Chief Nursing Research Articles

Unpicking the reasons for missed care.

Sam Foster, Chief Nurse, Oxford University Hospitals, reflects on the need to understand reasons for 'errrors of omission' and how they relate to the environment in which nurses provide care.

Erik Martin, DNP, RN, CENP

Erik Martin, DNP, RN, CENP

Understanding those 'future nurses'.

Sam Foster, Chief Nurse, Oxford University Hospitals, looks at the findings of a new report from UCAS and Health Education England into the mindset of the 2021 applicants to study nursing.

Does quality matter to you? Ward accreditation and improving patient care.

British Journal of NursingVol. 31, No. 3 CommentDoes quality matter to you? Ward accreditation and improving patient careMichelle HopeMichelle Hope(E-mail Address: [email protected])Associate Chief Nurse, West Hertfordshire Hospitals NHS TrustSearch for more papers by this authorMichelle HopePublished Online:12 Feb 2022https://doi.org/10.12968/bjon.2022.31.3.176AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Allen T, Walshe K, Proudlove N, Sutton M. Using quality indicators to predict inspection ratings: cross-sectional study of general practices in England. Br J Gen Pract. 2019;70(690):e55-e63. https://doi.org/10.3399/bjgp19X707141 Crossref, Medline, Google ScholarCare Quality Commission. A new strategy for the changing world of health and social care—CQC's new strategy, 2021. 2021. https://tinyurl.com/4masr2us (accessed 1 February 2022) Google ScholarDarzi AW, Department of Health. Quality at the heart of everything we do. In: High quality care for all. NHS next stage review final report. 2008: 47. https://tinyurl.com/2p82ah3t (accessed 1 February 2022) Google ScholarGottwald M, Lansdown G. Clinical governance: improving the quality of healthcare for patients and service users. Maidenhead: Open University Press/McGraw Hill; 2014. Google ScholarHanefeld J, Powell-Jackson T, Balabanova D. Understanding and measuring quality of care: dealing with complexity. Bull World Health Organ. 2017;95(5):368-374. https://doi.org/10.2471/BLT.16.179309 Crossref, Medline, Google ScholarIngelsby-Burke E. Example 2: Salford Royal NHS Foundation Trust. In: May RNHS Improvement. Guide to developing and implementing ward and unit accreditation programmes. March 2019: 20-22. https://tinyurl.com/mrymj79r (accessed 1 February 2022) Google ScholarLee, F. If Disney ran your hospital. Boseman (MT): Second River Healthcare Press; 2004. Google ScholarMay R; NHS Improvement. Guide to developing and implementing ward and unit accreditation programmes. March 2019. https://tinyurl.com/mrymj79r (accessed 1 February 2022) Google ScholarPeters, T. The problem is never the problem. The response to the problem is almost always the real problem. 7 April 2012. YouTube video. https://tinyurl.com/3j7a5yx3 (accessed 1 February 2022) Google ScholarUnited Kingdom Accreditation Service, British Standards Institution Health Quality Improvement Partnership. UKAS, BSI and HQIP: joint statement of intent regarding clinical service accreditation and health Executive summary Executive summary. 2019. https://tinyurl.com/4ezdh7ze (accessed 1 February 2022) Google ScholarWhat matters to you? A global movement to improve outcomes. 2020. https://wmty.world/ (accessed 1 February 2022) Google Scholar FiguresReferencesRelatedDetails 10 February 2022Volume 31Issue 3ISSN (print): 0966-0461ISSN (online): 2052-2819 Metrics History Published online 12 February 2022 Published in print 10 February 2022 Information© MA Healthcare LimitedAcknowledgement:I would like to thank Polly Pascoe, my supervisor during my recent MBA dissertation ‘The impact of ward accreditation on the quality of patient care. A realist literature review.’, on which this article is basedPDF download

COVID vaccines: then and now.

Sam Foster, Chief Nurse, Oxford University Hospitals, reflects on the contrast between the crowds attending for the first vaccinations in early 2021 and the reluctant latecomers emerging a year later.

Reflecting on the trainee nurse associate role uptake and impact.

Sam Foster, Chief Nurse, Oxford University Hospitals, considers the lessons from research into the trainee nurse associate role and the implications for workforce planning.

Designing the content aspects of lifelong medical education aimed at the development of professional opportunities of specialists with a secondary medical education

Improving the system of medical education and staffing is one of the priority areas for the development of healthcare, which provides for the constant improvement of the professional level and expansion of the qualifications of medical workers. Building an individual learning path implies the formation of an educational path when mastering new knowledge, improving general and professional competencies, taking into account national, federal and regional projects in the field of healthcare, as well as professional standards and educational needs of specialists and their employers. The material presents the results of a survey of chief and senior nurses in order to effectively design individual educational trajectories for specialists with secondary medical education.

