social processes in nursing organizational and leadership

BACKGROUND: Despite being simply defined as a process to further one's understanding about future medical care, the process of implementing advance care planning (ACP) within acute hospital settings can be complex. AIM: We describe different ACP service models adopted in Singapore, and the facilitators for, and barriers to, its effective implementation. DESIGN: Qualitative focus group study with thematic analysis. SETTINGS/PARTICIPANTS: We purposefully sampled four stakeholder groups involved in the implementation of ACP...

BACKGROUND: Organizational context is one factor influencing the translation of evidence into practice, but data pertaining to patients with acute stroke are limited. We aimed to determine the associations of organizational context in relation to four important evidence-based stroke care processes. METHODS: This was a mixed methods cross-sectional study. Among 19 hospitals in Queensland, Australia, a survey was conducted of the perceptions of stroke clinicians about their work using the Alberta Context Tool (ACT), a validated measure covering 10 concepts of organizational context, and with additional stroke-specific contextual questions...

AIM: To describe Finnish nurse leaders' perceptions of and experiences with knowledge management. BACKGROUND: Health science research has traditionally focused on knowledge transfer and research evidence instead of knowledge management, culture and organisational learning. Systematic reviews indicate a lack of awareness about nurse leaders' activities in knowledge management. DESIGN: Qualitative interview study according to the consolidated criteria for reporting qualitative research (see Supporting Information Table S1)...

AIMS: Evaluating the impact of the accreditation process on the basis of achievements, benefits and barriers from the viewpoint of leaders of the hospital accreditation in comparison to the hospital staff members. BACKGROUND: The implementation of standards for accreditation aim to improve the safety and quality of treatment. Partaking in this process has raised dilemmas regarding the actual benefits of accreditation in relation to the efforts invested in its achievement...

BACKGROUND: Despite substantial research on pediatric pain assessment and management, health care professionals do not adequately incorporate this knowledge into clinical practice. Organizational context (work environment) is a significant factor in influencing outcomes; however, the nature of the mechanisms are relatively unknown. The objective of this study was to assess how organizational context moderates the effect of research use and pain outcomes in hospitalized children. METHODS: A cross-sectional survey was undertaken with 779 nurses in 32 patient care units in 8 Canadian pediatric hospitals, following implementation of a multifaceted knowledge translation intervention, Evidence-based Practice for Improving Quality (EPIQ)...

BACKGROUND: Implementation of quality improvements in palliative care (PC) is challenging, and detailed knowledge about factors that may facilitate or hinder implementation is essential for success. One part of the EU-funded IMPACT project (IMplementation of quality indicators in PAlliative Care sTudy) aiming to increase the knowledge base, was to conduct national studies in PC services. This study aims to identify factors perceived as barriers or facilitators for improving PC in cancer and dementia settings in Norway...

OBJECTIVES: To describe care worker-reported quality of care and to examine its relationship with staffing variables, work environment, work stressors, and implicit rationing of nursing care. DESIGN: Cross-sectional study. SETTING: National, randomly selected sample of Swiss nursing homes, stratified according to language region and size. PARTICIPANTS: A total of 4311 care workers of all educational backgrounds (registered nurses, licensed practical nurses, nurse aides) from 402 units in 155 nursing homes completed a survey between May 2012 and April 2013...

Effective, patient-centered communication facilitates interception and correction of potentially harmful conditions and errors. All team members, including women, their families, physicians, midwives, nurses, and support staff, have a role in identifying the potential for harm during labor and birth. However, the results of collaborative research studies conducted by organizations that represent professionals who care for women during labor and birth indicate that health care providers may frequently witness, but may not always report, problems with safety or clinical performance...

BACKGROUND: We describe activities undertaken to conduct organizational surveys among faith-based organizations in Massachusetts as part of a larger study designed to promote parish-based cancer control programs for Latinos. METHOD: Catholic parishes located in Massachusetts that provided Spanish-language mass were eligible for study participation. Parishes were identified through diocesan records and online directories. Prior to parish recruitment, we implemented a variety of activities to gain support from Catholic leaders at the diocesan level...

