Marketing: A Nursing Leadership Imperative

The current level of competition in the health care marketplace requires a more sophisticated and strategic marketing plan. More savvy health care consumers, an aging population with greater health care needs, and rapidly developing technology must be considered when constructing marketing messages. Nursing leaders have an opportunity to play a critical role in designing and implementing corporate marketing plans given their deep knowledge of health care services, understanding of patient needs, and access to clinical outcome data. In many organizations, clinical and marketing departments function independently, leading to uncoordinated communication and missed opportunities to combine talents, . develop new messaging tactics, and explore new business opportunities Involving expert nurses in communicating internal and external messages can give meaning and depth to marketing initiatives as well as achieve a level of trust and compassion with the targeted audience

Components Of Developmental Care And The Evidence For Their Use In The Nicu

Developmental cane, a philosophy of cane that requires rethinking the relationships between infants, families, and healthcane providers, is in place in the majority of neonatal intensive care units in the United States. Developmental care includes a variety of activities designed to manage the environment and individualize the care of the premature infant based on behavioral observations. The goal is to promote a stable, well-organized infant who can conserve energy for growth and development. Research about the effects of developmental care has shown a trend toward improved short-term physiologic, development, and resource utilization outcomes for infants up to 24 months of age, but benefits beyond this age are unclear. Most of the research has focused on developmental care as a whole, but there is also strong scientific evidence for specific components of developmental care. The NICU care provider should use developmental care interventions that are clearly supported by evidence, and use others based on judgment and the infant\u27s responses

Cueing Into Infant Pain

Unfortunately the history of pain management in infant care has included decades of inadequate analgesia for a wide range of medical procedures, including major surgery. This was justified in part on fear of drug and analgesic risks to the infant, as well as the commonly held belief that infants do not respond to, or remember, painful experiences. Today we understand that infant pain is encoded into observable manifestations through which an infant communicates behavioral and physiological changes such as altered vital signs, characteristic cries, and facial expressions. The purposes of this article are to (1) describe infants\u27 physiological and behavioral responses to pain and its adverse effects, (2) review pharmacologic and nonpharmacologic infant pain management modalities and reliable pain assessment tools for use in clinical practice, and (3) educate healthcare professionals about the importance of assessment and management of infant pain

Meta-Analysis And Decision Analysis Bridge Research And Practice

Research synthesis methods provide meaningful quantitative data through systematic review of the research literature and translation of these findings into practice implications. Meta-analysis has been the gold standard for translation of research findings into practice. Decision analysis has emerged as an alternative to and extension of meta-analysis. Examples, contrasting the application of meta-analysis and decision analysis, are presented and discussed in relation to its relevance in providing clinical direction. The methods are points along the continuum of translating research findings into practice. Meta-analytic studies provide an essential foundation for estimating and assigning the probabilities used in decision analysis, whereas the outcomes of decision analysis provide data for estimating the cost effectiveness of different interventions or treatment options. Decision analysis can assist in bridging the research-practice gap. Nurse researchers are urged to collaborate with other disciplines that have used these methods to refine translation and use of research findings in practice

A Review Of Organizational Culture Instruments For Nurse Executives

Nurse executives are aware of the complexities of organizational culture. It impacts the nursing work environment and patient care safety and quality. The authors describe several widely available tools that nurse leaders can use to assess organizational culture in the work environment. The psychometric and conceptual strengths and weaknesses of the measures are described and recommendations for use in nursing and patient care administration are provided. © 2007 Lippincott Williams & Wilkins, Inc

Gene Therapy In The Post-Gelsinger Era

As gene therapy research races to a first cure of a genetic-based disease, the research community has struggled with the aftermath of the well-publicized death of Jesse Gelsinger from complications of an experimental treatment. In a wrongful death lawsuit against the University of Pennsylvania and its researchers, Jesse Gelsinger’s family alleged violations of federal regulations and research ethics. This article reviews gene therapy research, examines the role of the key players in this tragedy, and provides suggestions for preventing future misfortunes. © 2002 Lippincott Williams & Wilkins, Inc

Use Of The Internet In Staff Development And Its Application In Helping Critical Care Nurses To Lower Family Stress

A systematic review evaluated use of the Internet in nursing staff development and the feasibility of using the Internet to teach critical care nurses how to help families. Use of the Internet to provide staff development had varying success. The keys to success are careful development of the program according to needs and capabilities of the users, strong education pedagogical principles, and constant evaluation for success in order to make alterations as they are needed. © 2008 Lippincott Williams & Wilkins, Inc

The Relationship Between Continuous Quality Improvement And Research.

The adoption of new care processes can take years despite high-quality research findings that support the change in clinical practice. Healthcare quality professionals, with their leadership and continuous quality improvement (CQI) skills, are critical champions in accelerating and supporting the change toward evidence-based practice. Heightened attention to the relationship between CQI, research, and research utilization is vital. This article addresses CQI strategies and research activities that can help organizations advance quality of care and patient outcomes. By broadening their repertoire of CQI methods, healthcare quality professionals can provide more value to their organizations and expand the complex problems and projects that CQI teams can manage

Analysis Of Factors Related To The Development Of Ventilator-Associated Pneumonia: Use Of Existing Databases

Objective To investigate factors related to ventilator-associated pneumonia to assist in the development and implementation of prevention strategies. Methods A retrospective, descriptive design was used. Power analysis determined sample size. A consecutive sample of 120 patients admitted to the critical care units of a level I trauma center who were receiving mechanical ventilation was used. Data were obtained from clinical and financial databases. Variables included demographic data, causative organism of the pneumonia, medications, comorbid conditions, complications, duration of therapies, length of stay, and cost per case. Results The average patient was a 49-year-old man. The sample was 54.9% trauma patients, and the prevalence of ventilator-associated pneumonia was 16.7%. Significant factors included duration of intubation (r = 0.28, P = .005), mechanical ventilation (r = 0.26, P = .005), and tube feeding (r = 0.30, P = .001); trauma (0 = 0.24, P = .009); and use of histamine2 receptor antagonists (ø = -0.25, P =.006). The only variable that significantly increased the odds ratio for ventilator-associated pneumonia was trauma. The only variable that significantly decreased the odds ratio was use of histamine2 receptor antagonists. Patients in whom ventilator-associated pneumonia developed had a 16-day increase in length of stay (t = -2.68, P = .008), and a $29369 increase in cost per case (t = -3.649, P = .000). Conclusions These findings provide a baseline for discussions about potential changes in practice to help prevent ventilator-associated pneumonia