Nurse Executives Research Articles

Moving From Patient Care to Population Health: A New Competency for the Executive Nurse Leader

There are many social, political, and economic influences shaping healthcare delivery today that are expanding the scope of responsibility for the executive nurse leader. The focal point of change is the passing of the Patient Protection and Affordability Care Act (ACA), where there is a clear strategic shift to provide patient care in the right setting with the formation of Accountable Care Organizations (ACOs). Financial reimbursement strategies are being aligned to facilitate these changes. Executive nurse leaders are trying to navigate through these healthcare changes by developing cost-effective care delivery models, supporting the role of the professional and advanced practice nurse, and advocating for the patient. In healthcare reform, this translates to healthcare being delivered in community venues and the executive nurse leader being the advocate for the healthcare needs of the population in the community. There are many social, political, and economic influences shaping healthcare delivery today that are expanding the scope of responsibility for the executive nurse leader. The focal point of change is the passing of the Patient Protection and Affordability Care Act (ACA), where there is a clear strategic shift to provide patient care in the right setting with the formation of Accountable Care Organizations (ACOs). Financial reimbursement strategies are being aligned to facilitate these changes. Executive nurse leaders are trying to navigate through these healthcare changes by developing cost-effective care delivery models, supporting the role of the professional and advanced practice nurse, and advocating for the patient. In healthcare reform, this translates to healthcare being delivered in community venues and the executive nurse leader being the advocate for the healthcare needs of the population in the community.

Educating nurse leaders for board service: the northwest organization of nurse executives' story.

As more nurses consider serving on boards, it is important that they have resources to help them prepare for trustee positions. The Northwest Organization of Nurse Executives (NWONE) has recently put together a program to introduce nurse leaders to these roles. A variety of experts and experienced nurse board members shared their experiences and advice to the organization's members. NWONE encourages other organizations to support individuals who can add value to governance as we move into the next era.

Aging in rural America.

For older Americans, accessing high-quality care can be a challenge. For those in rural communities, it's even harder.

Postgraduate nurse practitioner training: what nurse executives need to know.

Nurse executives should be familiar with postgraduate nurse practitioner training programs. Supplemental training opportunities are gaining popularity across the country and are primarily funded by employers interested in recruiting and retaining qualified healthcare professionals. There is considerable variability in program learning objectives, clinical content, and titles used to describe participants' roles. This article offers program descriptions, associated costs, and a call for evidence of their impact on a growing constituent of the healthcare workforce.

Leading nursing through influence and structure: the system nurse executive role.

As health systems consolidate, the system chief nurse executive (SCNE) role is emerging as an important and strategic member of the health system leadership team. Based on a survey of incumbent SCNEs conducted by the American Organization of Nurse Executives (AONE), this article discusses the trends in this role including the structure and function in today's health systems. With the assistance of AONE, this group of leaders is creating a community of support and networking. Because of the broad influence of these roles, the SCNEs who serve in these roles are having a major influence on the practice of nursing in our nation's healthcare delivery system and clinical outcomes.

Influence of RN BS Education on Nursing Practice: Outcomes Create a Moral Imperative for Nurse Leaders

In 2013, the New York Organization of Nurse Executives and Leaders (NYONEL) sponsored a contest to systematically gather testimonials from direct care providers that would further support the concept that education to the bachelor of science (BS) degree makes a difference in the clinical practice of individuals already licensed as registered nurses (RNs). This initiative was catalyzed by nursing leaders in New York State (NYS) who were members of the Coalition for the Advancement of Nursing Education, leading the efforts that support legislation that would require a new registered nurse to obtain a bachelor's degree in nursing within 10 years of licensure. In 2013, the New York Organization of Nurse Executives and Leaders (NYONEL) sponsored a contest to systematically gather testimonials from direct care providers that would further support the concept that education to the bachelor of science (BS) degree makes a difference in the clinical practice of individuals already licensed as registered nurses (RNs). This initiative was catalyzed by nursing leaders in New York State (NYS) who were members of the Coalition for the Advancement of Nursing Education, leading the efforts that support legislation that would require a new registered nurse to obtain a bachelor's degree in nursing within 10 years of licensure.

