels of government, including the First Nations and Inuit Health Branch of the new federal department of Indigenous Services Canada, to increase and better support Indigenous nurses in the healthcare system...
2018: Nursing Leadership
Lorna Butler, Heather Exner-Pirot, Lois Berry
Canadian universities are developing strategies to address the Truth and Reconciliation Commission (TRC) Calls to Action. There has been much attention paid to the positivist, individualistic and Eurocentric foundations of nursing and its educational curricula, but limited focus on assessing organizational structures or engaging with stakeholders. Without both approaches, the success of new initiatives may be limited. The College of Nursing at the University of Saskatchewan implemented a "Learn Where You Live" model that demonstrated a sense of place by providing access and opportunity in rural, remote and northern regions of the province...
2018: Nursing Leadership
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