An Effective Academic Medical Center-Based Strategy to Enhance Diversity Among Nurse Researchers.

The Connell-Jones Endowed Chair Diversity Nursing Research Scholars Program was created to promote engagement in nursing research and scholarship among nurses of color. Preliminary evaluation suggests that the program was widely beneficial, resulting in enrollment in doctoral education for some. Establishing opportunities that promote exposure and participation in nursing research and scholarship among nurses of color helps cultivate cohorts of diverse nurses armed to address health disparities through the advancement of nursing knowledge.

Racism and Nursing Leadership in Massachusetts: A Mixed-Methods Study.

BACKGROUND: Nursing in the United States has evolved within the same historical context that has reproduced and spread racism worldwide. Nurse administrators are integral to the quality of nurses' practice and play a key role in eliminating racial injustice in places of work. PURPOSE: Using a feminist and critical race feminist framework, this study examined Massachusetts nurses' experiences of racism in their places of work, focusing on nurse administrators' influence on the nonadministrator (staff nurse) experience of racism experiences before and after George Floyd's death. METHODS: An investigator-developed, electronic survey was sent to Massachusetts professional nursing organizations for distribution to their members in 2021. Two hundred nineteen nurse respondents completed Likert-scale and open-ended branching logic survey questions to yield the quantitative and qualitative data analyzed for this mixed-methods study. FINDINGS: Nurse administrators were: 1) more likely than staff nurses to state that policies and meetings to address racism and diversity, equity, and inclusion had taken place before and after George Floyd's murder; and 2) less likely than staff nurses to directly experience racism at the hands of a colleague or a superior. Nurse administrators influence staff nurses' experiences of racism.

Mission possible: open innovation in nursing and patient care services at Massachusetts General Hospital.

OBJECTIVES: Although front-line nurses and staff are uniquely positioned to identify the inefficiencies and gaps in care delivery, formal processes are not always in place to hear from those very employees. DESIGN: We established a scalable process that embodies open innovation principles, to broaden and distribute the innovation locus. SETTING: Massachusetts General Hospital, Boston, MA. PARTICPITANTS: We invited 8800+ nurses and other direct caregivers to participate in organisational problem solving. INTERVENTIONS: We solicited employees to (1) identify pain points and develop solutions and (2) crowd vote to indicate which ideas they want to see implemented. RESULTS: 177 employees submitted 225 ideas, and 928 cast a vote. The 40 participants who submitted top-voted ideas were invited to develop a detailed implementation plan; of those, 27 submitted one. Four ideas emerged as winners. CONCLUSIONS: Formulating a clear call for ideas, securing leadership buy-in and generating excitement about the process were essential to our efforts. Challenges associated with opening the innovation process involved managing a large volume of participants and submissions, and providing on-the-go training to nurses and staff who were not used to being asked to participate in organisational problem solving.

Investigation of social support as a mediator of the relationship between physical and psychological health among hospitalised patients.

AIM: To investigate the self-reported levels of social support from friends and family and from nurses as mediators of the relationship between self-rated physical and psychological condition in hospitalised patients. DESIGN: Cross-sectional study of adult inpatients at a large tertiary-care hospital in the northeast United States. METHODS: Multiple mediation analysis of survey data. RESULTS: In surveys received from 324 inpatients, one fourth of the variation in patients' self-rated psychological condition was explained by self-rated physical condition. Social support from family and friends mediated a significant proportion (11.0%) of the relationship between self-rated physical and psychological condition, however social support from nurses did not. CONCLUSION: Social support from family and friends can positively influence the psychological health of inpatients, but nurses are not an adequate replacement for the social support provided by family and friends. IMPLICATIONS FOR NURSING: Although nurses cannot replace the social support provided by family and friends, the assessment of social isolation and care planning of interventions to support patients is a fundamental nursing role. Technology to connect patients with friends and family should be used to mitigate isolation for hospitalised patients unable to receive in-person visits from loved ones. IMPACT: The influence of social support from family and friends and nurses was addressed. The study found social support from family and friends, but not nurses, to influence the relationship between physical and psychological ratings. This finding has implications for the role of nurses in the hospital setting. REPORTING METHOD: Strengthening the Reporting of Observational Studies in Epidemiology guidelines were followed.

Nurse-sensitive indicators during COVID-19.

