Assessment of Nurse Educator Leadership: Instrument Development and Psychometric Analysis.

AIM: Study purposes were to 1) establish the relevance and clarity of a new instrument, the Leadership in Nursing Education (LNE©) for nurse educators, and 2) provide evidence to support the reliability and validity of the LNE. BACKGROUND: The future of nursing education is dependent upon the leadership of nurse faculty. Competency development requires self-assessment to engage in meaningful pathways for leadership development. METHOD: A Delphi study was conducted with 50 nurse faculty leaders to determine the content validity of the LNE. The final instrument was then sent to nurse faculty across the United States to assess its psychometric properties. RESULTS: The LNE was determined to be a reliable instrument for the population tested. Three distinct subscales emerged from the exploratory factor analysis: strategic, relational, and authentic. CONCLUSION: The LNE fills a gap in nurse educator leadership assessment and provides evidence to support the instrument's reliability and validity.

Cognitive and Noncognitive Factors Influencing Nursing Students' Academic Success: Structural Equation Model Analysis.

AIM: The study aim was to identify and explore relationships among cognitive and noncognitive factors that may contribute to prelicensure baccalaureate nursing students' academic success across their program of study. BACKGROUND: Nurse educators are challenged to improve students' academic success. With limited evidence, cognitive and noncognitive factors have been identified in the literature as potential factors that influence academic success and may support students' readiness for practice as new graduate nurses. METHOD: Data sets from 1,937 BSN students at multiple campuses were analyzed using an exploratory design and structural equation modeling. CONCLUSION: Six factors were conceptualized as contributing equally to the initial cognitive model. The final noncognitive model, with deletion of two factors, yielded the best fit for the four-factor model. Cognitive and noncognitive factors were not significantly correlated. This study provides a beginning understanding of cognitive and noncognitive factors associated with academic success that may support readiness for practice.

Feasibility and efficacy of integrating resiliency training into a pilot nurse residency program.

The high stress associated with the nursing profession can negatively affect the health of nurses and the quality of patient care that they provide. This quasi-experimental study aimed to 1) assess the feasibility of integrating a Stress Management and Resiliency Training (SMART) program within a nine-month pilot nurse residency program and 2) assess the effects of the program on participants' stress, anxiety, mindfulness, and resilience relative to a comparison group. A pre- and post-intervention survey design was used, with measurements taken at baseline and at 1, 3, 9, and 12 months after baseline. We enrolled 51 registered nurses (intervention group, n = 23; comparison group, n = 28) at a Midwestern US academic medical center. Nurses in the intervention group had a participation rate of 93%-100% with SMART program events. Despite the relatively limited adherence to the protocol by intervention group participants, significant improvements were noted for stress (P < .001), mindfulness (P < .001), and resilience (P < .001) in the intervention group compared with the comparison group. The SMART program can potentially be successfully integrated into a nurse residency program and positively impact nurse stress, mindfulness, and resilience. Further research is needed to determine the proper dose of the intervention and methods to enhance adherence.

Stress Management and Resiliency Training in a Nurse Residency Program: Findings From Participant Focus Groups.

Stress is a well-recognized phenomenon in the nursing profession, particularly for new nurses. This study (a) assessed nurse residents' experience with a stress management program and (b) informed adjustments to the program. Analysis of qualitative data revealed three themes: (a) enhanced personal and professional development, (b) sensitivity to learner needs, and (c) fostering the principles of mindfulness. A stress management program has the potential to positively enhance the new nurse's transition to work.

Conducting Replication Studies With Confidence.

Although essential to the development of a robust evidence base for nurse educators, the concepts of replication and reproducibility have received little attention in the nursing education literature. In this Methodology Corner installment, the concepts of study replication and reproducibility are explored in depth. In designing, conducting, and documenting the findings of studies in nursing education, researchers are encouraged to make design choices that improve study replicability and reproducibility of study findings. [J Nurs Educ. 2018;57(11):638-640.].

Perspectives of Nurses, Nurse Leaders, and Women Regarding Anticipatory Rounds in the Postpartum Period.

OBJECTIVE: To obtain the perspectives of staff nurses, nurse leaders, and women with regard to the relevance and timing of nursing interactions during anticipatory rounds in the postpartum period. DESIGN: A qualitative descriptive design using focus groups. SETTING: A hospital with 405 beds that serves a Midwestern U.S. community of approximately 256,000 people. PARTICIPANTS: A purposive sample of 12 staff nurses, 6 nurse leaders, and 15 women attended a total of 10 focus groups. METHODS: We conducted 10 semistructured focus groups: 6 with staff nurses, 1 with nurse leaders, and 3 with women. Each participant attended one focus group. Sessions were recorded and transcribed. Investigators independently coded transcripts and identified themes collectively. RESULTS: Participants identified one overarching theme, Taking the Whole Picture Into Account, and five subthemes that were reflective of relevant nursing interactions: Help With Newborn Feeding, Managing Patient Comfort, Appreciating the Need for Safety, Being There, and Knowing Ahead of Time. Participants agreed that conducting rounds once every 2 to 3 hours was the most appropriate time frame. CONCLUSION: Participants identified important nursing interactions and their timing. Moreover, anticipatory rounding for women after birth includes more than completion of simple tasks or checklists. These findings indicate beginning evidence for what should occur during anticipatory rounds on the mother-baby unit. Timing of rounds can be flexible based on each woman's unique needs, thus reinforcing patient-centered care. However, interactions and timing should take place only when the whole picture is taken into account.

Association of the Nurse Work Environment, Collective Efficacy, and Missed Care.

Missed nursing care is a significant threat to quality patient care. Promoting collective efficacy within nurse work environments could decrease missed care. The purpose was to understand how missed care is associated with nurse work environments and collective efficacy of hospital staff nurses. A cross-sectional, convenience sample was obtained through online surveys from registered nurses working at five southwestern U.S. hospitals. Descriptive, correlational, regression, and path analyses were conducted ( N = 233). The percentage of nurses who reported that at least one care activity was missed frequently or always was 94%. Mouth care (36.0% of nurses) and ambulation (35.3%) were missed frequently or always. Nurse work environments and collective efficacy were moderately, positively correlated. Nurse work environments and collective efficacy were associated with less missed care (χ2 = 10.714, p = .0054). Fostering collective efficacy in the nurse work environment could reduce missed care and improve patient outcomes.

Association of the nurse work environment with nurse incivility in hospitals.

AIM: To determine whether nurse coworker incivility is associated with the nurse work environment, defined as organisational characteristics that promote nurse autonomy. BACKGROUND: Workplace incivility can negatively affect nurses, hospitals and patients. Plentiful evidence documents that nurses working in better nurse work environments have improved job and health outcomes. There is minimal knowledge about how nurse coworker incivility relates to the United States nurse work environment. METHODS: Quantitative, cross-sectional. Data were collected through online surveys of registered nurses in a southwestern United States health system. The survey content included the National Quality Forum-endorsed Practice Environment Scale of the Nursing Work Index and the Workplace Incivility Scale. Data analyses were descriptive and correlational. RESULTS: Mean levels of incivility were low in this sample of 233 staff nurses. Incivility occurred 'sporadically' (mean = 0.58; range 0.00-5.29). The nurse work environment was rated highly (mean = 3.10; range of 1.00-4.00). The nurse work environment was significantly inversely associated with coworker incivility. The nurse manager qualities were the principal factor of the nurse work environment associated with incivility. CONCLUSIONS: Supportive nurse managers reduce coworker incivility. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers can shape nurse work environments to prevent nurse incivility.