Today's Complex Healthcare Environment Research Articles

Biblical Foundations for Interprofessional Collaboration in Nursing.

Interprofessional collaboration is an essential competency for nurses in today's complex healthcare environment. The Interprofessional Education Collaborative (IPEC) four competencies of values, teamwork, roles, and communication provide the organizing framework for effective interprofessional collaboration. In this article, the four competencies are used to explore biblical underpinnings and principles of collaboration for Christian nurses, showing how interprofessional collaboration helps achieve one's faith-based and professional commitments.

Interprofessional simulation to promote teamwork and communication between nursing and respiratory therapy students: A mixed-method research study

BackgroundCollaboration and teamwork are vitally important for safe patient care. Experiential learning through interprofessional simulation helps prepare students for the expansive requirements of today's complex healthcare environment. PurposeTo develop and evaluate an interprofessional simulation educational activity to promote teamwork and communication between respiratory therapy and nursing students. DesignA mixed method design employing surveys, observation, and focus groups with educators and students was used. Thirty-six students from two institutions in Western Canada participated in this study. Data was analyzed using descriptive statistics and content analysis. ResultsBaseline assessment revealed students were most familiar and comfortable with team functioning and communication interprofessional competencies, familiar but uncomfortable with collaborative leadership, conflict resolution, patient-centered care, and role clarification competencies. Correlation between communication and teamwork and collaborative leadership suggests these competencies play an important role in students' ability to enact more complex skills, such as conflict resolution competency. Overall, participants were highly satisfied and shared invaluable insights for improving this simulation experience in the future. ConclusionThis evaluation study demonstrated feasibility of interprofessional simulation and its potential to enhance acquisition of interprofessional competencies. A future study will incorporate additional disciplines, such as medicine and pharmacy, applying a controlled evaluation design.

What Keeps Neonatal Nurses Up at Night and What Gets Them Up in the Morning?

Occupational stress in neonatal nursing is a significant professional concern. Prolonged exposure to morally distressing patient care experiences and other healthcare issues may lead to worry among nurses. When worry becomes excessive, nurses and advanced practice registered nurses may lose joy that gives meaning to their work. Enhancing meaning in work may have a positive impact on nurse satisfaction, engagement, productivity, and burnout. To explore neonatal nurses' top professional satisfiers and top professional worries and concerns. A descriptive study was conducted in a convenience sample of neonatal nurses to identify the top professional satisfiers that get them up in the morning and the top professional worries and concerns that keep them awake at night. Complete data were available for 29 neonatal nurses. The top professional satisfiers were caring for infants and families, making a difference, witnessing resilience, intellectual challenge of specialty, positive working relationships with colleagues, and educating parents and families. The top professional worries and concerns were staffing, missed care, workload, making a mistake, and failure to rescue. Healthcare and professional organizations must develop strategies to address occupational stress in today's complex healthcare environment. Identifying professional worries and concerns may help nurses navigate challenging and distressing situations. Furthermore, understanding nurses' professional satisfiers may promote personal and professional resiliency and help organizations create healthier workplace environments. Future studies are needed to test effective interventions that may promote professional satisfaction and help neonatal nurses cope with occupational stressors.

Data Mining for Adverse Drug Events: Impact on Six Learning Styles.

Emerging technologies and big data influence the role of nurses, calling for new ways of thinking and teaching. Innovative educational methods are needed to prepare students for providing evidence-based care in today's complex healthcare environment. Active learning methods appeal to tech-savvy, self-directed learners who desire instant results during the learning process. The aim of this pretest/posttest study was to evaluate the impact of active learning methods on student attitudes and feelings, using the Grasha-Riechmann Student Learning Style Scale. Results were used to tailor active learning interventions using Twitter and Federal Adverse Event Reporting System data, for a research and evidence-based practice nursing course. Participants (N = 126) evaluated tweets describing adverse drug events and their concordance with federal reporting system data. Paired-samples t test results revealed significant differences (P < .05) between pretest/posttest for five of the six learning style preferences. Active learning methods resulted in high levels of student engagement and satisfaction. Data mining as an active learning intervention is popular with learners and offers a quick, valuable way to reveal real-world adverse drug event experiences while introducing basic research principles.

