Cycling Without Age Program: The Impact for Residents in Long-Term Care.

Long-term care facilities seek ways to enhance the quality of life for residents. Cycling Without Age (CWA), a new international cycling program, is gaining momentum for older adults. This study explored resident riders' and trishaw pilots' lived experience of their participation in the CWA program using a qualitative approach at a long-term care facility in the United States. Researchers conducted 27 face-to-face, semi-structured interviews with riders and pilots. For resident riders, the three themes identified included (a) breath of fresh air; (b) wave, chat, and remember; and (c) sit back and relax. Two themes were identified for the pilots: (a) change in frame of mind, and (b) mental and physical rewards. CWA can be as a new strategy for person-centered care. The CWA program provides nursing an opportunity to advocate, recommend, and obtain an order for residents to participate in the program.

Namaste Care™: A Person-Centered Care Approach for Alzheimer's and Advanced Dementia.

New methods of care are required to meet the needs of people with dementia and their caregivers. The Namaste Care™ program provides a person-centered approach through meaningful activities and loving touch. The purpose of this qualitative study was to explore the experiences of residents, staff, and family involved in the Namaste Care™ program at a long-term care facility in the United States. A descriptive approach was used to interview 14 staff members. The findings revealed six themes: peaceful sanctuary, relating their way, transforming experiences, connections and community, positive moments, and awakened to the possibilities. Results suggest that Namaste Care™ may be useful for individuals no longer able to participate in traditional long-term care setting activities. Further studies are indicated to confirm the impact on hospital readmissions, therapy enhancement, and medication use in relationship to Namaste Care™ program participation.

A Pilot Study to Explore Nurse Educator Workforce Issues.

As the demand for nurses continues to rise, the recruitment and retention of qualified nurse educators (NEs) is essential. The purpose of this descriptive study was to explore NE workforce issues using the Faculty Satisfaction Survey at a single nursing program. Respondents were somewhat to very satisfied with their job; however, they were less satisfied with salary/compensation and stated they would leave academia for higher wages. Satisfaction differences were noted between full-time and part-time NEs. Job motivators may be the key to recruitment and retention of NEs and a way to avoid a nursing shortage crisis.

Using SBAR to promote clinical judgment in undergraduate nursing students.

The purpose of this study was to describe how students identify and interpret multiple embedded clinical cues in a case study, and then reflect these using SBAR (Situation, Background, Assessment, and Recommendation). Using Tanner's model of clinical judgment, a descriptive design was used to examine SBAR assignments completed by second-semester nursing students (n = 80). The majority of students (n = 62, 77.5%) in the study were unable to successfully follow all of the clinical judgment phases of the model: noticing, interpreting, responding, and reflecting. Although SBAR is an important tool for communicating clinical information, gaps exist between noticing and interpreting clinical cues, and forming an appropriate course of action.

Learn to lead in the boardroom.

Nurses, positioned as members of one of the most highly trusted professions, are called to meet the health needs of patients and communities in a variety of ways. The Institute of Medicine calls nurses to partner with physicians and other professionals to redesign health care in the United States. One way that nurses can answer the call is by serving in the boardroom, where decisions regarding health and health care are made. Identified competencies for board leadership include (a) open communication, (b) planning, (c) active engagement, (d) collaboration, (e) decision-making skills, (f) financial stewardship, (g) organizational skills, (h) advocacy, and (i) visionary skills. Board competency development begins in nursing school and continues throughout one's professional career. A board leadership self-assessment tool is provided as a guide for personal and professional growth. Continuing education professionals play an important role in development of boardroom competency.

Work-Arounds Observed by Fourth-Year Nursing Students.

Much has been written about the need for health care professionals to consistently promote policies and best practices that create safe, high-quality care environments. At times, nurses deviate from established policies and procedures to create work-arounds or changes in work patterns to accomplish patient care goals. The purpose of this study was to identify common work-arounds and describe what influenced the nurse to engage in the work-around as observed by fourth-year baccalaureate students in clinical settings. A descriptive qualitative approach was used to describe the findings from a Quality and Safety Education for Nurses-based assignment. Ninety-six individual student assignments were included in this analysis; the themes of infection prevention and control and medication management emerged. The theme of workload emerged as the reason why students believed nurses engaged in work-arounds. Further studies are needed to determine how work-arounds influence short- and long-term patient outcomes.

Characteristics of nurse leaders in hospitals in the U.S.A. from 1992 to 2008.

AIM: Describe the nurse leader workforce in hospitals in the USA over time by exploring three research questions: (1) What are the characteristics of the nurse leader workforce in U.S. hospitals? (2) How does the nurse leader workforce change over time? (3) How do nurses in executive positions (administrators) differ from nurses in first-line supervisory positions (supervisors)? BACKGROUND: Effective nurse leaders use management skills to ensure safe patient care in hospitals in the USA. Changes in the nurse leader workforce have an impact on patient care. METHOD: non-experimental design was used to explore the characteristics of 10,150 nurse leaders using the 1992, 1996, 2000, 2004 and 2008 National Sample Surveys of Registered Nurses. RESULTS: Number of masters and doctorally prepared nurse leaders increased from 14.5% to 23.2% along with an increase in mean age. A 30% decrease in the number of nurses in leadership positions was found. Male nurses reported significantly higher salaries P < 0.000. CONCLUSIONS: Nurse leaders are older and have achieved higher educational degrees. Salary disparities based on gender still prevail. Implications for nursing management Identifying and developing future leaders with necessary skills and competencies is critical for organizational success.

Substitution of hospital staff in concurrent utilization review.

Substitution of hospital staff performing concurrent utilization review (CUR) was evaluated using a production process framework. There were no differences in the number of reimbursement denials or denied days among 4 job classifications of hospital staff performing CUR, indicating that educational preparation of staff did not affect outcomes. The implications are that hospitals could substitute assistive staff in place of registered nurses to complete the CUR function, potentially increasing the availability of professional nurses.

Resilient organizations: matrix model and service line management.

Resilient organizations modify structures to meet the demands of the marketplace. The author describes a structure that enables multihospital organizations to innovate and rapidly adapt to changes. Service line management within a matrix model is an evolving organizational structure for complex systems in which nurses are pivotal members.

Responses of hospital utilization review staff to reimbursement denials.

Utilization review (UR) is a strategy used by the managed care industry to monitor and control utilization of health care resources. The concurrent UR process requires that hospital staff report clinical information to payers, who either certify or deny reimbursement. Conflicts may arise when hospital staff disagree with denial decisions. The authors analyzed the various responses of a medical center UR staff to payer denials and found that although denials were not frequent, they were perceived negatively by hospital staff. Improving and standardizing communication among providers, payers, and patients is one means of reducing conflict and frustration in the event of reimbursement denial.