Leadership Development in Nursing: Planning from the Bedside to the Executive Suite

Nurses comprise the largest portion of the healthcare sector workforce over 4 million professional nurses licensed in the United States (National Council of State Boards of Nursing, 2019). Leading within a vast workforce such as nursing requires the nurse leader to have the expertise of the nursing profession along with leadership and business skills to maintain competitiveness in the complex healthcare industry. Consequences of effective leadership include improved patient outcomes, decreased staff turnover, and decreased costs to the organization related to patient outcomes and turnover costs. These results suggest the importance for organizations to ensure their leaders are properly trained and can improve their skills across the continuum of their leadership careers. The purpose of this project was to develop a comprehensive leadership development program for a six-hospital health system in the Las Vegas Valley, which was built upon the premise that leadership skills must be developed for the informal leaders at the bedside up through formal leadership positions in senior management. The scope of this project was only for the creation of the leadership development program. The activities that occurred during the program development included identifying core competencies of nursing leaders and aligning those competencies within Kouzes and Posner’s framework. The identified core leadership competencies were categorized into the appropriate role including bedside nurse, charge nurse/clinical supervisor, manager, director, and nurse executive. The objectives, curriculum, and learning strategies were developed for each stage of the development plan, culminating into one comprehensive leadership development program. The program will be evaluated using the Leadership Practices Inventory (LPI) of Kouzes and Posner. The self-form of the LPI will be completed by each participant in the leadership development program as a pre-post-post test assessment. The observer-form of the LPI will be completed also as a pre-post-post assessment by a minimum of five people who are familiar with the participant’s behavior, which may include managers, co-workers, peers, and others. Other outcome measures that will be evaluated by facilities who implement the program may include a decrease in RN turnover, decrease in nurse leadership turnover, a qualified pipeline of leadership candidates for the various leadership positions, and improvements in the employee engagement bi-annual survey in the questions specific to their manager and direct supervisor. Patient outcome measurement includes reductions in mortality and morbidity rates, hospital acquired conditions (HAC) such as infections and falls, improved patient satisfaction, and reductions in length of stay

The utilization of an infrared imaging system as a cooling slot blockage detector in the inspection of a transpiration cooled nozzle

A comprehensive examination of the 8 foot temperature tunnel's transpiration cooled nozzle was completed using an infrared imaging radiometer to locate regions of cooling flow irregularities caused by obstruction of three or more adjacent cooling slots. Restrictions in the cooling flow were found and cataloged. Blockages found were due primarily to the presence of residual phosphoric acid being discharged from some of the cooling slots. This acid was used during construction of the nozzle components and was to have been purged prior to its delivery to the NASA Langley Research Center (LaRC). In addition, a radial displacement of one selection of discs located in the spool piece was inspected and cataloged for future reference. There did not seem to be a serious restriction of flow in this defect, but evidence from the infrared images indicated reduced slot activity within the gouge. The radiometer survey uncovered regions where closer inspection is recommended but did not cover the entire surface area of the three nozzle subsections due to equipment limitations. A list of areas with suspected problems is included in Appendix A

Differential expression of cyclin-dependent kinases in the adult human retina in relation to CDK inhibitor retinotoxicity

Cyclin-dependent kinases (CDKs) are a family of kinases associated predominantly with cell cycle control, making CDK inhibitors interesting candidates for anti-cancer therapeutics. However, retinal toxicity (loss of photoreceptors) has been associated with CDK inhibitors, including the pan-CDK inhibitor AG-012896. The purpose of this research was to use a novel planar sectioning technique to determine CDK expression profiles in the ex vivo human retina with the aim of identifying isoforms responsible for CDK retinotoxicity. Four CDK isoforms (CDK11, 16, 17 and 18) were selected as a result of IC50 data comparing neurotoxic (AG-012986 and NVP-1) and non-neurotoxic (dinaciclib and NVP-2) CDK inhibitors, with IC50s at CDK11 showing a clear difference between the neurotoxic and non-neurotoxic drugs. CDK11 was maximally expressed in the photoreceptor layer, whereas CDK16, 17 and 18 showed maximal expression in the inner nuclear layer. CDK5 (an isoform associated with retinal homeostasis) was maximally expressed in the retinal ganglion cell layer. Apart from CDK18, each isoform showed expression in the photoreceptor layer. The human Müller cell line MIO-M1 expressed CDK5, 11, 16 and 17 and AG-01298 (0.02–60 µM) caused a dose-dependent increase in MIO-M1 cell death. In conclusion, CDK11 appears the most likely candidate for mediation of photoreceptor toxicity. RNA profiling can be used to determine the distribution of genes of interest in relation to retinal toxicity in the human retina

