Lessons learned: clinicians' post-occupancy perspective of facility design involvement.

OBJECTIVE: The research was conducted to determine clinician knowledge needs for competent involvement with the facility design process as well as to gather lessons learned on building stronger design teams. BACKGROUND: As clinical stakeholders are invited to the healthcare facility design table, the question arises as to the ability of professionally diverse team members to translate each other's comments and ideas accurately. In the past, hospitals were designed by a handful of hospital leaders and architects. More recently, multiple players have become involved throughout the design and construction of new healthcare facilities. Clinical consultants from two international healthcare companies observed that many clinicians were unprepared to effectively translate their needs to the architectural community or to competently utilize architectural tools and documents. METHODS: A qualitative, post-occupancy cross-case study was conducted to understand how clinicians could increase their competencies for successful involvement in facility design. Focus group interviews were held with teams from healthcare facilities occupying their new facility for more than 6 months and less than 2 years. RESULTS: Curriculum topics were validated and additional areas recommended based on the interviews. Open-ended questioins on lessons learned provided several new dimensions to the research. CONCLUSIONS: Although validating the curriculum was the initial intent, the feedback from the focus groups on lessons learned provided rich concepts for practice implications and further research on post-occupancy. KEYWORDS: Decision-making, design process, interdisciplinary, planning, post-occupancy.

An essential component of the Magnet journey: fostering an environment for evidence-based practice and nursing research.

Creating, advancing, and sustaining a practice environment grounded in evidence-based practice and nursing research is essential to achieving Magnet status. The purpose of this article is 2-fold. First, to describe a model for the integration of evidence-based practice. Second, to illustrate how a community hospital used this model as a framework for the integration of evidence-based practice and nursing research as part of its journey toward achieving Magnet status.

Getting over the rainbow: one community hospital's vision.

Nursing faces a challenging future due to both a projected nursing shortage and changing needs of patients. This will require greater flexibility, an increased knowledge base, and a strengthening of our caring foundations through more evidence-based practices. A nursing taxonomy needs to be determined so that we can support the research of nursing effectiveness through the use of technology. Institutions will need to increase their investments in continuing education, nursing research, and technology to enable more efficient and effective nursing practice. New relationships will need to be forged and new roles designed to maximize the profession's contributions to patient care. Questions that have been asked for decades regarding differentiated nursing practice and entry level into practice will need to be answered. This article describes a large suburban hospital's strategic initiatives that have been designed to meet the nursing challenges of the 21st century.

How legislation has historically helped nursing when in crisis point.

Health is a political issue. Healthcare is political because it is integral to development. Health-related services must be a part of socioeconomic plans developed at the national level. Nurses are directly influenced by these matters. Recruitment, retention, education and practice of nurses are affected by the demand for services, reimbursement systems, prevalent healthcare problems, and research findings.