PURPOSE: Nurses are on the forefront of delivering care to patients hospitalized with COVID-19. Nurses' impact on patient care can be discerned through assessment and documentation strategies, including structured and unstructured narratives, clinical pathways, flowsheets, and problem-based approaches. To date, there are no published reports regarding nursing assessment and documentation during the COVID-19 pandemic using an assessment framework to capture clinical decision making, nursing diagnoses, and key social determinant of health (SDoH) data. Hence, the purpose of this investigation was to conduct an exploratory nursing documentation audit of patients hospitalized with COVID-19 during the first surge to identify types and frequency of nurse-sensitive indicators, including SDoH. METHOD: This pilot study utilized a retrospective chart review design at a single academic medical center, utilizing Gordon's Eleven Functional Health Patterns (FHP) framework to extract clinical, social, and nursing assessment data for patients hospitalized with COVID-19. Descriptive statistics were computed for continuous variables and counts/percentages for categorical variables. FINDINGS: Data from 94 patient records were analyzed. Most patients were male (59.6%), with a mean age of 58 years. Nearly 15% of patients were Black and 12.8% were Hispanic, most residing in four geographic areas. Nine of the 11 FHPs were reflected in nurse-sensitive indicators documented in the electronic health record. SDoH data were inconsistently documented, including race, education, history of neglect/abuse, and occupation. CONCLUSION: The FHP framework captured many nurse-sensitive indicators during the first COVID-19 surge, although screening for and documenting SDoH data were limited. IMPLICATIONS FOR NURSING PRACTICE: Findings can influence the development of nursing assessment and documentation during crisis care delivery that are inclusive of distinct sociodemographic factors, in addition to clinical factors, to provide comprehensive, culturally sensitive care. Such documentation will enhance the use of nursing knowledge guided by a nursing framework to make visible the essential contributions of nurses to healthcare delivery.

Recruitment and Retention of Occupational Therapy Practitioners and Students of Color: A Qualitative Study.

IMPORTANCE: Matching the demographics of health professionals and patient populations increases access to quality care. However, a consensus has not been reached regarding the most effective strategies for recruitment and retention of diverse practitioners. OBJECTIVE: To answer the question "What are the perceived challenges to and facilitators of the recruitment and retention of occupational therapy practitioners (OTPs) and students of color?" DESIGN: A qualitative interpretive, constructionist design was used. Purposive recruitment that used convenience sampling was conducted at the 2017 American Occupational Therapy Association Annual Conference & Expo and via the National Black Occupational Therapy Caucus Facebook group. Data were collected online from three focus groups and four interviews. SETTING: Online through social media. PARTICIPANTS: The total sample included 5 OTPs and 7 students; 91.7% identified as African-American or Black. OUTCOMES AND MEASURES: Inductive analysis was used to interpret the open-ended questions. After transcription, each interview or focus group transcript was reviewed with Colaizzi's seven-step method of data analysis. RESULTS: Five themes were identified: (1) lack of representation in and knowledge about occupational therapy, (2) feeling like an outsider, (3) need for financial support, (4) individualized mentor-mentee relationships, and (5) connections with national organizations specifically for people of color. CONCLUSIONS AND RELEVANCE: This study identified experiences of OTPs and students of color and how identified barriers can be addressed. Implications for the profession include purposive recruitment, professional development for faculty, provision of mentoring, and financial support. Future research should focus on creation and evaluation of evidence-based strategies for the recruitment and retention of students of color in occupational therapy. WHAT THIS ARTICLE ADDS: This study provided voices of OTPs and students of color regarding challenges and facilitators experienced in the profession. With an accurate understanding of experiences of people of color, effective strategies can be developed to foster their successful transition into the occupational therapy workforce.

African American Nurses' Perspectives on a Leadership Development Program.

United States demographics are changing, but that change is yet to be recognized in the makeup of the nursing workforce. The underrepresentation of minorities in nursing is a longstanding problem, resulting in missed opportunities for culturally sensitive care that can foster optimal patient care outcomes. This report describes qualitative analysis of leadership opportunities emerging from a collaborative leadership development program between an urban baccalaureate nursing program and a large healthcare system in the northeast United States. The investigative team used qualitative methods to analyze the experiences of 19 participating African American (AA) RN graduates. Findings demonstrated that, for program participants, active engagement in personal and professional nursing leadership activities was enhanced. The academic-practice leadership program was an effective tool for enculturating AA nurses into the practice environment and into eventual leadership in nursing and healthcare.

Strengthening new graduate nurse residency programs in critical care: recommendations from nurse residents and organizational stakeholders.