OncoLog Volume 46, Number 02, February 2001

Specialized Training and Techniques of Pathologists Lead to Targeted Therapies Protocols: Studies Examine High-Dose Chemotherapy for Breast Cancer High-Dose Chemotherapy for Breast Cancer: Completion of Clinical Trials Necessary DiaLog: Many Specialties, One Goal, by Janet M. Bruner, MD, Chairman, Department of Pathology House Call: Support Groups Offer Patients a Helping Hand Study Reveals Types of Diagnostic Errors and Their Costshttps://openworks.mdanderson.org/oncolog/1093/thumbnail.jp

Productivity improvement in the water and sewerage industry in England since privatisation: Final report for Water UK.

Water UK has commissioned Frontier Economics to quantify the productivity gains achieved by the water and sewerage companies in England since privatisation in 1989. To undertake this work, Frontier Economics has estimated the Total Factor Productivity (TFP) growth achieved by the industry between 1992/93 and 2016/17. Our work is based on an update of previous work published by Saal & Parker (2001)1 . Notwithstanding the limited timescale of the project, the study has also sought to explore the potential for extending the analysis through further sensitivity of the model to different assumptions, and through the development of new techniques. Frontier Economics has completed this work in collaboration with Professor David Saal of the Centre for Productivity and Performance at Loughborough University, who is a leading expert in productivity analyses in the UK. The work has been independently reviewed by Professor Tom Weyman-Jones

Parents in transition: Experiences of parents of young people with a liver transplant transferring to adult services

Predictors of successful transition from pediatric to adult services include ability to self-manage and engage with healthcare services. Parents have a key role in healthcare management throughout childhood and adolescence including encouraging development of self-management skills in their children. Transition to adult services can be challenging for parents and young people, yet parents' views regarding transition remain largely unexplored. Nine parents of pediatric liver transplant recipients (15.2-25.1 yr) participated in semistructured interviews. Interviews were analyzed using IPA. Analysis revealed three key themes: "emotional impact of transplantation," "protection vs. independence," and "ending relationships and changing roles." Parents expressed the dichotomous nature of the desire to promote independence in their child while still maintaining control and protection, and discussed how changing roles and relationships were difficult to navigate. Parents are important facilitators of young people's development of self-management skills for successful transfer to adult services. Parents should be supported to move from a "managerial" to a "supervisory" role during transition to help young people engage independently with the healthcare team. Findings support the development of interventions for parents to emphasize their role in transition and guide the transfer of self-management skills from parent to young person

Protection of Trabecular Bone in Ovariectomized Rats by Turmeric (Curcuma longa L.) is Dependent on Extract Composition

This document is the Accepted Manuscript version of a Published Work that appeared in final form in the Journal of Agricultural and Food Chemistry, copyright © American Chemical Society after peer review and technical editing by the publisher. To access the final edited and published work see http://doi.org/10.1021/jf101873fExtracts prepared from turmeric (Curcuma longa L., [Zingiberaceae]) containing bioactive phenolic curcuminoids were evaluated for bone-protective effects in a hypogonadal rat model of postmenopausal osteoporosis. Three-month female Sprague Dawley rats were ovariectomized (OVX) and treated with a chemically complex turmeric fraction (41% curcuminoids by weight) or a curcuminoid-enriched turmeric fraction (94% curcuminoids by weight), both dosed at 60mg/kg 3x per week, or vehicle alone. Effects of two months of treatment on OVX-induced bone loss were followed prospectively by serial assessment of bone mineral density (BMD) of the distal femur using dual-energy x-ray absorptiometry (DXA), while treatment effects on trabecular bone microarchitecture were assessed at two months by micro-computerized tomography (μCT). Chemically complex turmeric did not prevent bone loss, however, the curcuminoid-enriched turmeric prevented up to 50% of OVX-induced loss of trabecular bone and also preserved the number and connectedness of the strut-like trabeculae. These results suggest that turmeric may have bone-protective effects but that extract composition is a critical factor