Another Piece of the Practice Environment Puzzle: Development and Validation of a Team Virtuousness Instrument.

The Practice Environment Scale of the Nursing Work Index, a widely used practice environment instrument, does not measure vital coworker interrelations. Team virtuousness measures coworker interrelations, yet the literature lacks a comprehensive instrument built from a theoretical foundation that captures the structure. This study sought to develop a comprehensive measure of team virtuousness built from Aquinas' Virtue Ethics Theory that captures the underlying structure. Subjects included nursing unit staff and master of business administration (MBA) students. A total of 114 items were generated and administered to MBA students. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were run on randomly split halves. Based on analyses, 33 items were subsequently administered to nursing unit staff. EFA and CFA were repeated on randomly split halves; CFA item loadings replicated EFA. Three components emerged from the MBA student data: integrity, α = .96; group benevolence, α = .70; and excellence, α = .91. Two components emerged from the nursing unit data: wisdom, α = .97; and excellence, α = .94. Team virtuousness varied significantly among units and correlated significantly with engagement. The two component instrument, named the Perceived Trustworthiness Indicator, is a comprehensive measure of team virtuousness built from a theoretical framework that captures the underlying structure, demonstrates adequate reliability and validity, and measures coworker interrelations on nursing units. Forgiveness and relational and inner harmony emerged as elements of team virtuousness, broadening understanding.

The Effectiveness of Charge Nurse Training on Leadership Style and Resiliency.

OBJECTIVE: The study objective was to investigate a charge nurse pilot training program as an effective, evidence-based training modality to improve leadership style and resiliency. BACKGROUND: Leadership is inherent and necessary in the charge nurse role. Little published research about charge nurse leadership training programs exists. METHODS: A pre-post design, with intervention and comparison groups, was conducted at an integrated healthcare system. A random sample of charge nurses was selected to pilot a standardized charge nurse leadership training program including in-person learning to foster leadership skills and nurture resiliency. RESULTS: The sample included 19 control participants and 22 intervention participants. Significant improvement was noted in transformational, transactional, leadership outcomes, and resiliency from preintervention to postintervention for the all subjects. Of the 22 intervention participants, the training elicited higher satisfaction with leadership behavior, followed by effectiveness and their ability to motivate. Charge nurses who attended training had higher resiliency scores pre-post intervention. CONCLUSION: The charge nurse pilot training was an effective program that led to improved leadership style and resiliency.

Clinical Nurse Leader Knowledge Production to Quality Improvement in a Seamless Trajectory: A Participatory Research Approach.

BACKGROUND: Health systems are actively implementing Clinical Nurse Leader (CNL)-integrated care delivery across the United States. PROBLEM: However, the CNL model is a complex health care intervention, making it difficult to generate evidence of effectiveness using traditional research frameworks. APPROACH: Participatory research is a growing alternative to traditional research frameworks, emphasizing partnership with target community members in all phases of research activities. This article describes a system-based participatory study that leveraged academic and practice knowledge to conduct research that was feasible and relevant, and which produced findings that were easily translated into systematic action by the health system. OUTCOMES: Study data were used to produce improvements in the health system's CNL onboarding process, role differentiation, performance, recruitment, and growth plus development. CONCLUSIONS: A participatory approach can be used in future CNL studies, providing a framework for research efforts and potentially speeding up CNL evidence generation and utilization in practice.