World Café for Leadership Development

Partnerships between academic and clinical entities are essential for change in nursing education and the healthcare arena to maximize improvements in quality, clinical, cost, and safety outcomes. The nursing profession has a strong legacy of partnerships in which respect and trust are essential to develop mutual goals and a common vision. In addition, the American Association of Colleges of Nursing and American Organization for Nurse Executives advocate and support these partnerships. These organizations have embraced key principles important to any partnership for strong outcomes and sustainability. These principles include collaborative relationships, mutual respect and trust, shared knowledge, commitment, and shared responsibility, sustainable transition initiatives, and shared infrastructure for data collection. 1 These principles align with the 2010 Institute of Medicine Future of Nursing report. 2

Innovation Through Partnership: Building Leadership Capacity in Academe and Practice

VISION AND MISSION The Indiana University Nurse Learning Partnership (IUNLP) was initially conceived 5 years ago and consists of leaders from the Indiana University School of Nursing, a National League for Nursing Center for Excellence in Nursing Education, and the Department of Nursing at the Indiana University Health (IUH) Academic Health Center (AHC), made up of 3 Magnet-designated hospitals. The formal partnership, led by Dean Marion E. Broome and Executive Vice President and Chief Nurse Executive Linda Q. Everett, began in 2009 when leaders in both settings recognized that although individual collaborations were occurring in both arenas, there was no formalized, intentional structure at the leadership level to bring resources to bear and create a synergistic environment for students, nurses, and nurse leaders at the school and hospital system. Inspired by the Carnegie Report1 on transforming nursing education, leaders from both settings met for a retreat in summer 2010, where the IUNLP model was formalized to better communicate intentions to all constituencies (Figure 1). The mission of this intentional academic–practice partnership is to demonstrate the value nursing brings to improving the health of the community. At the heart of this initiative lies a shared culture where practice and academic partners share a

Why do older RNs keep working?

To identify the reasons older RNs (≥45 years) remain in the healthcare workforce. Despite predictions of early retirements of older nurses, many continue to work past the age when they can gain access to their retirement funds. The authors surveyed nurses older than 45 years in New South Wales, Australia. The need for income was the most common reason for staying in nursing (61.9%; n = 210), with nearly 43% (n = 130) identifying this as the main reason for staying. Retaining older nurses in the workforce is an important strategy for managing workforce shortages. Nurse executives will need to consider strategies that will enhance retention of older nurses and focus on the reasons older nurses want to keep working.

Reducing patient suffering through compassionate connected care.

Patient experience continues to play an increasingly critical role in quality outcomes and reimbursement. Nurse executives are tasked with helping direct-care nurses connect with patients to improve care experiences. Connecting with patients in compassionate ways to alleviate inherent patient suffering and prevent avoidable suffering is key to improving the patient experience. The Compassionate Connected Care framework identifies strategies for meeting the challenges of connecting with patients and reducing suffering. Methods integrate clinical, operational, cultural, and behavioral aspects of care to target patient needs based on condition. Caregivers learn to better express empathy and compassion to patients, and nurse leaders are better equipped to engage nurses at the bedside.

The role of the nurse executive in health care philanthropy.

As the health care landscape continues to change with reform, obtaining funding for clinical initiatives is becoming increasingly difficult. At Catholic Health Initiatives, a number of nurse executives have recognized the need for creative philanthropy to advance specific projects. They have embraced opportunities for partnerships with their hospital foundation chief development officers to leverage philanthropy toward clinical innovations and to improve quality of care. Following are their discussions which reveal just how important nurse and employee involvement is to attracting and using philanthropy dollars in the next era of health care.

An assessment of the alignment between graduate nursing leadership education and established standards.

