Diving in: Using a "Shark Tank" approach to teach business skills to future DNP leaders.

Doctor of Nursing Practice (DNP) education prepares graduates to lead clinical improvement and innovation across practice settings. Advanced clinical knowledge, leadership skills, and the development of quality/safety competencies uniquely prepare the DNP program graduates to drive organizational change. Adding business and financial competencies to the skill set of DNP graduates strengthens the impact and value of their role on financial, quality, and operational outcomes. The Organizational Systems and Healthcare Financing course in a DNP program was redesigned to engage learners using an innovative approach to teach business and financial principles. This paper aims to (a) describe a novel "Shark Tank" approach whereby students develop and "pitch" their business proposals to a panel of healthcare executives; (b) share examples of impactful change projects by student teams; (c) report DNP course and program evaluations including students' satisfaction and perceptions of value and knowledge gained in business principles; and (d) report opportunities for bidirectional mentorship, faculty recruitment, and succession planning. The success of this innovative team-based approach for teaching business/financial skills better prepares future DNP leaders and has implications for other DNP programs. Using this teaching strategy created opportunities for faculty recruitment, succession planning, and bidirectional mentorship of DNP-prepared nurse leaders.

Using a Nursing Salon to Identify and Develop an Initiative for Family Caregivers of Older Adults.

The purpose of the Aging Well Nursing-Interprofessional Salon was to explore current local community healthcare issues for older adults and to develop innovative strategies that support and enhance their health. An initiative emerged from the salon that focuses on identifying caregivers to ensure their awareness of available support resources. We are in the process of developing a pilot plan that includes collaboration of PhD and doctorate of nursing practice students, nursing faculty, and community agencies that support older adults.

A Newly Licensed Nurse Orientation Program Evaluation: Focus on Outcomes.

The aim of this project was to evaluate the effectiveness and outcomes of a redesigned newly licensed nurse orientation program. A unique aspect of this program was an end-of-orientation simulated four-patient assignment that was designed to assess five categories of critical thinking: prioritization and delegation, problem recognition, clinical decision making, clinical implementation, and reflection. Newly licensed nurses' critical thinking was measured by the Advisory Board's Critical Thinking Diagnostic tool at 10 weeks, 6 months, and 12 months. Findings showed that in all five categories of critical thinking, a significant increase was found between the 10-week and 6-month evaluation. Two of the categories-prioritization and delegation, and problem recognition-were found to have a significant increase from the 6-month evaluation to the 12-month evaluation. In addition, newly licensed nurses reported improvement in their confidence and in their preparation to work independently. J Contin Educ Nurs. 2017;48(1):22-28.

Creativity and connections: the future of nursing education and practice: the Massachusetts Initiative.

Education and practice partnerships are key to effective academic program design and implementation in a time of decreasing supply and increasing demands on the nursing profession. An integrated education/practice competency model can positively impact patient safety, improve patient care, increase retention, and ensure a sufficient and competent nursing workforce, which is paramount to survival of the health care system. Through the contributions of nursing leaders from the broad spectrum of nursing and industry organizations within the state, the Massachusetts Nurse of the Future project developed a competency-based framework for the future design of nursing educational programs to meet current and future practice needs. The Massachusetts Nurse of the Future Nursing Core Competencies(©) expand on the Institute of Medicine's core competencies for all health care professionals and the Quality and Safety Education for Nurses competencies for quality and safety to define the expectations for all professional nurses of the future. The Massachusetts Nurse of the Future Nursing Core Competencies define the knowledge, attitude, and skills required as the minimal expectations for initial nursing practice following completion of a prelicensure professional nursing education program. These competencies are now being integrated into new models for seamless, coordinated nursing curriculum and transition into practice within the state and beyond.

Unraveling care omissions.

Evidence points to the omission of required nursing care as a pervasive problem in acute care hospitals. Labor and material resource constraints, increasing patient complexity, ineffective delegation, and poor communication have been identified as contributing factors. Nurse executives should examine the degree and causes of missed care in their organizations. Action plans should be developed based on identification of issues contributing to this serious concern, thus promoting safe patient care.

Nurses' and nursing assistants' reports of missed care and delegation.

OBJECTIVE: Measure RNs' and nursing assistants' reports of frequency and reasons for missed nursing care and identify factors related to successful delegation. BACKGROUND: Routine nursing tasks were identified as the most commonly occurring omissions. Reasons for omissions included poor utilization of staff resources, time required for the nursing interventions, poor teamwork, ineffective delegation, habit, and denial. METHODS: Quantitative, descriptive design. RESULTS: Widespread reports of missed care included turning, ambulating, feeding, mouth care, and toileting. Frequently reported reasons were unexpected increase in volume or acuity, heavy admission or discharge activity, and inadequate support staff. Factors affecting successful delegation were communication and relationship, nursing assistant competence and knowledge, and attitude and workload. CONCLUSION: Nurse leaders must focus on implementing strategies to mitigate factors and the consequences of care omissions, including poor patient outcomes. An analysis of point-of-care delivery system failures and ineffective processes is essential.

Critical thinking, delegation, and missed care in nursing practice.

OBJECTIVE: The aim of this study was to understand how nurses use critical thinking to delegate nursing care. BACKGROUND: Nurses must synthesize large amounts of information and think through complex and often emergent clinical situations when making critical decisions about patient care, including delegation. METHOD: A qualitative, descriptive study was used in this article. FINDINGS: Before delegating, nurses reported considering patient condition, competency, experience, and workload of unlicensed assistive personnel (UAP). Nurses expected UAP to report significant findings and have higher level knowledge, including assessment and prioritizing skills. Successful delegation was dependent on the relationship between the RN and the UAP, communication, system support, and nursing leadership. Nurses reported frequent instances of missed or omitted routine care. CONCLUSION: Findings from this project provide insight into factors that influence delegation effectiveness. These can guide CNOs and frontline nurse leaders to focus on implementing strategies to mitigate the consequence of missed care. Ineffective delegation of basic nursing care can result in poor patient outcomes, potentially impacting quality measures, satisfaction, and reimbursement for the institution.