A positive culture brings success.

In today's complex healthcare environment, it is essential to support newly qualified nurses and those making the transition into new nursing roles, as well as nurses already in practice.

Exploring Pre-Nursing Students' Perceptions of Caring and Nursing: A Phenomenological Study

Caring is the essence of professional nursing practice. In today's complex healthcare environment the challenge becomes how to balance the demands of the high acuity environment with caring practices. Nursing is at risk for losing the essence of caring as technology threatens to overwhelm our work (Wagner, 2008). As clinical nursing care reprioritizes caring knowledge and practices, it becomes critical to examine how caring practices are taught, how they are prioritized and evaluated in the baccalaureate curriculum. A phenomenological study was conducted to understand the presence of caring knowledge in pre-nursing students' essays. Fifty essays were analyzed revealing seven themes of caring. They are: the language of caring, sharing information, building relationships, role modeling, providing competent care, delivering caring actions and the results of being ill. Nursing education needs to consider these findings with caring as a way of being and a therapeutic intervention that is equal in importance to...

Letters

Letters

Current trends in interprofessional education of health sciences students: A literature review

There is a pressing need to redesign health professions education and integrate an interprofessional and systems approach into training. At the core of interprofessional education (IPE) are creating training synergies across healthcare professions and equipping learners with the collaborative skills required for today's complex healthcare environment. Educators are increasingly experimenting with new IPE models, but best practices for translating IPE into interprofessional practice and team-based care are not well defined. Our study explores current IPE models to identify emerging trends in strategies reported in published studies. We report key characteristics of 83 studies that report IPE activities between 2005 and 2010, including those utilizing qualitative, quantitative and mixed method research approaches. We found a wide array of IPE models and educational components. Although most studies reported outcomes in student learning about professional roles, team communication and general satisfaction with IPE activities, our review identified inconsistencies and shortcomings in how IPE activities are conceptualized, implemented, assessed and reported. Clearer specifications of minimal reporting requirements are useful for developing and testing IPE models that can inform and facilitate successful translation of IPE best practices into academic and clinical practice arenas.

A Framework for Patient Safety, Part 2

Last month in Part 1, the authors discussed the critical aspects associated with building a safety culture and holding staff and leadership accountable through measurement and expected performance. Sustaining a safety culture begins with the human aspects but must reach beyond the underlying systems and processes, which enable resilience and error prevention in today's complex healthcare environment.

Reducing the Failure Risk of Interdisciplinary Healthcare Teams

Interdisciplinary healthcare teams have become the new model for patient care delivery in today's complex healthcare environment of increased specialization and disciplinarity of healthcare providers. Research to support the efficacy of this model has been problematic because of poorly conceptualized interdisciplinary teams as well as methodological problems conducting the research. Findings from organizational studies and healthcare interdisciplinary research can be integrated into a theory-based model to design an educational workshop to develop team members. Development of team members is proposed as a means to enhance collaboration among team members and therefore reduce the risk of team failure.

Preceptor Perceptions of New Graduate Nurse Readiness for Practice

Preparing nursing graduates for entry into practice is a priority for academic and healthcare institutions. To effectively prepare competent entry-level practitioners, it is important to understand clinical agency expectations. Most clinical agencies utilize some form of a precepted orientation experience for new graduate nurses. The purpose of this study was to examine preceptors' perceptions of the competence of new graduate nurses. Data analysis indicated several areas of weakness in new graduate nurses' clinical skills. This information can be used by academic nursing programs to revise clinical experiences to better prepare graduates for entry into practice. Findings can also be utilized to assist healthcare institutions with designing orientation programs for new graduate nurses. Suggestions are provided to help train preceptors for their important role. It is essential, particularly in today's complex healthcare environment, that strategies be explored to facilitate success of the emerging nursing workforce.