The increasing complexity of healthcare systems is driving changes in the academic preparation of nurse leaders. The number of doctorate of nursing practice programs has increased. Leaders in the Council on Graduate Education for Administration in Nursing (CGEAN) were interested in learning how graduate nursing leadership programs have responded. An electronic survey was administered to CGEAN members to understand the emphasis of their graduate curricula. Results demonstrate good alignment between academic programs, American Association of College of Nursing essentials, and American Organization of Nurse Executives competencies.

Nursing and philanthropy: a partnership to advance professional excellence and exceptional care.

Michelle A. Janney, PhD, RN, NEA-BC, 2013 AONE President, Senior Vice President, and Wood-Prince Family Chief Nurse Executive at Northwestern Memorial Hospital, discusses the impact of engaging institutional leadership in nursing philanthropic and strategic priorities and the importance of developing a culture of philanthropy that permeates the organization and encourages participation from all levels. The article highlights key outcomes of Northwestern Memorial Hospital's collective efforts to build a culture of philanthropy that prioritizes nursing as consequential to the mission of the organization. The outcomes demonstrate how such a culture provides a critical platform for creating opportunities that enable nurses to be indispensable partners in a shared commitment to the highest-quality, scientifically driven, personalized care.

Medical Tourism: A Nurse Executive’s Need to Know

edical tourism is evolving as a rapidly growing market that spans the globe. As insurance premiums rise and co-payments for surgical procedures increase, US citizens are seeking affordable medical care that is not available in the United States. For people in countries outside the United States, wait lists limit and prohibit access to surgical procedures, so these prospective patients search for opportunities that provide additional options for surgical care outside their home countries. Nurse executives in perioperative settings might ask, “Why do I need to know about medical tourism?” The answer lies in their desire to be effective leaders and the accountability inherent in being competent at their leadership role. Competencies are considered the single biggest contributor to the difference between effective and ineffective managers. A number of major health care organizations have identified key competencies for clinical and organizational leadership roles. In particular, the American Organization of Nurse Executives (AONE) has outlined competencies expected of managers at all levels and in all settings. The AONE listing has become the standard in expectations of nurse leaders and managers. The AONE competencies include communication, knowledge of the health care environment, leadership, professionalism, and business skills. To be knowledgeable about the health care environment,

Who's Next? Developing High Potential Nurse Leaders for Nurse Executive Roles

Transformational leadership is an essential element of a high-performing organization in this era of rapid healthcare delivery system evolution. Specifically, recruiting and retaining top nurse executive talent is critical, as is development of senior nursing leadership talent, to ensure that a pipeline of prepared nurse executives exists for key leadership roles. A nurse executive residency program was developed to address the impending need for prepared, transformational nursing leaders. In this article, the terms chief nursing officer (CNO) and nurse executive are used interchangeably to describe this senior leadership role.

Instituting best practice for monitoring for opioid-induced advancing sedation in hospitalized patients.

Adverse events related to opioid-induced unintended advancing sedation and respiratory depression in hospitalized patients are occurring with increased frequency, and these adverse events can have a negative impact on quality and cost outcomes. The goal of this paper is to inform nurses on best practices for preventing opioid-induced advancing sedation and respiratory depression, and to inform nurse leaders on implementation strategies to guide change in policies and practice. This paper presents an evidenced-based systematic approach for organizations to use in implementing strategies to reduce adverse events secondary to opioid-induced advancing sedation and respiratory depression in the hospitalized adult patient. An action-oriented framework was developed based on the authors' experiences, strategies recommended by the Institute for Healthcare Improvement (IHI), the National Association of Healthcare Quality (NAHQ), and expert consensus-based best monitoring practices. Nurse executives and nurse managers assume accountability for ensuring that patient care is aligned with the best evidence, practices, and regulatory mandates. The framework presented in this paper can help prevent opioid-induced advancing sedation and respiratory depression, and assist nurse leaders in implementation strategies to guide policies and practice.

