social processes in nursing organizational and leadership

AIM: This article is a report on a case study that described and analysed the collaborative process among nurse practitioners and registered nurses in oncology outpatient settings to understand and improve collaborative practice among nurses. BACKGROUND: Changes in the health system have created new models of care delivery, such as collaborative nursing teams. This has resulted in the increased opportunity for enhanced collaboration among nurse practitioners and registered nurses...

BACKGROUND: There is a current push to use best practice guidelines (BPGs) in health care to enhance client care and outcomes. Even though intensive resources have been invested internationally to develop BPGs, a gap in knowledge exists about how to consistently and efficiently move them into practice. METHODS: Constructivist grounded theory was used to explore the complex processes of a breastfeeding BPG implementation and uptake in three acute care hospitals. Interviews (n = 120) with 112 participants representing clients, nurses, lactation consultants, midwives, physicians, managers, administrators, and nurse educators as well as document and field note analysis informed this study...

Depression is a socially- and physically-disabling condition. The Chronic Care Model (CCM) was developed to promote better management of long-term conditions, such as depression, in primary care settings. The aim of the study was to identify barriers to, and facilitators of, success when implementing the CCM for the management of depression in primary care. A systematic search was conducted in electronic databases from January 2005 to December 2011. Thirteen articles met the inclusion criteria and were reviewed by means of a thematic analysis...

Learning circles are an enabling process to critically examine and reflect on practices with the purpose of promoting individual and organizational growth and change. The authors adapted and developed a learning circle strategy to facilitate open discourse between registered nurses, clinical leaders, clinical facilitators and students, to critically reflect on practice experiences to promote a positive learning environment. This paper reports on an analysis of field notes taken during a critical reflection process used to create an effective learning community in the workplace...

OBJECTIVES: To identify the factors and strategies that were associated with successful implementation of hospital-based information technology (IT) systems in US Department of Veterans Affairs (VA) hospitals, and how these might apply to other hospitals. STUDY DESIGN: Qualitative analysis of 118 interviews conducted at 7 VA hospitals. The study focused on the inpatient setting, where nurses are the main patient-care providers; thus, the research emphasized the impact of Computerized Patient Record System and Bar Code Medication Administration on nurses...

Ethical issues arising in clinical practice are complex and clinicians must be able to manage the needs of ethically vulnerable patients and families. This paper describes a model for providing Clinical Ethics Support Services as a broad spectrum of care for management of conflict and ethically difficult situations in health care and describes how an ethics consultation process was transformed to a Holistic Care Continuum for managing the needs of ethically vulnerable patients. During a 4-year journey at a regional medical center, a Family Support Team played a central role in identification of ethically vulnerable patients/family, interdisciplinary connectivity, and iterative engagement in the clinical milieu...

Organizational ergonomics refers to the optimization of social technical systems, including their organizational structures, policies and processes. The relevant topics include communications, management of resources, work projects, temporal organization of work, team work, participative project, new work paradigms, cooperative work, organizational culture, network organizations and quality management (IEA, 2000). The purpose of this study was the reorganization of the methods and processes of the occupational health sector (SMS/SO - Portuguese acronym of the area) of a petrochemical company...

Manufacturing organizations have used Lean management principles for years to help eliminate waste, streamline processes, and cut costs. This pragmatic approach to structured problem solving can be applied to health care process improvement projects. Health care leaders can use a step-by-step approach to document processes and then identify problems and opportunities for improvement using a value stream process map. Leaders can help a team identify problems and root causes and consider additional problems associated with methods, materials, manpower, machinery, and the environment by using a cause-and-effect diagram...

BACKGROUND: Little is known about how to use patient feedback to improve experiences of health care. The Veterans Health Administration (VA) conducts regular patient surveys that have indicated improved care experiences over the past decade. The goal of this study was to assess factors that were barriers to, or promoters of, efforts to improve care experiences in VA facilities. METHODS: We conducted case studies at two VA facilities, one with stable high scores on inpatient reports of emotional support between 2002 and 2006, and one with stable low scores over the same period...

