Role of Magnet®-recognized hospital nurse managers in implementing evidence-based practice: A mixed-method study.

BACKGROUND: Healthcare systems recognize evidence-based practice (EBP) as the prestigious standard for providing safe and high-quality patient care, nursing excellence, and Magnet Recognition. Despite the well-documented benefits, implementation of EBP is inconsistent and remains elusive in the US and throughout the world and many patients still fail to receive evidence-based care. The literature revealed a huge gap between nursing science and practice but provided evidence that nurse managers (NMs) had a pivotal leadership role in implementing EBP. AIM: To gain a deeper understanding of Magnet-recognized hospital nurse managers' (MRHNMs) leadership roles, the influencing factors, and their experience in implementing EBP to enhance EBP initiatives and sustain Magnet recognition. METHOD: This mixed-method study guided by Goodall's (Australasian Psychiatry, 2016. 24, 231) theory of expert leadership used a sequential explanatory method with a quantitative-driven design based on a national correlational survey augmented by a qualitative descriptive component using semi-structured interviews. RESULTS: The findings of the study demonstrated that MRHNMs had a 54.6% effective leadership role in implementing EBP and produced numerous themes indicating that MRHNMs did implement EBP with struggle. MRHNMs in this study viewed EBP as a healthcare priority and leadership of NMs is necessary to promote EBP. However, lack of knowledge, difficulties with the EBP process, time constraints, and staffing issues negatively impacted EBP. Postgraduate degree, formal EBP education, critical care units as workplace, collaboration with doctorally prepared nurses, and Magnet culture enhanced EBP among MRHNMs. LINKING EVIDENCE TO ACTION: EBP is essential for Magnet recognition and is a hallmark of nursing excellence, however, is a complex and challenging process. The leadership of NMs is necessary to shape evidence-based care, and NMs require EBP preparation during leadership training, necessary resources, and time to complete the EBP process. EBP cannot become a reality without leaders being engaged, supportive, and persistent.

Factors Influencing Nurse Intent to Leave Acute Care Hospitals: A Systematic Literature Review.

Professional nurses are leaving their current positions in acute care hospitals and, in some cases, the profession in greater numbers than ever. Nurse leaders must understand factors surrounding nurses' intent to leave to develop strategies to mitigate this phenomenon and retain nurses. This review of the literature seeks to synthesize studies on nurses' intent to leave. Themes include job satisfaction, resources and staffing impacting workloads, leadership, and burnout.

Infusion Center Outpatient Acuity: An Integrative Review of the Literature.

PROBLEM: Patient acuity is a concept used in the health care setting and is a driver of nurse staffing and patient scheduling practices, but it is sometimes used without any well-defined understanding of its true meaning. As healthcare transitions to the ambulatory setting, which includes infusion centers, it is imperative that it provides high-quality care that increases patient and provider satisfaction. An integrative literature review was conducted to identify the current state of outpatient acuity and opportunities for classifying patients in the infusion center. Eligibility criteria: Key words included outpatient acuity and nurse satisfaction with workload from peer-reviewed sources in the English language and nursing discipline. Associated MeSH terms were also included in the search. SAMPLE: Articles from the Cochrane Library, PubMed, Ovid, CINAHL, and SCOPUS databases were used for this analysis. RESULTS: Forty-five relevant abstracts and 13 were included in the analysis. CONCLUSION: There is no systematic way to assign nurse workload in the ambulatory setting. A review of the articles revealed themes of effective resource allocation, satisfaction, and classification and acuity tools, which supports the implementation or use of an acuity system to assign patient workload in the ambulatory setting. IMPLICATIONS: The lack of research evidence also supports the need for additional research. Leaders must take an active role in researching the evidence and developing evidence-based practice guidelines to ensure that safe and quality care is consistently rendered. Research is needed to test the impact of a patient acuity system for the pediatric ambulatory infusion center on nurse satisfaction.

Finding Antecedents of Psychological Safety: A Step Toward Quality Improvement.

PURPOSE: The study's aim is to review the literature on psychological safety in the healthcare setting, more specifically, to identify environmental climates which promote and support psychological safety in healthcare organizations. CONCLUSION: The findings show the complex dyadic interplay between leaders and team members. Current literature supports the significant role of leaders as one of the major contextual influences in promoting a psychologically safe environment. Specific leadership behaviors found in this review, including leadership inclusiveness, trustworthiness, change-oriented leaders, and ethical leadership, can foster a psychologically safe environment. The development and training of such leaders must incorporate cultivation of different domains of leadership. PRACTICE IMPLICATION: Knowledge of the factors influencing psychological safety will assist healthcare organizations to cultivate and promote the psychological safety among healthcare personnel, thereby promoting patient safety and increasing healthcare quality.

Reiki therapy: a nursing intervention for critical care.

Complementary and alternative medicine (CAM) is not generally associated with the complexity and intensity of critical care. Most CAM therapies involve slow, calming techniques that seem to be in direct contrast with the fast-paced, highly technical nature of critical care. However, patients in critical care often find themselves coping with the pain and stress of their illness exacerbated by the stress of the critical care environment. Complementary and alternative medicine-related research reveals that complementary therapies, such as Reiki, relieve pain and anxiety and reduce symptoms of stress such as elevated blood pressure and pulse rates. Patients and health care professionals alike have become increasingly interested in complementary and alternative therapies that do not rely on expensive, invasive technology, and are holistic in focus. Reiki is cost-effective, noninvasive, and can easily be incorporated into patient care. The purpose of this article is to examine the science of Reiki therapy and to explore Reiki as a valuable nursing intervention.