Development and Testing of the Relational and Structural Components of Innovativeness Across Academia and Practice for Healthcare Progress Scale.

OBJECTIVE: Using data from 5 academic-practice sites across the United States, researchers developed and validated a scale to measure conditions that enable healthcare innovations. BACKGROUND: Academic-practice partnerships are a catalyst for innovation and healthcare development. However, limited theoretically grounded evidence exists to provide strategic direction for healthcare innovation across practice and academia. METHODS: Phase 1 of the analytical strategy involved scale development using 16 subject matter experts. Phase 2 involved pilot testing the scale. RESULTS: The final Innovativeness Across Academia and Practice for Healthcare Progress Scale (IA-APHPS) consisted of 7 domains: 3 relational domains, 2 structural domains, and 2 impact domains. The confirmatory factor analysis model fits well with a comparative fit index of 0.92 and a root-mean-square error of approximation of 0.06 (n = 477). CONCLUSION: As the 1st validated scale of healthcare innovation, the IA-APHPS allows nurses to use a diagnostic tool to facilitate innovative processes and outputs across academic-practice partnerships.

A Culture of Inquiry: Practice-Based Knowledge for Nurse Leaders.

A culture of inquiry has not traditionally been associated with nursing leadership. As healthcare evolves, leaders must reevaluate barriers to improving healthcare outcomes. One noted barrier has been a need for more inquisitiveness to innovate. Through an American Organization for Nursing Leadership workgroup, the authors advanced the understanding of a "culture of inquiry," applying a practice-based learning approach for knowledge development. Three recommended foundational elements are psychological safety, building connections, and using design thinking at all organizational levels.

Creating an Organizational Culture and Climate of Meaningful Recognition for Nurse Managers.

OBJECTIVES: To examine the current nurse manager (NM) recognition culture and climate in organizations and to develop a theoretical foundation for meaningful recognition. BACKGROUND: Nurse managers call for wider recognition, but the theoretical conceptualization and underpinnings of meaningful recognition are sparse in the literature. METHODS: A qualitative descriptive design was used utilizing individual interviews. The study participants included 30 individuals consisting of NMs, chief nursing officers, and chief nursing executives. Content analysis was conducted. RESULTS: A theoretical model with super-categories and supportive quotes was created to operationalize a culture and climate of meaningful recognition in the organizations represented by the sample. CONCLUSION: This qualitative descriptive study highlights the importance of recognizing the value of NMs for their contributions to nursing leadership and patient care. Implications of recognizing NMs are counteracting the feeling of being invisible and mitigating issues within the work environment.

A Conceptual Model for Professional Identity in Nursing: An Interdependent Perspective.

The purpose of this initiative was to define the development, verification, and evolution of the conceptual model for Professional Identity in Nursing. This action research design occurred over two phases, utilizing observations, a modified Norris process for model development, and focus groups. Analysis consisted of conventional content analysis and the Fawcett method for conceptual model analysis and evaluation. The model was modified, and results are presented based on the model's philosophical underpinnings, content, socialness, and evolution. The model resonates with nurses both in the United States and internationally. The interdependency shown in the model encourages collaboration, accountability, and sustainability within the profession and society.

AONL Foundation Innovates to Bridge Science and Practice.

In this column, leaders from AONL discuss the AONL Foundation and its charitable mission of providing resources that create opportunities to bridge science and practice to shape the future of nursing.

National Study of Nursing Faculty and Administrators' Perceptions of Professional Identity in Nursing.

BACKGROUND: Establishing a professional identity in nursing is integral to professional development, yet this area of inquiry remains understudied. PURPOSE: This segment of a multiphased national study measured nursing faculty's perceived level of importance regarding key components of professional identity in nursing using the newly developed Professional Identity in Nursing Survey (PINS). METHODS: Fifty subject matter experts from nursing education, practice, and regulation utilized the DeVellis scale development process to develop the PINS over the course of 2 years. Nearly 1200 nurse educators evaluated the importance of a 34-item scale relating to professional identity in nursing. RESULTS: At endorsement of 95% or greater, 28 items were found to be important components of nursing identity. Effective communication, integrity, and being trustworthy and respectful were reported as most important to nursing identity. CONCLUSIONS: Nurse educators identified the important items to assess professional identity in nursing. Item refinement and psychometric evaluation of the survey are the next phase of the multiphased study.

Building the Science to Guide Nursing Administration and Leadership Decision Making.