Cross-level effects of health-promoting leadership on nurse presenteeism: The mediation and moderation effect of workload and performance pressure

This study examines the cross-level influence mechanism of leaders’ health-promoting leadership on subordinates’ presenteeism among nursing industry. A multilevel mediated moderation model was hypothesized to explore whether health-promoting leadership is associated with subordinates’ presenteeism via the workload of subordinates, and how leader’s performance pressure plays the role in the model. Questionnaires were distributed to 110 nursing teams, which including 110 chief nurses and 660 subordinate nurses. Our findings showed that although health-promoting leadership has no direct impact on presenteeism, health-promoting leadership has an indirect impact on presenteeism via workload, and workload acts as a complete mediator. Meanwhile, performance pressure moderated the relationship between health-promoting leadership and workload. With an increase in performance pressure of leaders, the negative impact of health-promoting leadership on nurse workload gradually weakened. In this multilevel mediated moderation model, the mediated moderating effect of performance pressure was significant and the moderating effect was completely mediated, which means that the interaction between health-promoting leadership and performance pressure can affect presenteeism through workload. When leaders were under high performance pressure, the protective effect of health-promoting leadership on workload would be inhibited. These findings contribute to enriching the research on presenteeism, providing insight into how the health development of employees and performance demands of leaders may be balanced, and affording fresh thoughts for effective prevention and treatment of nurse presenteeism.

Development of a Scale for the Role of the Chief Nurse who Supports Families of Patients with Life-Threatening Conditions and Nurses

Development of a Scale for the Role of the Chief Nurse who Supports Families of Patients with Life-Threatening Conditions and Nurses

The Roles Chief Nursing Officers Play in the Provision of In-Service Education in Hospitals with Fewer Than 300 Beds

The Roles Chief Nursing Officers Play in the Provision of In-Service Education in Hospitals with Fewer Than 300 Beds

Commentary: Dear Federal Chief Nursing Officer: Why Canada Needs You.

Calls for national-level chief nursing officers are over a century old. However, global uptake of these roles and Canadian opportunities for nurses to lead in federal health policy environments have been limited. The absence of such a role in Canada limits connection to global activities, reduces Canadian capacity to participate as a member state in World Health Organization-led nursing activities and, within our borders, leaves the healthcare system without national leadership to coordinate and liaise with senior nurses across our provinces and territories for the benefit of our citizens and systems. In this article, a brief history of global advocacy for state or national level chief nursing officer roles and examples of federal chief nursing officers, in the Canadian context, offers a consideration of the unique contribution of nursing knowledge and leadership to health policy - extending arguments for nursing leadership in the policy arena beyond traditional arguments of strength in numbers or unique claims to caring. Findings from a Canadian national project by the Global Nursing Leadership Institute further illuminate the concrete steps we need to take toward enabling full-spectrum nursing leadership in policy, where policy science, political competency, identification of policy nurses and a revitalization of organizational structures across the country can extend the vision for nursing leadership in policy beyond a single seat at a single table.

Tackling workplace violence.

Sam Foster, Chief Nurse, Oxford University Hospitals, considers the problem of the harassment, abuse and violence towards NHS staff from patients and members of the public.

Patient safety incident framework will ensure affected staff are not overlooked.

Sam Foster, Chief Nurse, Oxford University Hospitals, considers the term 'second victim', which is used to describe staff who are affected psychologically and emotionally in the aftermath of an incident.

Overseas recruitment.

Sam Foster, Chief Nurse, Oxford University Hospitals, reflects on the continued role for overseas recruitment of nurses in NHS staffing.