The Practice Doctorate: Where Do Canadian Nursing Leaders Stand?

This article calls upon Canadian nursing leaders to examine the merits and downsides of the new practice doctorate degree - the Doctor of Nursing Practice (DNP). The impetus for the DNP arose from within the American nursing profession in order to address the knowledge and skills needed by advanced practice nurses to work in today's complex healthcare environment. The DNP is the newest practice doctorate degree and in 2015 will be the entry to practice degree required of all new advanced practice nurses in the United States. Advanced practice nurses who will have the practice doctorate include clinical nurse specialists, nurse practitioners, nurse midwives and nurse anaesthetists. With the establishment and acceptance of the DNP in the United States, American advanced practice nurses will have a different knowledge base than Canadian advanced practice nurses. The evolution and state of advanced practice nursing in Canada are discussed in this article. Canadian nursing leaders must discuss the DNP, its merits and downsides within the Canadian context and begin to make informed decisions about whether or not the DNP should come to Canada.

Critical Thinking

In today's complex healthcare environment, it is more important than ever that nurses possess critical thinking skills to provide optimal care for their patients. This article offers a definition of critical thinking for nurses and describes the importance of critical thinking in the care of our growing elderly patient population. Examples related to geriatric nursing care, including acute care, dementia care, and end-of-life care, are provided to reinforce the importance of critical thinking and its benefits to our elderly patient population.

Future Nursing Administration Graduate Curricula, Part 2

In part 2 of a 2-part series on future nursing administration graduate curricula, the authors build on the call to action in part 1 (October 2006). First, they briefly describe important reference documents that formed the foundation for this collaborative work. Second, a new American Organization of Nurse Executives(AONE)-Council on Graduate Education for Administration in Nursing (CGEAN) Three-dimensional Administration Curriculum Model visually proposes 5 domains, 10 domain threads, and 5 competency levels. The authors then emphasize the MSN and PhD degrees as essential for the survival of nursing administration science. Fourth, ideas about innovative teaching strategies for the future are described. Finally, the series concludes with issues that need further attention. Readers are invited to provide insight from their own experience. This article offers academic program coordinators and nurse executives a starting point for evaluating, revising, and refreshing nursing administration graduate curricula. The goal is to more closely align curricula and teaching strategies with realities in today's complex healthcare environment.

Educational opportunities for medical students and young orthopaedic surgeons.

As part of its strategic mission, the American Academy of Orthopaedic Surgeons (AAOS) recently created the Council on Academic Affairs. The Council's mission is to meet the needs and expectations of AAOS Fellows working in an academic practice setting as well as to address the needs of orthopaedic residents and candidate members. The Council is composed of six committees: Diversity; Candidate Members; Medical Student, Resident, and Fellow Education; Academic Advocacy; Clinician Scientist Programs; and Academic Business and Practice Management. This report will focus on the activities of the Candidate Members and the Medical Student, Resident, and Fellow Education Committees. The primary mission of the Candidate Members Committee is to serve as an avenue of advocacy for orthopaedic surgeons who will become members of the AAOS. It is the entry portal for this important group of future members and leaders. The AAOS is committed to doing everything possible to help our young members by immediately giving them the opportunity to establish a relationship with the Academy. Our young members want information from the AAOS about job opportunities and about selecting a practice. They seek information and education from the AAOS about Board certification within their specialty. They want more in-depth knowledge of the business side of medicine, licensing, and contract negotiations, which they may not have received in their residency programs. They have spent the last twelve to fourteen years learning how to become an orthopaedic surgeon yet very little time learning about how one does that successfully in today's complex health-care environment. The more information the AAOS can provide in a technology-friendly (Internet) manner, the better, as this generation is far more technologically savvy than the current membership. To this end, the Resident and Candidate Member web site has been upgraded and expanded and now contains links to many AAOS …