Effect of compassion rounds on nurses' professional quality of life on a COVID-19 unit.

INTRODUCTION: Evidence suggests that support groups enhance nurses' professional quality of life (QOL), and positive professional QOL is associated with better patient and nurse outcomes. This study examined the effect of a unit-level support group on the professional QOL of nurses working on a progressive care unit-turned-dedicated-COVID-19 unit. AIM: We hypothesized that a professionally facilitated Compassion Rounds (CR) support group would improve compassion satisfaction (CS) and reduce compassion fatigue (CF) among COVID-19 unit nurses. METHODS: For this pre/post, within-group trial we recruited an inclusive, convenience sample of 84 nurses on a COVID-19 unit within a 377-bed, Magnet®-designated hospital. The 10-week, CR consisted of biweekly meetings, and the ProQOL version 5 measured pre/post CS and CF. RESULTS: Paired t-testing showed that CS scores fell after CR (n = 10; p = .005), while scores rose for CF burnout (p = .05) and secondary traumatic stress (p = .008). Results were similar for unpaired analysis (N = 38; p < .05). IMPLICATIONS/CONCLUSION: Although pandemic-related challenges likely overwhelmed CR's potential to improve professional QOL, CR may have prevented worse deterioration of work-life quality. CR may also create clinically meaningful improvements for groups or individual nurses, and thus enhance nurse and patient outcomes.

Quiet Time to Increase Breastfeeding Rates and Enhance Women's Hospital Experiences in the Postpartum Period.

OBJECTIVE: To facilitate optimal hospital experiences and breastfeeding clinical outcomes among women by reducing interruptions during their first 24 hours in the postpartum period. DESIGN: Evidence-based practice change initiated by a registered nurse staff member. SETTING/LOCAL PROBLEM: There was concern that numerous visitor and staff interruptions to women during their early postpartum hours were interfering with establishing breastfeeding and maintaining a restful environment on our 21-bed postpartum unit within a 377-bed, Magnet-recognized, religiously affiliated hospital in suburban southern California. PARTICIPANTS: Medically stable women with uncomplicated childbirth during the previous 24 hours and women in the postpartum period whose responses were recorded in facility databases maintained by the departments of Lactation Services and Nursing Research. INTERVENTION/MEASUREMENTS: A daily quiet time from 1:00 p.m. to 3:00 p.m. was instituted on the postpartum unit. Measurements before and after implementing quiet time included data on (a) interruptions, as the number of times someone opened or entered women's room doors; (b) exclusive breastfeeding rates; and (c) women's postdischarge reports of their hospital experiences. RESULTS: After quiet time was implemented, interruptions fell from an average of 74 to an average of 37 per day (n = 21, p = .02), and the percentage of women breastfeeding rose from 34% to 48% (n = 193, p = .39). Women's ratings of unit quietness improved significantly (n = 169, p = .008) to above the benchmark, and their overall facility rating and willingness to recommend the facility remained above the benchmark on surveys from the Hospital Consumer Assessment of Healthcare Providers and Systems. CONCLUSION: A daily afternoon quiet time for women hospitalized in the postpartum period may reduce interruptions to women and thereby potentially increase breastfeeding rates and improve women's perceptions of their hospital experiences. Unsolicited reports from staff suggested that quiet time was well received by nurses providing postpartum care.

Meaning of Courtesy and Respect: Nurse and Patient Experiences.

BACKGROUND: Treating patients with courtesy and respect has quality, ethical, and fiscal ramifications. PURPOSE: This qualitative study revealed meanings of nurse courtesy and respect as imbedded in nurse and patient stories. METHODS: Audio-recorded interviews were collected from 15 registered nurses and 17 patients on a medical-surgical unit in a 377-bed, nonprofit, Magnet-recognized facility. RESULTS: Six themes related to courtesy and respect emerged during descriptive content analysis by 2 researchers: (1) being attentive (with subthemes taking time, physical care, and proactive engagement); (2) giving empathetic support; (3) honoring culture and beliefs; (4) recognizing the family; (5) recognizing patient space; and (6) recognizing personhood (with subthemes of showing ordinary politeness and recognizing the individual and honoring choices). CONCLUSIONS: Informants' stories contributed toward a better understanding of what it means to treat patients with courtesy and respect; and they created context for interpreting HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) numerical results. Further research is warranted.

Exploring Resilience at Work Among First-Line Nurse Managers.

OBJECTIVES: This study explored the assessment of resilience at work among 1st-line nurse managers (NMs). BACKGROUND: Resilience is the ability to cope with stress. NMs have stressful roles and may ultimately withdraw from management if they lack resilient behaviors. Having a measurement of resilience at work in NMs and other healthcare workers may facilitate resilience development approaches. METHODS: In a descriptive, cross-sectional design, an electronic survey of 25-item, 7-subscale Resilience at Work (RAW) self-report assessment was distributed to 77 NMs. RESULTS: The highest reported subscale was living authentically; lowest was maintaining perspective. Total years as NM was related to overall RAW mean, maintaining perspective, staying healthy. CONCLUSION: The application of an instrument to determine resilience may focus support for NMs on maintaining perspective, for example. Further study exploring the application of the RAW assessment to healthcare workers is indicated.

Enhancing and Advancing Shared Governance Through a Targeted Decision-Making Redesign.

OBJECTIVE: The study aim was to determine if a targeted redesign of shared decision making improved shared governance (SG). BACKGROUND: Nursing SG is collaborative decision making between nurses at every level; it improves quality of care, empowers nurses, and enhances nurse satisfaction. METHODS: Using a quasi-experimental, pretest/posttest design, researchers electronically distributed the Index of Professional Nursing Governance (IPNG) to an inclusive, convenience sample of RNs in a Magnet®-designated 377-bed community medical center. Preintervention scores were used to tailor a redesign of shared decision making, and postintervention data were collected within 1 year to measure outcomes. RESULTS: IPNG overall score and 5 of 6 subscale scores significantly increased after the redesign. CONCLUSIONS: Changes to an SG structure can take 2 to 5 years to be realized. Our findings corroborate that the IPNG is a valuable tool in promoting setting-specific SG.

Partnering to Promote Evidence-Based Practice in a Community Hospital: Implications for Nursing Professional Development Specialists.

Nursing professional development specialists working in community hospitals face significant barriers to evidence-based practice that academic medical centers do not. This article describes 7 years of a multifaceted, service academic partnership in a large, urban, community hospital. The partnership has strengthened the nursing professional development role in promoting evidence-based practice across the scope of practice and serves as a model for others.

Nurse staffing and skill mix patterns: Are there differences in outcomes?

The purpose of this study was to examine the impact on patient outcomes of nurse staffing and registered nurse (RN) skill mix patterns used by medical-surgical units in California hospitals after enactment of nurse-to-patient staffing ratio laws, and determine if there are differences in patient outcomes for conditions that are considered sensitive to nursing care. Results from this study demonstrated an association between total nursing hours per patient day (NHPPD) and two outcomes: urinary tract infections (UTI) and length of stay (LOS). A stronger association was observed between the RN proportions of the total nursing hours of care and the same outcomes. The higher the total NHPPD and RN proportion, the lower the LOS and the lower the odds of hospitalized patients' developing UTI.

"Here comes Santa Claus": what is the evidence?

The purpose of this article is to examine the strength of evidence regarding our holiday Santa Claus (SC) practices and the opportunities for new descriptive, correlation, or experimental research on SC. Although existing evidence generally supports SC, in the end we may conclude, "the most real things in the world are those that neither children nor men can see" (Church, as cited in Newseum, n.d.).