BACKGROUND: : Very little research has been focused on the interdisciplinary staffing characteristics of the operating room team, an essential component of providing safe patient care in a high-risk setting. OBJECTIVES: : The aim of this study was to determine how the operating room staffing of two surgical specialties compares in terms of social network variables. METHODS: : Staffing data from all general and neurosurgical procedures performed at a large Midwestern hospital were analyzed using Social Network Analysis methods...

This pilot study explored (a) front-line nurse managers' stressor experiences and (b) coping strategies used in order to respond to the myriad of challenges and demands of their role. The nurse managers who participated indicated that limited resources, ever-increasing challenges and work expectations contributed to the stressors they experience. Coping responses included support, cognitive, personal and social strategies, but findings indicated managers still lacked the ability to cope effectively. Managers faced considerable job stress and conflicting demands, often caught between focusing on staff relations and organizational productivity...

Mutual trust and shared nurse leadership behaviors between the chief nurse executive and nursing staff are linked to improved clinical outcomes through an initial visioning process. The authors outline a hospital's strategy to improve nurse-driven outcomes by using visioning in the hiring process. Visioning, implemented in the hiring process, is a unique application of this tool for creating a desired future.

STUDY OBJECTIVE: We inform the future development of a new geriatric emergency management practice model. We perform a systematic review of the existing evidence for emergency department (ED)-based case management models designed to improve the health, social, and health service utilization outcomes for noninstitutionalized older patients within the context of an index ED visit. METHODS: This was a systematic review of English-language articles indexed in MEDLINE and CINAHL (1966 to 2010), describing ED-based case management models for older adults...

AIMS: This study aimed to (1) identify how leadership is perceived and experienced by community nurses, and (2) examine the interaction between recent policy and leadership development in community nursing in the United Kingdom (UK). BACKGROUND: Leadership is a 'hot topic' yet little is known about leadership in community nursing. Traditionally, the study of leadership is viewed from a leader-centric perspective in which the discussion of followership and its impact on leadership in theory and research is noticeable absent...

Many new nursing leaders assuming deanships, assistant, or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, Jana L. Pressler, PhD, RN, and Carole A. Kenner, PhD, RNC-NIC, FAAN, the editors of this department, address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs...

AIM: The aim of the present study was to describe three case studies that exemplify decision making by a nursing leader related to retention of expert clinical nurses in the Emergency Department. BACKGROUND: Further understanding of decision-making processes that help nursing leaders to retain (or let go of) expert clinical nurses is needed so that sufficient numbers of expert nurses are available in the workforce to provide high-quality and safe patient care. EVALUATION: Decision processes related to retention of expert clinical nurses are exemplified in three case studies...

AIM: The present study aimed to explore Registered Nurse Intellectual Disabilities (RNIDs) experiences of managerial support. BACKGROUND: The current work environment for RNIDs is undergoing immense change. These changes include the introduction of social care leaders and care staff to care for people with an intellectual disability (ID) and community-based approaches to care. This has led to ambiguity and marginalization for RNIDs thus requiring them to re-establish their role boundaries...

UNLABELLED: BACKGROUND INFORMATION AND SIGNIFICANCE: Critical thinking (CT) skills and the inclination to engage in critical thinking are essential for nurse managers to function as transformational leaders capable of influencing staff to align with organizational goals. In an extensive literature review, numerous studies were found examining the concept of CT in students and no studies were found exploring CT in nurse managers. Identifying the attributes, such as CT, that lead to success in the nurse manager role is useful when preparing nurse managers to lead effectively in the current healthcare climate...

AIM: The purpose of the study was to describe empowerment from the perspective of intensive care staff. What makes intensive care staff experience inner strength and power? BACKGROUND: Intensive care staff are repeatedly exposed to traumatic situations and demanding events, which could result in stress and burnout symptoms. A higher level of psychological empowerment at the workplace is associated with increased work satisfaction and mental health, fewer burnout symptoms and a decreased number of sick leave days...

BACKGROUND: Clinical practice guidelines (CPGs) aimed at preventing falls and fall injuries have been shown to be effective in acute care hospitals. However, although CPGs are systematically developed and evidence-based tools, there has been a problem with their implementation in clinical practice. AIM: To describe influences on health care professionals' attitudes to CPGs for preventing falls and fall injuries. METHODS: A qualitative approach was chosen and five focus group discussions were conducted, which included physicians, nurses, physiotherapists, and occupational therapists...