Effective, patient-centered communication facilitates interception and correction of potentially harmful conditions and errors. All team members, including women, their families, physicians, midwives, nurses, and support staff, have a role in identifying the potential for harm during labor and birth. However, the results of collaborative research studies conducted by organizations that represent professionals who care for women during labor and birth indicate that health care providers may frequently witness, but may not always report, problems with safety or clinical performance...

Effective, patient-centered communication facilitates interception and correction of potentially harmful conditions and errors. All team members, including women, their families, physicians, midwives, nurses, and support staff, have roles in identifying the potential for harm during labor and birth. However, the results of collaborative research studies conducted by organizations that represent professionals who care for women during labor and birth indicate that health care providers may frequently witness, but may not always report, problems with safety or clinical performance...

BACKGROUND: Those in nursing have been charged with practicing to the full extent of their education and training by the Institute of Medicine. Therefore, evidence-based practice (EBP) has never been more important to nursing than in the current healthcare environment. Frequently the burden of EBP is the responsibility of the bedside practitioner, but has been found to be a process that requires leadership and organizational support. A key underlying component of a strong EBP environment includes effective communications and collaboration among staff and nursing leadership...

BACKGROUND: Recruitment and retention strategies have emphasized the importance of positive work environments that support professional nursing practice for sustaining the nursing workforce. Unit leadership that creates empowering workplace conditions plays a key role in establishing supportive practice environments that increase work effectiveness, and, ultimately, improves job satisfaction. OBJECTIVES: To test a multi-level model examining the effect of both contextual and individual factors on individual nurse job satisfaction...

BACKGROUND: The importance of a strong safety culture for enhancing patient safety has been stated for over a decade in healthcare. However, this complex construct continues to face definitional and measurement challenges. Continuing improvements in the measurement of this construct are necessary for enhancing the utility of patient safety climate surveys (PSCS) in research and in practice. This study examines the revised Canadian PSCS (Can-PSCS) for use across a range of care settings...

AIM: To discuss the complexities of moving research into practice and through a case example, explore how empirical findings from one specific study could be applied to nursing in other contexts. BACKGROUND: The processes of moving research findings into practice are complex and multidimensional. In this paper, an innovative approach to social support, network-focused nursing (NFN), is used as a case example to illustrate these complexities. Social support is associated with better recovery and survival after illness and based on this, a NFN programme was developed in a Danish oncology youth unit...

This study explored the process of how power is exercised in nurse-manager relationships in the hospital setting, to better understand what fosters and constrains staff nurse empowerment. Semi-structured interviews and participant observations were conducted with 26 participants in a hospital in Western Canada. Seeking connectivity was the basic social process in which nurses strive to connect with their manager to create a workable partnership in the provision of high-quality patient care while responding to the demands of the organizational context...

BACKGROUND: Although collaborative team models (CTM) improve care processes and health outcomes, their diffusion poses challenges related to difficulties in securing their adoption by primary care clinicians (PCPs). The objectives of this study are to understand: (1) how the perceived characteristics of a CTM influenced clinicians' decision to adopt -or not- the model; and (2) the model's diffusion process. METHODS: We conducted a longitudinal case study based on the Diffusion of Innovations Theory...

AIM: To explore nursing discourses of spirituality and leadership. BACKGROUND: Global migration has brought unprecedented plurality to modern societies, and spirituality and religion into the purview of nurse leaders. METHOD: An innovative mixed methods approach, including a literature review, qualitative research and philosophic analysis, was utilized to examine discourses of spirituality in contexts of nursing leadership. After a literature synthesis protocol, 38 nursing literature sources were reviewed...

This article is the first in a series of four examining the components of good corporate governance. Poor governance can result in patients receiving poor quality care; all healthcare professionals, therefore, have a role in ensuring effective governance. This article discusses how an organisation's culture and leadership can contribute to good corporate governance. Nurse leaders can influence the culture of effective governance by building trust and respect and challenging the behaviours that led to poor quality care...

AIM: This article is a report on a case study that described and analysed the collaborative process among nurse practitioners and registered nurses in oncology outpatient settings to understand and improve collaborative practice among nurses. BACKGROUND: Changes in the health system have created new models of care delivery, such as collaborative nursing teams. This has resulted in the increased opportunity for enhanced collaboration among nurse practitioners and registered nurses...