Envisioning the new AACN essentials in a competency-based DNP strategic and financial business planning course.

Faculty members teaching in the Doctor of Nursing Practice (DNP) programs are charged with undergoing curriculum restructure that is aligned with the American Association of Colleges of Nursing (AACN) newly released Essentials. The purpose of this article is to share an existing course structure that was designed to teach students the business acumen in a strategic and financial business planning course and present a strategy for nursing faculty to consider when applying the Essentials to new or existing courses. This article includes a brief review of the literature, a discussion of a strategic and financial business planning course, and application of the Essentials for graduate nursing programs. Based on findings from the literature, and reported student outcomes, a strategic and financial program planning course is an effective way to meet the new Essentials for graduate nursing students that are competency-based, while providing valuable business acumen learning experiences.

Health Care Quality and Safety in a Correctional System: Creating Goals and Performance Measures for Improvement.

This article summarizes a collaboration between the Illinois Department of Corrections and an academic partner, University of Illinois at Chicago College of Nursing (UIC Nursing), to deliver a quality improvement (QI) and patient safety plan to the state. Included is a description of the need for meaningful data-driven QI as a method to deliver health care to the incarcerated population. An overview of the assessment, gap analysis, and collaboration between partners to develop a mission, vision, and performance dashboard with a beginning set of measures is presented. The dashboard with performance measures was developed to highlight the priorities of the organization and to focus improvement work to meet those goals. Next step recommendations for UIC Nursing to consult on implementation priorities and training are described.

The Impact of Preoperative Stoma Marking on Health-Related Quality of Life: A Comparison Cohort Study.

PURPOSE: The purpose of this study was to compare health-related quality of life (HRQOL) in patients receiving preoperative stoma marking by a certified wound, ostomy and continence nurse (CWOCN) to patients who did not receive preoperative marking. DESIGN: Quasi-experimental, nonrandomized comparison cohort study. SUBJECTS AND SETTING: The sample comprised 59 patients immediately following creation of a fecal stoma during an 18-month period between 2008 and 2010. The experimental group consisted of 35 patients with a mean age of 49.7 years who received preoperative stoma site marking by a CWOCN. Six of those 35 patients (17%) received preoperative ostomy education and stoma site marking. The control group consisted of 24 patients with a mean age of 60.1 years who did not receive preoperative stoma site marking or preoperative ostomy education. The study setting was a 500-bed Midwest Magnet-designated teaching hospital. METHODS: Data collection occurred at 2 points: within 72 hours before hospital discharge and 8 weeks after discharge. The Stoma Quality of Life (Stoma-QOL) instrument was used to measure HRQOL. Two CWOCNs and 3 RNs, all members of Memorial's Ostomy & Wound Services, administered the Stoma QOL within 72 hours before hospital discharge. The 2 CWOCNs followed a scripted message to collect functional lifestyle factors and administer the Stoma-QOL, for the second time at 8 weeks after discharge. RESULTS: Groups were compared using analysis of covariance to control for age; analysis demonstrated significantly higher HOQOL in the marked group compared to the unmarked group (F = 4.9, P = .031). CONCLUSION: Findings demonstrated that patients who underwent stoma site marking reported higher HRQOL than those who did not.

Evaluation of a Nurse-Driven Protocol to Remove Urinary Catheters: Nurses' Perceptions.

This article describes nurses' perceptions of the effect of a nurse-driven protocol in a Magnet-designated hospital. Post-protocol implementation data indicate improved job ease and positive patient feedback following protocol implementation. Younger or less-experienced nurses were likely to use the protocol.

No more "fumbling alone": effect of a nurse-led academic advising service in a Magnet(®) hospital.

BACKGROUND: A nurse-led, hospital-based academic advising service (AAS) was developed at a large Magnet(®) hospital. The AAS aided nurses and aspiring nurses as they considered advancing education. This research project was developed to evaluate the AAS. METHODS: This qualitative study used a web-based survey to gather information from those who had accessed the service; there were 80 participants. Satisfaction was determined quantitatively, and qualitative data analysis was completed with naturalistic inquiry approaches and standards of rigor. RESULTS: A total of 347 codes were isolated from the data and collapsed into nine categories. One comment, "I did not have to fumble through this alone," suggested the idea of coaching within a context of football as the overarching metaphor. Quantitative results indicated that advises were satisfied, with 61 of 80 respondents taking specific action after the session. CONCLUSION: Nurses and aspiring nurses found academic advising at work helpful, and the AAS facilitated a return to formal education for some of the participants.