OBJECTIVE: The aim of this study was to identify the challenges, barriers, and solutions for conducting nursing administration and leadership science (NALS) research. BACKGROUND: Evidence from leadership science should be at the forefront of nurse leaders' decision making. Yet, challenges remain in building the evidence and moving it into nursing administration and leadership practice. METHODS: This study used a Delphi technique with open-ended questions and direct content analysis to evaluate survey responses of members of the Association for Leadership Science in Nursing and American Organization for Nursing Leadership. RESULTS: Open-ended responses were coded to yield super categories and supportive codes for areas with limited evidence to guide leadership practice and the challenges for conducting NALS research. CONCLUSIONS: These findings provide future directions for continuously driving NALS research and for building and leveraging leadership science to support nursing administration decision making.

Setting the Research Agenda for Nursing Administration and Leadership Science: A Delphi Study.

OBJECTIVE: The aim of this study was to identify and prioritize research topics for nursing administration and leadership science. BACKGROUND: Nursing administration and leadership research priorities should provide a framework for building the science needed to inform practice. METHODS: The Association for Leadership Science in Nursing (ALSN) and American Organization for Nursing Leadership (AONL) Foundation (AONL-F) for Nursing Leadership and Education collaborated on a Delphi study. Initial input on research priority items were received from ALSN and AONL members. National experts participated in a 3-round Delphi study. RESULTS: Top-ranked priorities included: 1) nurses' health, well-being, resiliency, and safety in the workplace; 2) developing and managing a nursing workforce to meet current and future healthcare needs; 3) healthy work/practice environments for direct care nurses; 4) healthy work/ practice environments for nurse leaders; 5) quantification of nursing's value across the healthcare delivery system; and 6) nurse leader development and essential competencies. CONCLUSIONS: Researchers and funders should use these priorities to guide future studies.

Filling the Knowledge Gap for Nurse Leaders: Next Steps Following COVID-19.

The purpose of this article is to share gaps in knowledge and research related to pandemic management identified by nurse leaders during the COVID-19 pandemic. As part of a larger Delphi study, nurse leaders responded to an open-ended question about gaps in research they saw as important following the pandemic. Responses were analyzed using directed content analysis. Results are presented as 4 supercategories: Organizational leadership preparedness, adaptive leadership in crisis, innovations in care delivery, and health, well-being, and resilience.

A Typology of Innovations in Nursing.

OBJECTIVE: The purposes of this project were to identify innovations conceived from nurse faculty at a college of nursing and nurses in an academic medical center, examine their characteristics, and create a typology of nursing innovations. BACKGROUND: Innovation is a crucial component for progress in healthcare. Jobs to Be Done Theory suggests that to make progress in nursing, workers must be solution focused to answer problems. METHODS: This qualitative study used directed content analysis to evaluate survey responses of nurses in 1 university's academic and practice setting about solutions or innovations to achieve progress in their jobs. RESULTS: Fifty-seven examples of situations needing an innovative solution were coded and categorized by challenges to yield an 8 characteristic typology in nursing innovation. CONCLUSIONS: These findings serve as a guide for nurse executives to understand and leverage how innovations are conceptualized and translated in academia and practice.

Health care innovations across practice and academia: A theoretical framework.

BACKGROUND: An innovation scholarly interest group used the Jobs to Be Done Theory from the business literature to provide insight into the solution-focused progress that nurses are trying to make in challenging situations. PURPOSE: This article presents a theoretical framework for understanding the progress nurses are trying to make through health care innovations across both practice and academic environments. METHOD: This was a qualitative descriptive study using directed content analysis. We used the Jobs to Be Done Theory to guide the development of the semistructured questionnaire and the interpretation of findings. FINDINGS: A theoretical framework of nursing innovations was derived to summarize and visually display the pathways and linkages of challenges, innovations, and impact domains of nursing innovations. Situations and opportunities arise within the context of interconnectedness and can lead to health care innovations in care delivery, patient care interventions, role transitions, research and translational methods, communication and collaboration, technology and data, teaching methods, and processes to improve care. DISCUSSION: This theoretical framework offers insight into the dynamic interactions of academic-practice partnerships for innovation. Workplace situations are interconnected and can result in needed innovations designed to impact care delivery.

C-Suite Strategies for Nurse Empowerment and Executive Accountability.

OBJECTIVE: We examined C-suite executives' strategies to empower the nursing workforce and to ensure their own accountability for nursing empowerment. BACKGROUND: Leadership affects workforce empowerment. The literature provides little formal guidance on optimal strategies C-suite executives can adopt for improving nurse empowerment or ensuring leadership accountability for empowering the workforce. METHODS: A system's top 47 executives were invited to be panelists in a Delphi study. Two Delphi rounds revealed leadership strategies for embedding empowerment and strategies for assessing leadership performance in workforce empowerment. RESULTS: C-suite executives rated specific strategies higher for nursing workforce empowerment and for holding themselves accountable. Specific strategies were rated high as easier to implement and more likely to have a major impact. CONCLUSIONS: C-suite executives implementing strategies with greater impact may accelerate nursing empowerment, especially when executives also adopt their own strategies for holding themselves accountable.

