Transfection of human osteoblasts with SV40 DNA: Characterisation of immortalised cell lines

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Construction and Initial Evaluation of a Systems Model of Nursing Best Practice from a Complexity Science Perspective

Despite the acceptance of best practice as a standard for quality health care delivery, the exact nature of what constitutes best practice does not share universal definition or application. The purpose of this dissertation is to propose an integrative conceptual representation of nursing best practice from the philosophical perspective of complexity science.A five-step concept clarification approach was used to identify the concept, systematize observations and descriptions, develop an operational definition, construct a model, and formulate hypotheses. An expert panel explored preliminary validity of the definition and model.Purposive recruitment of clinicians and scholars was conducted for expert panel membership. The expert panel rated the strength of the model dimensions of adequacy, representative-ness, consistency, clarity, simplicity, generalness, accessibility, importance, and relevance, as well as interest in development and application. Narrative data from open-ended questions was incorporated into model refinement.Clinician properties and context properties emerged as two principle domains of interdependent influence. Key dynamic processes included critical thinking by which clinicians operationalize properties into practice choices, and informative reflection by which the organization monitors and improves performance through information flow and learning. All aspects of the conceptual model, with the exception of consistency of relationships, were ultimately rated as strengths by the expert panel. Relationships among constructs were identified as complex, diverse, and difficult to isolate. Expert perception was that clinician and context properties most likely equally influence nursing best practice, but that context properties may have greater influence than clinician properties over time.This model incorporates a full range of interdependence across clinician and context domains of influence. This model requires further operationalization of constructs prior to formal validity testing. The application of complexity science introduces challenges to research and measurement in the study of complex adaptive systems. The model presented in this dissertation provides a perspective from which a better understanding of health care system interdependencies may arise

Growing and Sustaining the Clinical Nurse Leader Initiative: Shifting the Focus From Pioneering Innovation to Evidence-Driven Integration Into Healthcare Delivery.

The Clinical Nurse Leader (CNL) initiative has been characterized by innovation. While an innovation framework for diffusing CNL practice remains relevant, generalizable evidence of effectiveness is necessary to sustain nationwide momentum. A framework is proposed in this department for a national-level CNL research collaborative linking research, policy, education, and practice stakeholders in an ongoing partnership to advance CNL evidence, education, policy, and practice

Illustrated guide to textiles

168 p.; 23 cm

Factors Influencing Implementation Success of the Clinical Nurse Leader Care Delivery Model: Findings From a National-Level Mixed-Methods Study.

BACKGROUND: The clinical nurse leader (CNL) care model has existed since 2007. However, there is limited understanding how the model can best be implemented. PURPOSE: A validated CNL Practice Survey measuring domains theorized to influence CNL implementation was used to examine the link between CNL domains and CNL implementation success. METHODS: Mixed methods were used to analyze data from a nationwide 2015 survey administered to clinicians and administrators involved in CNL initiatives. RESULTS: Of total respondents (n = 920), 543 (59%) provided success scores, with 349 (38%) providing comments. Respondents with negative comments gave significantly lower average CNL success scores. The majority of negative comments mapped onto Readiness and Structuring domains, providing details of barriers to CNL implementation success. CONCLUSIONS: Findings provide information about structural domains that can be strategically targeted to better prepare settings for CNL implementation and success

Diffusion of a Nurse-led Healthcare Innovation: Describing Certified Clinical Nurse Leader Integration Into Care Delivery.

BackgroundThe Clinical Nurse Leader™ (CNL) initiative is in its 2nd decade. Despite a growing theoretical and empirical body of CNL knowledge, little is known about CNLs themselves or where and how their competencies are being integrated into care delivery across the country.ObjectiveThe aim of this study was to describe certified CNL characteristics and roles as part of a larger study validating a model for CNL practice.MethodsThis study used a descriptive analysis of survey data from a national sample of certified CNLs.ResultsSurvey response rate was 19%. Sixty percent have greater than 10 years of RN experience, and 75% have additional specialty certifications. Fifty-eight percent are practicing in a formal CNL role and report a high degree of accountability for all 9 CNL essential competencies.ConclusionsFindings help understand the extent of CNL adoption and spread across the country and the level to which the initial vision of CNL practice is being achieved

Diffusion of a Nurse-led Healthcare Innovation: Describing Certified Clinical Nurse Leader Integration Into Care Delivery.

BackgroundThe Clinical Nurse Leader™ (CNL) initiative is in its 2nd decade. Despite a growing theoretical and empirical body of CNL knowledge, little is known about CNLs themselves or where and how their competencies are being integrated into care delivery across the country.ObjectiveThe aim of this study was to describe certified CNL characteristics and roles as part of a larger study validating a model for CNL practice.MethodsThis study used a descriptive analysis of survey data from a national sample of certified CNLs.ResultsSurvey response rate was 19%. Sixty percent have greater than 10 years of RN experience, and 75% have additional specialty certifications. Fifty-eight percent are practicing in a formal CNL role and report a high degree of accountability for all 9 CNL essential competencies.ConclusionsFindings help understand the extent of CNL adoption and spread across the country and the level to which the initial vision of CNL practice is being achieved