Managing the human side of change.

Change initiatives (strategic plans) often fail, not because the idea was wrong, but because the change process failed to consider the human side of change. Achieving desired change outcomes requires an accentuation of transition management efforts or a focus on people. This article proposes 12 steps to managing transition and preparing "change-ready" employees and highlights strategies for both staff and managers to consider in the process.

Delivery-of-care systems using clinical nursing assistants: making it work.

This article describes a systems approach for effectively implementing a delivery model of care using unlicensed support personnel, unlicensed workers trained in assistive tasks of clinical care under the direct supervision of the RN. The approaches described derive from practice, research, and consultant experiences. Successful implementation requires an ongoing, multisystems approach to the development of a change plan, development of roles, development of staff, and development of rituals of practice that promote successful differentiated practice and team functioning.

The master of science in nursing curriculum: integrating diversity content within an individual model's paradigm.

Faculty can play an integral role in both facilitating success for diverse student groups and promoting diversity through experiential approaches. A willingness to evaluate your own teaching style for cultural biases is the first step. Once this is done, decide on the culture-general skills as well as the culture-specific skills that are essential for students within your area of specialization. With those outcomes in mind, you can design experiences to develop in students the appreciation of diversity, the skills to interact in a diverse world, and an awareness of the many issues of diversity that exist in our homes, communities, workplace, and society.

Models of care using unlicensed assistive personnel. Part II: Perceived effectiveness.

This article describes the results of a NAON-funded descriptive design research project developed to gather data on how clinical nursing assistants are being used in the practice setting by examining the role responsibilities, extent of delegation, training effectiveness, and evaluation measures designed by agencies to evaluate the effectiveness of this model of care. Fifty-three hospitals from 31 states participated in the investigation, with 53 nurses managers, 620 staff nurses, and 305 nursing assistants responding to questionnaires. Overall results indicated that models of care using unlicensed assistive personnel are not working. Primary impediments were identified as lack of role clarity, ineffective educational preparation of nursing assistants, ineffective educational preparation of staff nurses, lack of an adequate infrastructure to support the model, and lack of evaluation systems.

Models of care using unlicensed assistive personnel. Part I: Job scope, preparation and utilization patterns.

This article describes the results of a NAON-funded descriptive design research project developed to gather data on how clinical nursing assistants are being used in the practice setting by examining the role responsibilities, extent of delegation, training effectiveness, and evaluation measures designed by agencies to evaluate the effectiveness of this model of care. Fifty-three hospitals from 31 states participated in the investigation, with 53 nurses managers, 620 staff nurses, and 305 nursing assistants responding to questionnaires. The most common role description of clinical nursing assistants was in providing supportive care; however, there was a clear trend toward using clinical assistants to provide care requiring higher levels of observation and technical skill. Deficiencies in the infrastructure to support this model were identified as limited education and training of both assistants and staff nurses, inadequate mechanisms to deal with role confusion and delegation deficits, lack of evaluation systems, and lack of ongoing procedures to assure competency.

Orthopaedic nursing research priorities: a Delphi study.

Research has been an integral component of the mission of the National Association of Orthopaedic Nurses. Operationalization of this component of the mission has included a national research committee, funding of research grants, offering of educational sessions that highlight research methodology as well as research findings, and the formalization of a research editor position within Orthopaedic Nursing. The National Center for Nursing Research has recognized that the individual specialty nursing organizations have a role to play in determining priorities for that specialty. Consequently, NAON has been queried as to its research emphasis. This article presents the study conducted by NAON's Research Committee to determine research priorities within orthopaedic nursing.

CE feature. Part 2. Nontechnologic strategies for coping with chronic low back pain.

Nontechnologic interventions of relaxation, distraction, therapeutic touch, and spirituality can relieve chronic low back pain. Awareness of nontechnologic strategies by nurses is needed to facilitate patient-centered intervention.

An interview at Robert Wood Johnson University Hospital. ProACT model.

In its deliberations on the shortage of nurses, the Executive Board of NAON charged the Orthopaedic Nursing journal with bringing information to our readers concerning innovations in nursing care which have resulted partly in response to the current nursing crisis. This article presents an innovative care model implemented on an orthopaedic unit at Robert Wood Johnson University Hospital in New Brunswick, New Jersey. It describes not only the developed system but also the process that was used in implementing the design.