ENHANCING HEALTHCARE THROUGH THE DEVELOPMENT OF MANAGERIAL COMPETENCIES OF THE HEALTHCARE LEADERS

Abstract. The study aims at diagnosing the managerial competencies of the medical managers as well as practical tools for their development in order to enhance healthcare in crisis and under unstable conditions. The authors suggest a methodical approach to form a profile of the managerial competencies of the heads of medical facilities, which is based on the use of the method of expert evaluations and provides for the three stages: preparatory (within which the scientific and methodological basis for analysis is formed), evaluatory (which involves diagnosis of the managerial competencies of the medical managers in the context of three groups: instrumental, interpersonal and systemic), and recommendatory (which provides practical tools for the development of the medical institution head’s competencies in order to enhance healthcare in crisis and under unstable conditions). To form the basis of the study a questionnaire was created, which lists managerial competencies in terms of three groups: instrumental, interpersonal and systemic. The survey was conducted among the heads of medical institutions, their departments and the chief nurses of the healthcare institutions in Precarpathia. The article substantiates that nowadays it is not enough for a medical institution manager to have only a high level of knowledge on medicines, but also be aware of the elements of financial management, strategic planning and marketing, risk and conflict management, high-rate readiness for change and teamwork. The study of managerial competencies of the supervising physicians allowed to create profiles of the managerial competencies of the actual and future medical managers, to offer practical tools for their managerial competencies development, taking account of the need to work in crisis and under unpredictable conditions.
 Keywords: medical care, heads of medical institutions, managerial competencies, instability.
 JEL Classification M12, M14, I10
 Formulas: 0; fig.: 1; tabl.: 5; bibl.: 15.

Reflections from a System Chief Nursing Executive: Intention to lead.

The integration and utilization of Chief Nurses (CNs) to lead and support complex health systems and health workforce optimization in governments, nongovernmental organizations, and across all health and social sectors is of paramount importance. At a time when the global nursing profession is challenged with a strained workforce and a growing leadership gap, it is essential that we examine and pay attention to the importance of the CN role. To attain universal health coverage, sustainable development goals, and global health, the need for the right number and a well-prepared nursing workforce is evident. While nursing recruitment and retention are key for system sustainability, it requires the right governance, leadership, infrastructure, and resources. A System CN can lead, advise, and impact the success of the nursing workforce in collaboration with senior leadership teams. At this time of major health challenges, too many health and social systems, both at government and nongovernmental levels, do not have a CN at all, or the role is delegated to a staff position with limited ability to impact the system on the local, regional, national, and global scale. Recruitment and investments targeting CNs are required to resuscitate, stabilize, and invigorate knowledgeable leaders who can transform, inspire, and maximize nursing contributions to assure access and quality healthcare. My personal and professional CN journey is highlighted here as an illustration for nurses who lead formally and informally, as they contemplate their own current and future ambitions and contributions.

Rebuilding a foundation of trust: A call to action in creating a safe environment for everyone

Well before the COVID-19 pandemic, incivility and physical threats directed toward healthcare employees and often registered nurses was a growing concern by Chief Nurse Executive (CNE) leaders. In 2019, conversations initiated by The Beryl Institute’s Nurse Executive Council (NEC) to consider how best to achieve a much-needed balance between patient/family and staff safety have now become a critical priority to ensure the safety of everyone receiving and providing health care services. The heart of this work was organized around a set of newly developed ethical precepts designed to guide the exploration of key concepts. A call to action grounded in rebuilding a foundation of trust is proposed. In pursuing future steps to deepen this foundation, and to reaffirm the vital role for nurse leaders and of all in healthcare, we must be willing to engage in dialogue, to ask openly, and question respectfully. We believe healthcare systems and nurse leaders both play a vital role in elevating the humanity on which we will find brighter days ahead. Through a sustained commitment to this aim, we seek to strengthen health care delivery environments that shape physically and psychologically safe environments for everyone.

Chief Nursing Officer Perspectives on Nursing Theory-Guided Practice.

The purpose of this study was to identify what guides nursing practice. Change occurred when the Magnet Recognition Program® no longer required a nursing theory. This was a mixed-methods study to identify the process used to implement nursing theory-guided practice and the relationship to professional practice recognition. Deidentified quantitative data were collected from 36 chief nursing officers (CNOs). Seventeen CNOs participated in the qualitative interview. Thirteen CNOs were from a Magnet®-designated facility. Ten CNOs were on the Magnet journey, and 2 had no intent to seek Magnet recognition. Two CNOs were from a Pathway to Excellence®-designated facility. One CNO was on the Pathway to Excellence journey. The majority of respondents who were Magnet® recognized who participated in the survey used Watson's Theory of Human Caring. Themes were identified that share the benefits and strategies to integrate nursing-guided theory into nursing processes, structures, and outcomes. Findings will benefit CNOs as they make decisions related to pursuing Magnet status recognition.

Creating a safe space to speak up.

Sam Foster, Chief Nurse, Oxford University Hospitals, considers why it is so important to create environments where staff can raise concerns, and steps leaders can take to build these.

An intervention for nurse wellbeing.

Sam Foster, Chief Nurse, Oxford University Hospitals, considers the potential benefits of the professional nurse advocate programme and this new approach for clinical supervision and employee support.