Self-Care Activities and Nurse Manager Well-Being

The role of the nurse manager is important in organizations and influences outcomes such as the safety and quality of care provided on a unit, satisfaction, turnover of nursing staff, and overall health of the work environment. Stressors for managing nurses can impair physical and emotional health and lead to poor patient and staff satisfaction, safety, and outcomes. The evidence-based practice project will explore nurse managers\u27 well-being and self-care activities. The theoretical framework of the project is the Relationship-Based Care Model as well as Kotter\u27s change theory. The literature suggests that self-care activities can reduce stress and improve well-being. A group of nurse managers who have accountability for inpatient hospital units will be recruited to participate in the project through public discussion boards and email groups of organizations that support nurse leaders. They will be educated through a self-guided learning module about stress and self-care and then will be asked to participate in self-care activities 3 times weekly for 4 weeks. Following the education, the nurse managers will complete a researcher-crafted posteducational assessment to evaluate whether the education and activities met their needs, whether they learned new information, and the helpfulness of the project. Nurse managers participating in regular self-care are able influence positive social change by role modeling healthy coping skills to nurses providing direct care to patients. Self-care promotes effective stress management and contributes a healthier work environment

Identifying nurse managers' essential information needs in daily unit operation in perioperative settings

Aim To identify nurse managers' essential information needs in daily unit operation in perioperative settings. Design Qualitative and quantitative descriptive design. Methods The study consisted of (I) generation of an item pool of potential information needs, (II) assessment of the item pool by an expert panel and (III) confirming the essential information needs of nurse managers in daily unit operation with a survey (N = 288). Content validity index values were calculated for the assessments by expert panel and in the survey. Internal consistency of the final item pool was explored with Cronbach's alpha. The data were collected from 2011-2015. Results During the study process, the number of essential information needs decreased from 92-41. The final item pool consisted of 12 subthemes, and they were categorized into four main themes: patient's care process, surgical procedure, human resources and tangible resources. The findings can be used to create a knowledge map for information system purposes.Peer reviewe

Nurse managers' knowledge of staff nurse burnout

Nursing burnout affects the nurse’s home and work life and can lead to serious physical and emotional symptoms as well as patient dissatisfaction and increased nursing turnover. With a shortage of nurses expected to increase to 30% across the state of North Carolina by the year 2020, it is imperative we prevent further loss to burnout. An educational needs assessment was conducted via a mailed survey to determine the current knowledge of nurse managers employed in hospitals in North Carolina regarding causes of burnout and methods of burnout prevention and reversal for staff nurses. The responses of 214 nurse managers allowed the identification of their level of knowledge about staff nurse burnout. Through comparison with published knowledge about the subject, the educational needs of the managers are apparent. The findings of this research can inform the provision of appropriate education for nurse managers, leading to reduced burnout in staff nurses, a reduction in the nursing shortage, and improved quality of patient care. The burnout information least known by nurse managers is evidence-based knowledge and theoretical knowledge is better known. The findings reveal a positive correlation between nurse manager’s total knowledge and age, years as nurse manager, and level of education completed. The greatest knowledge need is in the area of environmental causes of staff nurse burnout

Identifying nurse managers' essential information needs in daily unit operation in perioperative settings

Aim To identify nurse managers' essential information needs in daily unit operation in perioperative settings.Design Qualitative and quantitative descriptive design.Methods The study consisted of (I) generation of an item pool of potential information needs, (II) assessment of the item pool by an expert panel and (III) confirming the essential information needs of nurse managers in daily unit operation with a survey (N = 288). Content validity index values were calculated for the assessments by expert panel and in the survey. Internal consistency of the final item pool was explored with Cronbach's alpha. The data were collected from 2011-2015.Results During the study process, the number of essential information needs decreased from 92-41. The final item pool consisted of 12 subthemes, and they were categorized into four main themes: patient's care process, surgical procedure, human resources and tangible resources. The findings can be used to create a knowledge map for information system purposes

Plugging a hole and lightening the burden: A process evaluation of a practice education team

Aim: To investigate the perceptions of clinical and senior managers about the role of Practice Educators employed in one acute hospital in the UK. Background: Producing nurses who are fit for practice, purpose and academic award is a key issue for nurse education partnership providers in the UK. Various new models for practice learning support structures and new roles within health care institutions have been established. To sustain funding and policy support for these models, there is a need for evaluation research. Design: A process evaluation methodology was employed to determine the current value of a practice education team and to provide information to guide future direction. Methods: Data were collected through semi-structured telephone interviews using a previously designed schedule. All senior nurse managers (N=5) and a purposive sample of clinical managers (n=13) who had personal experience of and perceptions about the role of practice educators provided the data. Interview notes were transcribed, coded and a thematic framework devised to present the results. Results: A number of key themes emerged including: qualities needed for being a successful practice educator; visibility and presence of practice educators; providing a link with the university; ‘plugging a hole’ in supporting learning needs; providing relief to practitioners in dealing with ‘the burden of students’; alleviating the ‘plight of students’; and effects on student attrition. Conclusions: Findings provided evidence for the continued funding of the practice educator role with improvements to be made in dealing with stakeholder expectations and outcomes. Relevance to clinical practice: In the UK, there still remain concerns about the fitness for practice of newly registered nurses, prompting a recent national consultation by the professional regulating body. Despite fiscal pressures, recommendations for further strengthening of all systems that will support the quality of practice learning may continue to sustain practice learning support roles

