The Journal of nursing administration
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Multicenter Study
Improving nursing practice and patient care: building capacity with appreciative inquiry.
Appreciative inquiry is a philosophy and methodology for promoting positive organizational change. Nursing leaders at 6 community hospitals are partnering with the authors on a project that uses appreciative inquiry to improve communication and collaboration, to increase nurse involvement in decision making, and to enhance cultural awareness and sensitivity. In this article, the authors describe appreciative inquiry, how hospitals are using it, and the initial lessons learned.
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Multicenter Study
Nurse executive and staff nurse perceptions of the effects of reorganization in Veterans Health Administration hospitals.
To examine nurse executive perceptions of effects of service line reorganization on nurse executive roles, nursing staff and patient care, and compare nurse executive responses to staff nurse reports of job satisfaction and quality of care in the same types of Veterans Health Administration facilities. ⋯ Nurse executives in Veterans Health Administration described significant changes in the nurse executive role, and new challenges for managing nursing practice and achieving consistent quality of nursing care. Although nursing management perceived differences in the overall effects of restructuring on nursing staff depending on the type of reorganization, staff nurses reported significant differences in perceived quality of patient care across organization types.
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Multicenter Study Comparative Study
Nurse staffing, nursing intensity, staff mix, and direct nursing care costs across Massachusetts hospitals.
This study describes the distribution of patient-to-registered nurse (RN) ratios, RN intensity of care, total staff intensity of care, RN to total staff skill mix percent, and RN costs per patient day in 65 acute community hospitals and 9 academic medical centers in Massachusetts. ⋯ The significant differences between community hospitals and medical centers, unit type, as well as the high degree of variability in patient-to-RN ratios, nursing intensity, skill mix, and RN costs per patient day suggest that nursing resource expenditure at Massachusetts hospitals is complex and affected by case mix, unit size, and complexity of care.
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Healthcare organizations continue their struggle to establish a culture of open communication and collaboration. Lessons are learned from the aviation industry, which long ago acknowledged that most errors were the result of poor communication and coordination rather than individual mistakes. The author presents a review of how some healthcare organizations have successfully adopted aviation's curriculum called Crew Resource Management, which promotes and reinforces the conscious, learned team behaviors of cooperation, coordination, and sharing.