Health equity: A concept analysis.

BACKGROUND: Although health equity is critically important for healthcare delivery, there are inconsistencies in its definitions or lack of definitions. PURPOSE: Develop a comprehensive understanding of health equity to guide nursing practice and healthcare policy. METHOD: Walker and Avant's concept analysis method was used to establish defining attributes, antecedents, consequences, and empirical referents of health equity. FINDINGS: Health equity defining attributes are grounded in ethical principles, the absence of unfair and avoidable differences, and fair and just opportunities to attain a person's full health potential. Health equity antecedents are categorized into environmental; financial or economic; law, politics, and policy; societal and structural; research; and digital and technology. DISCUSSION: Health equity's antecedents are useful to distinguish health disparities from health outcomes resulting from individual preferences. To achieve health equity, organizations need to focus on addressing the antecedents.

Relationship Between Burnout and Professional Behaviors and Beliefs Among US Nurses.

OBJECTIVE: To evaluate the relationship between burnout and professional behaviors and beliefs among US nurses. METHODS: We used data from 2256 nurses who completed a survey that included the Maslach Burnout Inventory and items exploring their professional conduct (documented something they had not done so they could "close out" an encounter in the EHR or part of the assessment not completed, requested continuing education credit for an activity not attended) and beliefs about reporting impaired colleagues. RESULTS: On multivariable analysis, burnout was independently associated with higher odds of reporting 1 or more unprofessional behaviors in the last year and not believing nurses have a duty to report impairment among colleagues due to substance use or mental health problems. CONCLUSIONS: Occupational burnout is associated with self-reported unprofessional behaviors and less favorable beliefs about reporting impaired colleagues among nurses.

Original Research: An Investigation of Career Choice Regret Among American Nurses.

PURPOSE: To explore whether burnout is an independent predictor of career choice regret among nurses. METHODS: In November 2017 we invited a random sample of 89,995 members of the American Nurses Association to participate in an anonymous online survey. The survey collected demographic and professional information and included the Maslach Burnout Inventory-Human Services Survey for Medical Personnel (known as the MBI-HSS [MP]), as well as several items exploring career choice regret. Of the 86,858 nurses who received the e-mail invitation, 8,638 (9.9%) responded. Multivariable logistic regression analysis was conducted for the final sample of 6,933 nurses who provided complete responses to the MBI-HSS (MP) and the career choice regret survey items. RESULTS: Fifteen percent of the 6,933 participating nurses had career choice regret. On multivariable analysis, experiencing burnout, working unplanned or mandatory overtime, being male, and having a higher academic degree related to nursing were independent predictors of career choice regret. Burnout was the strongest such predictor. CONCLUSION: Career choice regret among U.S. nurses is relatively common. Of the independent predictors this study identified, burnout had the strongest relationship with career choice regret. Organizational strategies aimed at reducing burnout and supporting nurses' ongoing professional development should be pursued.

Burnout and Satisfaction With Work-Life Integration Among Nurses.

OBJECTIVES: To evaluate characteristics associated with burnout and satisfaction with work-life integration (WLI) among nurses and compare their experience to other American workers. METHODS: We used data from 8638 nurses and 5198 workers to evaluate factors associated with burnout and satisfaction with WLI, and compare nurses to workers in other fields. RESULTS: In the multivariable analysis, demographics, work hours, and highest academic degree obtained related to nursing were independent predictors of burnout. Factors independently associated with satisfaction with WLI included work hours. In pooled multivariable analyses including nurses and other workers, nurses were not more likely to have symptoms of burnout but were more likely to have lower satisfaction with WLI. CONCLUSIONS: Work hours and professional development related to the risk of burnout among nurses. Nurses are at similar risk for burnout relative to other US workers but experience greater struggles with WLI.

Building a nursing research fellowship in a community hospital.

Often, registered nurses feel that they are using "evidence" to guide practice, but in reality the sources of evidence are not based on research. The nursing leadership team at Northwest Community Hospital was committed to integrating evidence-based practice and nursing research into the clinical setting for RNs at all levels of the organization. The scope of the fellowship program enabled direct care RNs to receive protected release time for a 12-month period to develop a research proposal, implement the study, and disseminate the findings. The Nursing Research Fellowship Program was successful from the perspective of the Magnet appraisers who recognized the program as a Magnet exemplar, the chief executive officer, the CNE, members of the nursing leadership team, professional colleagues, the fellows and partners, and registered nurses at all levels in the organization. Nursing research is now part of the professional nursing culture.