Translational research: a concept analysis.

UNLABELLED: BACKGROUND/CONCEPTUAL FRAMEWORK: Little is known about which approaches facilitate adoption and sustainment of evidence-based practice change in the highly complex care environments that constitute clinical practice today. The purpose of this article was to complete a concept analysis of translational research using a modified Walker and Avant approach. DESIGN/DATA COLLECTION: Using a rigorous and thorough review of the recent health care literature generated by a deep electronic search from 2004-2011, 85 appropriate documents were retrieved. Close reading of the articles by three coresearchers yielded an analysis of the emerging concept of translational research. DATA ANALYSIS: Using the iterative process described by Walker and Avant, a tentative definition of the concept of translational research, along with antecedents and consequences were identified. Implications for health care professionals in education, practice, and research are offered. Further research is needed to determine the adequacy of the definition, to identify empirical referents, and to guide theory development. RESULTS: The study resulted in a theoretical definition of the concept of translational research, along with identification of antecedents and consequences and a description of an ideal or model case to illustrate the definition. IMPLICATIONS/CONCLUSIONS: Implications for practice and education include the importance of focusing on translational research approaches that may reduce the research-practice gap in health care, thereby improving patient care delivery. Research is needed to determine the usefulness of the definition in health care clinical practice.

Weathering the storm: nurses' satisfaction with a mobile admission nurse service.

AIM: To evaluate nurses' satisfaction with, and perceptions of, a practice innovation introducing a Mobile Admission Nurse service. BACKGROUND: Staff nurses identified that the admission process, while crucial to initiating safe and appropriate acute care, can be disruptive and interfere with care in progress. A pilot project implementing the role of a Mobile Admission Nurse was introduced to address this need. METHOD: A self-developed web-based survey was administered to a convenience sample of 104 RNs who had used the services during the pilot project. RESULTS: Staff nurses (n = 78) reported a chaotic, demanding work environment within which the admission process disrupts the flow of care. The Mobile Admission Nurse helped them in 'weathering the storm', which was the overarching theme that emerged during data analysis. CONCLUSIONS: Having an admission nurse complete the admission process steadied workflow processes for nurses. Improved patient safety and increased staff and family satisfaction were also reported. The strongly positive feedback led to expansion of the service. IMPLICATIONS FOR NURSING MANAGEMENT: Proactively redesigning work processes, using a structured theoretical model such as the (Plan-Do-Study-Act) PDSA approach, may improve outcomes in a chaotic practice environment.

Pilot testing an educational intervention to improve communication with patients with dementia.

Approximately one quarter of all hospitalized patients over age 75 years have a secondary diagnosis of dementia. A unique hospital-wide program to encourage appropriate communication techniques with patients who have dementia was provided to all departments of a hospital. Evaluation indicated improvement in some communication techniques. Additional education is needed to disperse the information to as many staff as possible and to sustain the change.

Smart pumps: implications for nurse leaders.

Nurse leaders are challenged to stay abreast of the unintended consequences of safety technology. Many hospitals have adopted smart pumps to improve medication safety. Unfortunately, this technology has limitations. Despite their success in averting some errors, lethal outcomes are still reported in organizations using smart pumps. Documented workarounds, such as bypassing safety features, threaten patient safety. This concerning information has prompted leaders to evaluate current implementation strategies. This article provides an overview of smart pumps, highlights the Institute for Safe Medication Practices' implementation guidelines, and presents a case report of the use of smart pump data to improve clinical practice.

The special needs of the hospitalized patient with dementia.

As the population ages, the number of patients with dementia will increase rapidly. Nurses caring for patients with dementia will need knowledge of interventions for communicating; managing agitation, nutrition, hygiene, and pain; providing spiritual care; and determining decision-making capacity.