Leadership Influence in the Adoption of Innovation by Critical Care Nurses

Innovation is critical to the survival and continued success of hospitals. Public and political criticism coalesces around costs, quality, and access. This qualitative research study was conducted to discover strategies that may be useful to nurse managers in supporting innovation adoption. The research design of this case study is useful in understanding how managers and nurses experience innovation in critical care settings. Data collection was carried out on the campus of a university-affiliated research hospital located in the southeastern U.S. A semistructured, protocol-driven, interview process, was used to collect data from 12 participants including nurse leaders and staff nurses. Emphasis was placed on culture, emotional intelligence, transformational leadership, education, and competency. Data were triangulated using interview transcripts and the 2016 Community Health Needs Assessment of the site organization. Thematic analysis and the Diffusion of Innovations framework (Rogers, 2003) was used to identify five themes. Findings included information useful in developing strategies that nurse leaders may use to influence the adoption of innovation. Future researchers may seek answers to questions such as reducing barriers to innovation, effective approaches to protected time for creativity and innovation, and effective methods of teaching innovation skills

Hospice Nurses’ Perception of Factors Influencing Nurse Retention

Aim. To identify factors that affect hospice nurses’ intent to remain employed. Background. Recent literature indicates that turnover is a major problem for health care organizations, since it is costly and negatively affects patient care. Several strategies have been highlighted to help improve retention rates, however hospice nurses have special needs. Methods. To assess hospice nurse perspectives, a survey was conducted using registered nurses working in a multi-county Hospice and Palliative Care facility in the southeastern U.S. Survey items were based on information gathered from previous focus groups exploring determinants of nurse retention. Results. Eighty-eight percent (n=7) of nurses chose “supportive colleagues” as an important factor. The next most highly chosen response (n= 6, 75%) was a “supportive and responsive organization.” Half of the respondents chose “flexible/self-scheduling” and/or “supportive & empathetic manager/leader.” The most selected disincentive (n= 3, 38%) to remain employed was “emotional/physical exhaustion.” Implication for nursing management. Leaders should implement strategies to ensure that support among staff, managers, and the organization is strengthened to help offset the emotional strain that hospice nurses often face in their daily work. Adequate support can help promote retention for this specialty group

Participatory eHealth development to support nurses in antimicrobial stewardship

Background Antimicrobial resistance poses a threat to patient safety worldwide. To stop antimicrobial resistance, Antimicrobial Stewardship Programs (ASPs; programs for optimizing antimicrobial use), need to be implemented. Within these programs, nurses are important actors, as they put antimicrobial treatment into effect. To optimally support nurses in ASPs, they should have access to information that supports them in their preparation, administration and monitoring tasks. In addition, it should help them to detect possible risks or adverse events associated with antimicrobial therapy. In this formative study, we investigate how nurses’ can be supported in ASPs by means of an eHealth intervention that targets their information needs. Methods We applied a participatory development approach that involves iterative cycles in which health care workers, mostly nurses, participate. Focus groups, observations, prototype evaluations (via a card sort task and a scenario-based information searching task) and interviews are done with stakeholders (nurses, managers, pharmacist, and microbiologist) on two pulmonary wards of a 1000-bed teaching hospital. Results To perform the complex antimicrobial-related tasks well, nurses need to consult various information sources on a myriad of occasions. In addition, the current information infrastructure is unsupportive of ASP-related tasks, mainly because information is not structured to match nurse tasks, is hard to find, out of date, and insufficiently supportive of awareness. Based our findings, we created a concept for a nurse information application. We attuned the application’s functionality, content, and structure to nurse work practice and tasks. Conclusions By applying a participatory development approach, we showed that task support is a basic need for nurses. Participatory development proved useful regarding several aspects. First, it allows for combining bottom-up needs (nurses’) and top-down legislations (medical protocols). Second, it enabled us to fragmentise and analyse tasks and to reduce and translate extensive information into task-oriented content. Third, this facilitated a tailored application to support awareness and enhance patient safety. Finally, the involvement of stakeholders created commitment and ownership, and helped to weigh needs from multiple perspective

Transforming the Workforce to Provide Better Chronic Care: The Role of Nurse Care Managers in Rhode Island

This series explores the evolution of primary care systems to better meet the needs of consumers with complex health conditions. It demonstrates that changes in the workforce are required to empower consumers to better manage their health.The series is a collaboration of the National Academy for State Health Policy and the AARP Public Policy Institute. We recognize that it takes a team of skilled professionals to deliver improved chronic care. In this series, we focus on how registered nurses -- who make up the largest segment of the health care workforce -- are being deployed in ambulatory delivery systems to take on new roles. Future series will focus on other members of the health care team.We selected six initiatives that offer replicable policy strategies to develop, implement, and sustain patient-centered approaches to care. Each case study highlights one of these initiatives and provides policy recommendations and an "on-the-ground" look at the work of its nurses

Complex Care Management Program Overview

This report includes brief updates on various forms of complex care management including: Aetna - Medicare Advantage Embedded Case Management ProgramBrigham and Women's Hospital - Care Management ProgramIndependent Health - Care PartnersIntermountain Healthcare and Oregon Health and Science University - Care Management PlusJohns Hopkins University - Hospital at HomeMount Sinai Medical Center -- New York - Mount Sinai Visiting Doctors Program/ Chelsea-Village House Calls ProgramsPartners in Care Foundation - HomeMeds ProgramPrinceton HealthCare System - Partnerships for PIECEQuality Improvement for Complex Chronic Conditions - CarePartner ProgramSenior Services - Project Enhance/EnhanceWellnessSenior Whole Health - Complex Care Management ProgramSumma Health/Ohio Department of Aging - PASSPORT Medicaid Waiver ProgramSutter Health - Sutter Care Coordination ProgramUniversity of Washington School of Medicine - TEAMcar