A Qualitative Inquiry Exploring Clinical Faculty Transition to a Concept-Based Curriculum.

AIM: This study explores the transition process clinical faculty experience when changing to teaching in a concept-based curriculum. BACKGROUND: Literature related to faculty support during curricular change is sparse and offers little guidance to assist clinical faculty. METHOD: A qualitative study was conducted with participants from nursing programs in a statewide consortium. Semistructured interviews were transcribed to identify themes that linked participants' experiences to transition stages. Additional research included review of clinical assignments and observation of faculty while teaching at a clinical site. RESULTS: Nine clinical faculty from six nursing programs participated in the study. Five themes linked to the stages of the Bridges Transition Model were identified: Collaboration, Communication, Coordination, Coherence, and Futility. CONCLUSION: The identified themes revealed that clinical faculty varied in their transition process. These results add to the knowledge of transitional change for clinical faculty.

Why nurses stay: Analysis of the registered nurse workforce and the relationship to work environments.

AIM: To examine how factors such as a sense of belonging to a nursing work group, work environmental characteristics, and workplace violence effects the duration of employment in professional settings in a southwest region of the United States. DESIGN: The descriptive correlational survey study conducted in 2014. METHODS: A random sample of 700 licensed registered nurses (RN) from a Board of Nursing's list of currently licensed RNs' (approximate n = 2300). Participants completed and returned four survey tools to the principal investigator. The return rate was 36.8% (258/700). RESULTS/FINDINGS: Analysis indicated that a sense of belonging, as well as supportive workplace characteristics, played a role in why nurses stay. The three survey tools provided strong correlations in the survey data and further authenticated the tools' reliability. A healthy work environment supports nurse retention. CONCLUSION: The three survey tools used in this study showed substantial and significant correlations. Although not all sub-scales correlated, those that did had strong Cronbach alpha scores. The weakest correlations were with the belongingness scale. Rapid turnover rates of nursing staff continue to plague healthcare organizations. A variety of reasons including difficult practice settings and stressful work environments contribute to the outflow of nurses. IMPACT: Health care administration and management leaders can improve retention via their efforts to continue to create and sustain healthy work environments that address affiliation, belongingness, and the characteristics that attract and retain nurses.

Charting Cognitive Growth of Nursing Students Using Linguistic Software.

BACKGROUND: Students' word choice when writing in a reflective journal may reveal their emotional development, sense of belonging, cognitive processing, and ability to appraise their own growth and understanding. New linguistic analysis software can scan and categorize these journals for the use of pronouns, positive and negative emotions, and cognitive keywords. METHODS: A retrospective study design evaluated student journaling from a psychiatric clinical course. Journal entries from weeks 1 and 12 were compared by z-score analysis. FINDINGS: Significant increases were found in the use of "we" (P = .001), positive emotions (P < .001), inclusion words (P < .001), and insight words (P = .004), whereas the use of cause and self-discrepancy words were not significantly different. CONCLUSION: Identification of learning as expressed in words could have an impact on how student assignments are designed by including the use of the Linguistic Inquiry and Word Count software to assess changes in student cognition.

Strategies for success: crisis management model for remediation of at-risk students.

Student success is a concern for all nursing schools. Accountability for NCLEX(®) pass rates, along with accountability for student attrition and progression, compel nursing schools to carefully select applicants and then actively manage their progress. One of the strategies of managing student progression is to use standardized, nationally normalized exit examinations to identify students at risk for NCLEX-RN failure. This article describes the response of one baccalaureate nursing program to an unacceptable number of exit examination failures among senior students preparing to graduate. As a unique approach to this matter, a crisis management process was used to assess the problem, to develop and implement an intervention for at-risk students, and to revise program policies to better support ongoing student success.

The impact of work environment on telephone advice nursing.

Telephone advice nursing (TAN) is part of a current effort to improve patient access while reducing cost and encouraging self-care. However, the environment in which TAN occurs can significantly affect both nurse and patient outcomes. This research builds on findings from a large health maintenance organization study by Valanis et al. in which questionnaires and call descriptions were used to correlate TAN nurse and caller/patient perceptions of calls at three regional sites. The survey tools were used to identify nurse perceptions of their work environments (WEs) as well as caller perceptions of using the advice service. The sample included 88 nurse questionnaires and 865 caller questionnaires. Multivariate analysis of covariance revealed significant site perception differences in the WE of stress, communication, and autonomy, whereas no significant differences were noted in collegial relationships and organizational support. Each site was also determined to be a unique predictor of patient perceptions of satisfaction with the advice. Findings indicate nursing professionals act as a filter to mask stressful WE effects experienced by nurses and ensure patient outcomes thereby supporting patient satisfaction with the service.

Implementing interdisciplinary practice change in an international health-care organization.

The current emphasis on adopting evidence-based practice often results in the need to change interdisciplinary practice. This article describes the successful system-wide change to evidence-based wound care practices in a large, Middle-Eastern health services organization using a multinational workforce. Elements within this change initiative are identified that stimulated experimentation and collaboration among members of this organization's workforce while also preserving culturally determined expectations for authority and decision-making. The result was a system-wide practice change accomplished through consensus-building and interdisciplinary learning while also utilizing the strengths to be found in an established organizational hierarchy. This description of practice change among the members of a multicultural, multinational workforce provides lessons for managing a diversity of perspectives, creating consensus and accomplishing change in an environment where multiple cultural values intersect.

Discourse on the transformational leader metanarrative or finding the right person for the job.

Changes in healthcare today have called for leadership styles that place a heavy demand on organizations. Shifts in markets and reimbursement strategies call for new leaders with vision that can guide healthcare organizations to change. In a postmodern era, organizations see the transformational leader as a valuable asset in changing times. This article addresses the foundations of the transformational leader metanarrative and, through a postmodern discourse, deconstructs the concept. The article presents a review of postmodern thought in relation to the metanarrative of leadership and applications to nursing administration.

Differentiating quality improvement from research.

Monitoring of quality of care has always been an important part of health care. Self-regulation and external standards require care providers to furnish safe environments for the patient. Similarities in methods used by quality improvement (QI) projects and clinical research have created some confusion in differentiating the two practices. This article reviews the current literature and differences between QI and research. In addition, the article identifies and discusses four criteria: intervention, risk, audience, and data source, which allow investigators to differentiate between the two practices and follow the appropriate procedures for project review.