C-Suite Roles and Competencies to Support a Culture of Shared Governance and Empowerment.

OBJECTIVE: The aim of this study was to examine C-suite executives' perspectives on empowerment early in shared governance implementation. BACKGROUND: Leadership influences a workplace culture for empowerment. However, the literature lacks clarity regarding the specific roles of C-suite executives in fostering empowerment. METHODS: A system's top 47 executives were invited to participate in a Delphi study. Two Delphi rounds identified leadership empowerment philosophies, plus techniques for (a) understanding staff needs, (b) embedding empowerment, and (c) ensuing leadership accountability. In round 3, leaders rated the 3 types of techniques for ease and impact. RESULTS: Results revealed a passive C-suite culture regarding empowerment. However, C-suite executives recognized the need for active promotion of an empowering culture. Optimal techniques for understanding staff empowerment needs were identified. CONCLUSIONS: Modeling empowerment by the C-suite executives enables alignment between councils and levels of nursing leadership, allowing organizations to achieve the goals for professional nursing practice and shared governance.

Nurse Leader DNP Capstone Projects Evaluation: An Action Framework.

BACKGROUND: Little is known about available guidelines that can be used to evaluate health systems' Doctor of Nursing Practice (DNP) capstone projects. OBJECTIVES: The twofold purpose of this study was to identify the scope of nurse executive leadership practices, as demonstrated in final health systems' DNP Projects and propose a framework to guide evaluating health systems' DNP capstone projects. METHODS: This qualitative study used content analysis to evaluate DNP project posters of 10 health systems' DNP students graduating from one Midwestern college of nursing. Students were engaged in activities pertinent to managerial and executive-level nurse leaders. RESULTS: Students were engaged in activities pertinent to both managerial and executive level nurse leaders and followed AONE competencies. Leadership styles were operational and transformational. Six types of activities were identified. Leadership activities and themes were organized into a framework for action that can guide curriculum. CONCLUSIONS: The Framework for Action themes can be used to coach students in nurse manager or executive roles and identify developmental needs of students. IMPLICATIONS FOR NURSING: A specific new competency on impact is indicated. Use of simulation techniques is an opportunity in health systems education.

Leading Healthcare Change Across the Care Continuum: An Interview With Dr Kenneth Rempher.

Kenneth Rempher, PhD, MBA, CENP, RN, is the chief nursing officer for the University of Iowa (UI) Hospitals and Clinics. In his 20-year career, he has distinguished himself as a visionary healthcare leader. Colleagues describe Dr Rempher as a strong, transformational leader, guiding the UI enterprise through a time of uncertainty and change. This interview by the CGEAN provides insight to his leadership style, successes, and ideas on the future of care delivery.

A theory-based approach to nursing shared governance.

BACKGROUND: The discipline of nursing uses a general definition of shared governance. The discipline's lack of a specified theory with precepts and propositions contributes to persistent barriers in progress toward building evidence-based knowledge through systematic study. PURPOSE: The purposes of this article were to describe the development and elements of a program theory approach for nursing shared governance implementation and to recommend further testing. METHOD: Five studies using multiple methods are described using a structured framework. The studies led to the use of Lipsey's method of theory development for program implementation to develop a theory for shared governance for nursing. DISCUSSION: Nine competencies were verified to define nursing practice council effectiveness. Other findings reveal that nurse empowerment results from alignment between the competencies of self- directed work teams and the competencies of organizational leaders. Implementation of GEMS theory based nursing shared governance can advance goals at the individual, unit, department, and organization level. CONCLUSION: Advancing professional nursing practice requires that nursing concepts are systematically studied and then formalized for implementation. This article describes the development of a theoretical foundation for the systematic study and implementation of nursing shared governance.

Innovating Traditional Nursing Administration Challenges.

The evolving and complex practice environment calls for new mindsets among nurse leaders, academics, and nurse innovators to envision innovative ways to manage and optimize traditional tasks and processes in nursing administration. The purpose of this article is to present 3 case studies that used linear programming and simulation to innovate staffing enterprises, financial management of healthcare systems, and curricula development.

Leadership for Transitions of Care: An Active Learning Innovation.

Active learning assignments can be achieved in online discussions, resulting in creative linkages for innovation. This article describes how the teaching strategy of active learning assignment evolved into a group of student learners engaging in the development of a creative advanced clinical care scenario in an online graduate core course on leadership and management. The advanced clinical scenario that resulted from the students envisioning the assignment through the continuum of care was innovative and creative. Most importantly, the scenario stimulated vigorous conversation and excitement over the assignment, which promoted learning, pride in accomplishment, and on-the-job impact. This article serves as a model of ways to engage students in active learning for synthesis and evaluation to enable creativity and innovation.