Creating an Organizational Culture and Climate of Meaningful Recognition for Nurse Managers.

OBJECTIVES: To examine the current nurse manager (NM) recognition culture and climate in organizations and to develop a theoretical foundation for meaningful recognition. BACKGROUND: Nurse managers call for wider recognition, but the theoretical conceptualization and underpinnings of meaningful recognition are sparse in the literature. METHODS: A qualitative descriptive design was used utilizing individual interviews. The study participants included 30 individuals consisting of NMs, chief nursing officers, and chief nursing executives. Content analysis was conducted. RESULTS: A theoretical model with super-categories and supportive quotes was created to operationalize a culture and climate of meaningful recognition in the organizations represented by the sample. CONCLUSION: This qualitative descriptive study highlights the importance of recognizing the value of NMs for their contributions to nursing leadership and patient care. Implications of recognizing NMs are counteracting the feeling of being invisible and mitigating issues within the work environment.

Nursing's Leadership Role in Advancing Professional Practice/Work Environments as Part of the Quadruple Aim.

Development of healthy professional practice/work environments (PPWEs) for nursing practice is critical to optimizing patient safety and workforce satisfaction while limiting turnover. Healthy PPWEs are linked with improved outcomes for patients, the workforce, and organizations. Nurses constitute the greatest professional segment of the US health care workforce and influence PPWEs, patient experience, health care quality, and cost per capita, all aspects of the quadruple aim. This article shares a model of leadership identified by executive nurse leaders to address and foster healthy PPWEs. A focus group of 16 expert nurse leaders convened an invitational meeting in Richmond, Virginia, to discuss nurse leaders' roles in optimizing the quadruple aim. The discussions led to shared perceptions about the prevalence of barriers to optimizing PPWEs; nursing leaders' responsibility to address the barriers to supporting improvement of the work-life of nursing professionals; and the need for early integration of leadership education, theory, and practice in every nurse's career.

Implementation of a Hydrotherapy Protocol to Improve Postpartum Pain Management.

INTRODUCTION: A growing number of women are seeking alternatives to traditional pharmacologic pain management during birth. While there has been an extensive array of nonpharmacologic options developed for labor, there are limited offerings in the postpartum period. The purpose of this quality improvement project was to implement a hydrotherapy protocol in the early postpartum period to improve pain management for women choosing a nonmedicated birth. PROCESS: The postpartum hydrotherapy protocol was initiated in a certified nurse-midwife (CNM) practice in an urban academic medical center. All women who met criteria were offered a 30-minute warm water immersion bath at one hour postpartum. Pain scores were assessed prior to the bath, at 15 minutes after onset, and again at the conclusion (30 minutes). Women who completed the bath were also asked to complete a brief survey on their experience with postpartum hydrotherapy. OUTCOMES: In women who used the bath (N = 45), there was a significant reduction in pain scores (P < .001) between the onset of the bath and scores at both 15 minutes and 30 minutes. There was no significant difference between pain scores at 15 minutes and 30 minutes (P = .97). Of those women who completed a survey (n = 43), 97.7% reported both that the bath reduced their pain and improved their birth experience. One hundred percent reported they would use it again in another birth. DISCUSSION: This project demonstrated successful implementation of a hydrotherapy protocol as an alternative or adjunct to medication for early postpartum pain management that significantly reduced pain and improved the birth experience for those who used it. It offers a nonpharmacologic alternative where there have traditionally been limited options.

The VCU Pressure Ulcer Summit: Collaboration to Operationalize Hospital-Acquired Pressure Ulcer Prevention Best Practice Recommendations.

This executive summary reports outcomes of an interprofessional collaboration between experts in pressure ulcer prevention, bedside clinicians, regulatory agencies, quality improvement, informatics experts, and professional nursing organizations. The goal of the collaboration was to develop a framework to assist facilities to operationalize best practice recommendations to sustain organizational culture change in hospital-acquired pressure ulcer prevention, to develop a hospital-acquired pressure ulcer severity score, and to address topics related to the unavoidable pressure ulcer.