ABSTRACT
Despite the abundant literature documenting the need for nurse management education and career development, only recently have professional standards been targeted for this group. Competency standards for nurse leaders repeatedly identify systems-level concepts including finance and budget, communication skills, strategic management, human resources management, change management, and computer technology skills. However, educational initiatives to meet these standards are still at the early stages and most nurse leaders continue to acquire knowledge and experience through "on-the-job" training. This article will illustrate the need for partnerships and collaboration between academia and hospitals to advance nursing leadership to the next century. In addition, a tool to measure the impact of a graduate certificate program in nursing administration on nurse leader competencies is presented. Overall, the certificate program has been successful in multiple ways; it has "graduated" almost 80 nurse leaders, improved participant competence in their role at the systems level, as well as providing an impetus for completion of a graduate degree post program.
Subject(s)
Clinical Competence , Education, Nursing, Graduate/methods , Leadership , Models, Nursing , Nurse Administrators/education , Humans , Interinstitutional Relations , Nursing Evaluation Research , Program DevelopmentABSTRACT
Indicators of quality and nurse staffing in pediatrics are distinct from adults. A retrospective, correlational, linear mixed model design was used to describe relationships between pediatric nurse staffing and 5 indicators of quality care from a convenience sample of 7 academic children's hospitals. Key findings supported a strong inverse relationship between the proportion of hours of pediatric nursing care delivered by registered nurses and the rate of occurrence of central line (P < .001) and bloodstream infections (P < .05). Supplemental nurse staffing hours also demonstrated relationships between bloodstream infections and parent/family complaints.
Subject(s)
Nursing Staff, Hospital/organization & administration , Pediatric Nursing/organization & administration , Personnel Staffing and Scheduling/organization & administration , Quality Indicators, Health Care/organization & administration , Workload/statistics & numerical data , Catheterization, Central Venous/adverse effects , Catheterization, Central Venous/nursing , Cross Infection/epidemiology , Cross Infection/etiology , Humans , Linear Models , Medication Errors/nursing , Medication Errors/statistics & numerical data , Nursing Administration Research , Nursing Evaluation Research , Outcome Assessment, Health Care , Parents/psychology , Patient Satisfaction , Retrospective Studies , Risk Factors , Sepsis/epidemiology , Sepsis/etiology , Time Factors , United StatesABSTRACT
Driven by the institutionalization of healthcare, and the attendant financial and regulatory issues, health caregivers now need to objectively define and assess the quality of care that is delivered to patients. Measures of quality care for children lag behind the measures that are utilized for adults. To date, little is understood about how quality care for children is identified and measured. Pediatric literature acknowledges, but has poorly studied, the relationship between health care providers and parents in providing and evaluating quality care for children. This paper applies qualitative descriptive theory that is informed by grounded theory to explore parents' experiences of the care they received for their hospitalized children. From a convenience sample of six parent participants, this study finds that parents experience childcare in a hospitalized setting in terms of four interconnecting, circular processes: (a) facing boundaries, (b) attempting to understand, (c) coping with uncertainty and (d) seeking reassurance from caregivers. The experiences shared by the parent participants in this study convey new meaning to the interactional nature of the parent-caregiver relationship. In particular, the researcher finds that parents use the parent-caregiver relationship to help cope with their child's condition, and this in turn influences the parents' sense that their and their child's needs are being met.
Subject(s)
Adaptation, Psychological , Child, Hospitalized , Critical Illness , Parents/psychology , Stress, Psychological , Adolescent , Adult , Aged , Anecdotes as Topic , Child , Child, Preschool , Critical Illness/nursing , Critical Illness/psychology , Humans , Infant , Infant, Newborn , Middle Aged , Nursing Methodology Research , Parent-Child Relations , Stress, Psychological/nursing , Surveys and Questionnaires , Uncertainty , United StatesABSTRACT
Medication administration errors can threaten patient outcomes and are a dimension of patient safety directly linked to nursing care. Children are particularly vulnerable to medication errors because of their unique physiology and developmental needs. This descriptive study surveyed a convenience sample of 57 pediatric and 227 adult hospital nurses regarding their perceptions of the proportion of medication errors reported on their units, why medication errors occur, and why medication errors are not always reported. In this study, which focuses on pediatric data, pediatric nurses indicated that a higher proportion of errors were reported (67%) than adult nurses indicated (56%). The medication error rates per 1,000 patient-days computed from actual occurrence reports were also higher on pediatric (14.80) as compared with adult units (5.66). Pediatric nurses selected distractions/interruptions and RN-to-patient ratios as major reasons medication errors occurred. Nursing administration's focus on the person rather than the system and the fear of adverse consequences (reprimand) were primary reasons selected for not reporting medication errors. Results suggest the need to explore both individual and systematic safeguards to focus on the reported causes and underreporting of medication errors.