BACKGROUND: Thirty-four new graduate nurses participated in a critical care nurse residency program in preparation for opening a new intensive care unit. At the end of the program, multi-constituent focus groups were held to assess program effectiveness. METHOD: Participants included 34 new graduate nurses, 18 preceptors and staff nurse partners, five clinical nurse specialists, and five nurse directors. Twelve focus groups were held; groups included four to eight nurses from the same role group. Two independent reviewers analyzed recordings and transcripts of focus group content to identify themes. RESULTS: Five themes were identified: program design, developing nursing expertise, program impact on the unit, future expectations, and communication. Comments were used to guide program improvements and offer new insights for residency programs in acute and critical care. CONCLUSION: Obtaining structured input from multiple program stakeholders is beneficial in evaluating a program's impact and identifying areas for improvement.

Using career nurse mentors to support minority nursing students and facilitate their transition to practice.

The Clinical Leadership Collaborative for Diversity in Nursing was developed through an academe-service partnership focused on supporting minority nursing students and facilitating transition to practice. A key program element is mentoring. Students are paired with an experienced, minority clinical nurse or nurse leader from one of the partnering agencies, who helps guide the student throughout the junior and senior year of school and first year of employment. The mentoring component was evaluated through surveys in which mentors and mentees rated one another and offered open-ended comments on the program's impact. Aspects of mentees rated highest by mentors include manner (courteous and professional), ability to communicate and get along with others, preparation for meetings, and fully utilizing their time with mentors. Aspects of mentors rated highest by mentees include warmth, encouragement, and willingness to listen; enthusiasm for nursing and how they sparked the mentee's interest; and clarity regarding expectations for mentees and how they pushed mentees to achieve high standards. In the open-ended comments, mentees consistently identified mentoring as the program's strongest component. Sixty-four minority students have participated to date with a zero rate of attrition and very low job turnover among graduates.

Evaluating dedicated education units for clinical education quality.

Dedicated education units (DEUs) have emerged as an important clinical education innovation within academic practice partnerships. However, rigorous evaluation has not been conducted previously. This article presents findings from a randomized, controlled, multiyear, multisite study comparing the clinical education quality for students educated in either the DEU innovation or traditional clinical education model within the same nursing course. The evaluation occurred within a larger study focusing on teaching capacity, faculty work life, and educational quality at one large, urban university collaborating with three agency partners. To examine learning outcomes, the question posed was, "In what ways, if any, does the DEU intervention, when compared to traditional clinical education, enhance educational quality?" Results indicate that educational quality and learning gains are significantly more positive for students clinically instructed in DEUs. Findings will be of interest to education and practice leaders seeking to enhance the quality of clinical teaching, learning, and nursing practice.

Enhancing diversity in nursing: a partnership approach.

Recent census data highlight the ongoing shift toward greater levels of racial and ethnic diversity in the US population. In 2000, non-Hispanic whites accounted for 69% of the population. By 2010, this decreased to 64%. The Census Bureau predicts that minorities will become the majority over the upcoming decades. In nursing and other healthcare professions, however, a different picture emerges, with minorities consistently underrepresented. The authors describe the development, outcomes, and benefits of the clinical leadership collaborative for diversity in nursing. Strategies for overcoming barriers to increasing diversity in the nursing profession are addressed.

Partnering and leadership: core requirements for developing a dedicated education unit.

Preparing new nurses to practice independently and provide safe and effective care has always been a priority for nurse leaders in academe and service but is becoming more of a challenge as patient acuity intensifies and care systems become more complex. Recent reports by the Carnegie Foundation and by the Institute of Medicine and RWJF call for nurse leaders to improve how nurses are prepared and educated by reducing the gap between classroom and clinical teaching and making better use of resources and partnerships available in the community. The development of a dedicated education unit is one strategy to address this gap.

Enhancing quality and safety competency development at the unit level: an initial evaluation of student learning and clinical teaching on dedicated education units.

The need to attend to quality and safety competency development, increase capacity in nursing education programs, address the faculty and nursing shortages, and find new ways to keep step with an ever-changing health care environment has brought forth numerous creative curricular responses and collaborative efforts. To tackle these multiple needs and challenges simultaneously, a new academic-service partnership was created to collaboratively develop an innovative clinical education delivery model. The designed dedicated education unit model not only promoted student learning about quality and safety competencies via unit-based projects but also supported quality improvements in nursing care delivery. Following the initial semester of the model's implementation, a pilot study was conducted. The findings generated the evidence required to take this innovation to the next level. Moreover, the education-practice partnership, which was created to implement the clinical education delivery model, was strengthened as a result of this preliminary evaluation.