The Advanced Practice Registered Nurse Leadership Role in Nursing Homes: Leading Efforts Toward High Quality and Safe Care.

This article highlights the critical role of advanced practice registered nurses in the care of older adults living in nursing homes. This population is one of the frailest, marginalized, and often neglected in the United States. The COVID-19 pandemic impact on nursing homes resulted in a stunning number of infections and subsequent resident deaths. This is a shameful reminder of the many challenges and gaps in the nursing home industry including inadequate staffing, high staff turnover, improper isolation technique, and lack of fundamental knowledge of how to adequately implement infection prevention and control processes. Strong advanced practice registered nurse leadership may have mitigated some of these factors.

Nurse well-being: A concept analysis.

BACKGROUND: An understanding of nurse well-being remains elusive, particularly in the current toxic health care environment. Therefore, a conceptual definition of nurse well-being is needed. PURPOSE: The purpose of this paper is to report results of a concept analysis of nurse well-being. METHODS: Rodgers' Evolutionary Method of concept analysis was used to examine the attributes, antecedents, consequences, and related concepts of nurse well-being. FINDINGS: Findings revealed varying levels of nurse well-being: individual, organizational and community. Individual attributes included happiness, satisfaction, optimism, compassion, gratitude, forgiveness, and sound body/spirit. Organizational/community attributes included teamwork, sense of mission, pride in work, and social integration. Antecedents reflected commonalities with Maslow's hierarchy of needs, ranging from basic human needs to self-actualization. Consequences included resilience, collegial relationships, continued growth and development, empowerment, purposeful work, and physical/mental health. DISCUSSION: Standardized definitions of individual and organizational/community nurse well-being should guide future research and policy development. Organizations must build capacity for nurses' well-being and explore its connection to patient safety and quality outcomes.

Expert nurse response to workforce recommendations made by The Coronavirus Commission For Safety And Quality In Nursing Homes.

COVID-19 has exposed the longstanding internal problems in nursing homes and the weak structures and policies that are meant to protect residents. The Centers for Medicare and Medicaid Services convened the Coronavirus Commission for Safety and Quality in NHs in April, 2020 to address this situation by recommending steps to improve infection prevention and control, safety procedures, and the quality of life of residents in nursing homes. The authors of this paper respond to the Final Report of the Commission and put forth additional recommendations to federal policymakers for meaningful nursing home reform: 1) ensuring 24/7 registered nurse (RN) coverage and adequate compensation to maintain total staffing levels that are based on residents' care needs; 2) ensuring RNs have geriatric nursing and leadership competencies; 3) increasing efforts to recruit and retain the NH workforce, particularly RNs; and 4) supporting care delivery models that strengthen the role of the RN for quality resident-centered care.

A Call to the CMS: Mandate Adequate Professional Nurse Staffing in Nursing Homes.

Editor's note: This article is by 22 nursing gerontology experts who are all advocates of nursing home reform. They are listed at the end of this article.