Effect of the full-time rehabilitation nursing on the functional recovery after the noncemented total hip replacement

Objective To explore the effect of the full-time rehabilitation nursing on the functional recovery after the noncemented total hip replacement .Methods One hundred and fourteen patients with noncemented total hip replacement were chosen and randomly divided into the control group （ n=51 ） and the observation group （n=63）.The control group received the random rehabilitation nursing through the executive nurses, and the observation group received the full-time rehabilitation nursing through the full-time rehabilitation nurses.Results The scores of Harris at 1 d before discharge , 6 weeks after the operation and 3 months after the surgery were respectively （64.9 ±6.4）, （78.5 ±5.1）, （90.0 ±4.2） in the observation group, and were higher than those in the control group , and the differences were statistically significant （ t =5.377,3.059, 4.288, respectively;P〈0.01）.The scores of pain degree , living ability, walk ability at 1 d before discharge, 6 weeks after the operation and 3 moths after the operation between two groups had statistical significances （ P〈0.01）;when two groups of patients discharged hip X-ray showed good prosthesis , no exception.Experimental group patients with complications of 0.0%, the control group in the incidence of complications was 11.8%, the difference was statistically significant （χ2 =6.981,P 〈0.01）.Conclusions The full-time rehabilitation nursing promotes the functional recovery after the noncemented total hip replacement . Key words: Total hip replacement; Full-time rehabilitation nursing; Functional recovery

Why Nurses Need to Understand Nursing Informatics

N ursing informatics is an exciting nursing specialtydit affects learning environments, meaningful use, interprofessional collaboration, patient care settings, strategic planning, patient satisfaction, and, ultimately, patient outcomes. Simply put, nursing informatics is the practice of using nursing science and technology to enhance the pathway that data take to become knowledge to improve patient care. Furthermore, nursing informatics “is the synthesis of nursing science, information science, computer science, and cognitive science for the purpose of managing and enhancing health care data, information, knowledge, and wisdom to improve patient care and the nursing profession.” According to Hebda and Czar, it is “broadly defined as the use of information and computer technology to support all aspects of nursing practice, including direct delivery of care, administration, education, and research. The definition of nursing informatics is evolving as advances occur in nursing practice and technology.” Nursing informatics is important to all nursing specialty areas. It is important for nurses to understand the relevance of nursing informatics to their practice. In clinical practice, for example, nursing informatics can be used to track patient outcomes, find data trends, and assess workload and interventions. It also can help develop technologies, such as apps, to help health care workers virtually monitor and stay in touch with patients, improve workflows, and help patients deal with their diseases. The use of nursing informatics in nursing education supports virtual teaching and learning, assessment, analytics associated with educational outcomes, and the paradigm shift of bringing the library to the student virtually. Nurse executives use nursing informatics to help them with cost containment, improved workflows, decision support, budgeting tools, and trending costs and savings. Nursing informatics also can facilitate and support nursing research by evaluating patient outcomes, evidence-based practice, standardized terminologies, and virtual knowledge bases. As nurses learn nursing informatics, they must learn to use all information technologies effectively, recognize the benefits and limitations of this technology, and integrate them into how they implement these technologies. In this era of large amounts of data, nursing informatics competencies are key to safe, efficient, and quality practice, and good use of nursing informatics can result in enhanced patient care outcomes.

Establishing a culture of camaraderie, congeniality, and cohesiveness among nursing educators and Chief Nurse Executives (CNEs)

This article utilizes reflective thinking combined with many varied opportunities in nursing education and clinical management for Deans of nursing schools and/or Chief Nursing Executives (CNE) to utilize techniques of strategic planning changing corporate culture in measurable ways.

Nurse Executives in Industry: Making the Business Case for Clinical Leadership

The Bureau of Labor and Statistics recently reported that 60% of the 3 million-plus practicing nurses work in a clinical setting and that employment of registered nurses is expected to grow 19% between 2012 and 2022. 1 This bodes well for patients and for nurses alike, and from all indications, nursing will continue to be a noble and popular career and profession in an expanding and ever-changing marketplace.