Collaborative Partnerships: Raising the Professional Practice of Nursing.

The journey to Magnet® provides the ideal platform to demonstrate the impact of nursing and how strong interprofessional partnerships advance care and problem solving in an increasingly complex healthcare arena. Nurses in Magnet organizations use collaborative partnerships to forge innovative solutions, improve nursing care across the continuum, advance health in populations, effect desired change, and improve outcomes.

Strategies for establishing an endowed chair in a service setting.

To advance care for patients and families requires that providers and administrators in clinical settings place a high priority on the scientific domain of nursing. New knowledge intended to benefit nursing care is most effectively and efficiently achieved when a vibrant and well-supported nursing research program is embedded within a health care system. An endowed chair in nursing research is an esteemed strategy acknowledging the contributions of nursing science, providing credibility to a researcher and research programs, and demonstrating commitment to the infrastructure for nursing research. Organizational readiness through leadership; systems thinking; relationship development; and knowledge of the dynamics, process, and expectations of philanthropy are essential to establishing an endowed chair. Philanthropic endeavors can be used to strategically develop a high-impact campaign that resonates across public and private sectors to secure funding to solidify and advance nursing research. By actively engaging stakeholders including system leaders, frontline nurses, and other care providers and development leaders, a successful campaign can establish and sustain an endowed chair in nursing research. This article describes the stakeholders, processes, structure, and outcomes for the first endowed chair in nursing research at Children's National Health System in Washington, DC.

Financial literacy as an essential element in nursing management practice.

Grooming nurses at all levels of the organization to master health care executive skills is critical to the organization's success and the individual's growth. Selecting and executing next steps for nursing leadership team development is critical to success. Leaders must make it their responsibility to provide nurses with increased exposure to quality, safety, and financial data, thereby allowing nurses to translate data while achieving and sustaining successful outcomes. The work of the CNO Dashboard to measure, report, trend, and translate clinical and non-clinical outcomes must be integrated throughout all levels of nursing staff so that nursing practice is positioned to continually strive for best practice. The education and evolution of nurses as business managers is critical to building a strong RN workforce.

Cardiopulmonary monitors and clinically significant events in critically ill children.

Cardiopulmonary monitors (CPMs) generate false alarm rates ranging from 85%-99% with few of these alarms actually representing serious clinical events. The overabundance of clinically insignificant alarms in hospitals desensitizes the clinician to true-positive alarms and poses significant safety issues. In this IRB-approved externally funded study, we sought to assess the clinical conditions associated with true and false-positive CPM alarms and attempted to define optimal alarm parameters that would reduce false-positive alarm rates (as they relate to clinically significant events) and thus improve overall CPM performance in critically ill children. Prior to the study, clinically significant events (CSEs) were defined and validated. Over a seven-month period in 2009, critically ill children underwent evaluation of CSEs while connected to a CPM. Comparative CPM and CSE data were analyzed with an aim to estimate sensitivity, specificity, and positive and negative predictive values for CSEs. CPM and CSE data were evaluated in 98 critically ill children. Overall, 2,245 high priority alarms were recorded with 68 CSEs noted in 45 observational days. During the course of the study, the team developed a firm understanding of CPM functionality, including the pitfalls associated with aggregation and analysis of CPM alarm data. The inability to capture all levels of CPM alarms represented a significant study challenge. Selective CPM data can be easily queried with standard reporting, however the default settings with this reporting exclude critical information necessary in compiling a coherent study denominator database. Although the association between CPM alarms and CSEs could not be comprehensively evaluated, preliminary analysis reflected poor CPM alarm specificity. This study provided the necessary considerations for the proper design of a future study that improves the positive predictive value of CPM alarms. In addition, this investigation has resulted in improved awareness of CPM alarm parameter settings and associated false-positive alarms. This information has been incorporated into nursing educational programs.