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The GRACE program was feasible and acceptable to deliver, and initial proof-of-concept evidence was supported.For more than 40 years, shared governance has supported structural empowerment and engaged nurses in their practice. Although progress has been made in advancing nursing ownership of practice through shared governance, mature nursing autonomy has yet to be achieved. It is time to evolve to professional governance, emphasizing accountability, professional obligation, collateral relationships, and decision making. Nurse leaders are provided with historical context and recommendations for effectively leading professional governance in an empowering work culture.
The aim of this study was to examine the factors influencing job satisfaction of nurses, physicians, and advanced practice providers in ambulatory oncology settings.
Job satisfaction is essential to clinician well-being and quality of care.
In 2017, clinicians from 29 ambulatory medical oncology practices completed anonymous paper questionnaires that examined job satisfaction, clinician-to-clinician communication, and perceptions of patient safety. Linear regression, adjusted for clustered observations, examined the relationship between job satisfaction, clinician communication, and patient safety perceptions.
Of 280 respondents (response rate of 68%), 85% reported that they were satisfied or very satisfied with their current position. Patient safety and accuracy of clinician communication were positively and significantly associated with job satisfaction.
Although most surveyed clinicians were satisfied, 15% were dissatisfied and reported communication and safety concerns. Leadership efforts to strengthen clinician communication actions and develop positive safety cultures are promising strategies to promote clinician well-being and high-quality cancer care.
Although most surveyed clinicians were satisfied, 15% were dissatisfied and reported communication and safety concerns. Leadership efforts to strengthen clinician communication actions and develop positive safety cultures are promising strategies to promote clinician well-being and high-quality cancer care.
Objectives were to evaluate patient perceptions of a nurse-led, patient-centered gratitude intervention and if nurses identified actionable items to improve patient's hospitalization experience.
Research demonstrates positive effects of gratitude and caring interventions on patient health and well-being. Evidence is sparse regarding nurse-led gratitude interventions improving hospitalized patient's experiences.
In this pilot study, 91 adult medical patients completed gratitude forms twice daily for up to 6 shifts and a study discharge form documenting intervention perceptions. In response to the patients' gratitude-related feedback, RNs recorded patient experience-related actions they and interprofessional teams could implement.
On average, patients perceived the nurse-led gratitude intervention as helpful (4.2) (1 = very unhelpful, 5 = very helpful) and improved hospitalization experiences (4.3) (1 = seldom, 5 = never). Most of the time actions were required or to be taken, based on patient gratitude intervention responses.
Patient perceptions of nurse-led gratitude intervention demonstrated helpfulness and improved hospitalization experience.
Patient perceptions of nurse-led gratitude intervention demonstrated helpfulness and improved hospitalization experience.
This pilot study investigated increasing nurse resiliency utilizing a toolkit of stress-reducing interventions on medical-surgical units at 4 hospitals.
Resiliency-building activities are time consuming and undertaken outside work hours. Although the activities show a positive impact on resilience, researchers investigated whether similar results could be achieved where nurses experience work stress.
This quasi-experimental pretest and posttest interventional study used a within-subjects design. Provided toolkits included written instructions to carry out the study. Nurses completed surveys at baseline, at 10 time points over a 6-week period, and at study conclusion.
The Connor-Davidson Resilience Scale-10 scores increased significantly at follow-up (P < .02). find more Self-reported stress levels decreased over the 10 shifts with continued use of the interventions.
Using stress-reducing interventions during work decreased stress and increased resiliency, thereby offering nurse leaders additional options to promote a healthy workforce at the bedside.
Using stress-reducing interventions during work decreased stress and increased resiliency, thereby offering nurse leaders additional options to promote a healthy workforce at the bedside.To meet the growing demands in the US healthcare system caused by multiculturalism and the expansion of health inequities, due diligence must be given to testing the efficacy of tools used in teaching nurses to provide culturally competent care. This project assessed the utility of a free US government-developed training module. The team found an improved trend in nurse-patient communication scores and improved willingness to ask for help with cultural issues for the intervention unit. The use of no-cost, publicly available resources may be a cost-effective option for training materials.This month's column highlights organizational, practice, and patient care advantages to adding advanced practice leaders to health systems' leadership teams and ideal characteristics of effective, executive advanced practice leaders.The COVID-19 pandemic exhausted the nursing workforce, casting doubt that future supply will meet demand. To preserve their workforces, nursing leaders are offering emotional support to the frontline. Although these efforts are essential, leaders are overlooking an untapped opportunity to safeguard staffing levels creating a more flexible nursing workforce. In this article, the authors discuss flexible nurse staffing and suggest 4 key opportunities for improvement.This month's Magnet® Perspectives column examines American Nurses Credentialing Center's Magnet Recognition Program® and Pathway to Excellence® Program as partners for nursing excellence. We explore the differences between the programs, how they complement one another, and how they can be combined to impact a host of key measures, including nurse engagement, interprofessional collaboration, and patient safety. Nursing leaders at 2 dual-designated hospitals share their decision to pursue both credentials and ways in which the combined designation adds value for nurses and the patient care environment. They discuss how the essential elements of a Magnet and Pathway culture contributed to a nimble, innovative response to the COVID-19 pandemic and strategies nursing leaders can employ to create and sustain an environment where change flourishes and nurses thrive.
To examine the effects of unilateral hearing loss on children's ability to perceive familiar words and to learn and retain new words. Because children with unilateral hearing loss receive full auditory input in one ear, their performance was expected to be consistent with that of children with normal hearing rather than that of children with moderate bilateral hearing loss.
Participants were 36 school-age children with normal hearing bilaterally, 11 children with moderate bilateral hearing loss, and 11 children with mild-to-profound unilateral hearing loss (six right and five left). Half of the normally hearing children and two-thirds of the children with unilateral hearing loss were from bilingual Spanish/English-speaking homes. One of the 11 children with bilateral hearing loss was from a bilingual Spanish/English-speaking home. All children completed a word recognition test in English and in Spanish, a word-learning task comprised of nonsense words constructed using the phonotactic rules of English, Spanish, and Arabic, and a next-day word-retention test.
Word recognition did not differ across groups in English or Spanish. Learning and retention of nonsense words was highest for the children with normal hearing in all three languages. The children with unilateral and bilateral losses learned and recalled the English nonsense words as well as their normally hearing peers, but performance for the Spanish and Arabic nonsense words was significantly and similarly reduced by hearing loss in either ear.
Failure to learn and retain new words given a full auditory representation in one ear suggests that children with unilateral and bilateral hearing losses may share a unifying feature of impairment at the level of the central auditory system.
Failure to learn and retain new words given a full auditory representation in one ear suggests that children with unilateral and bilateral hearing losses may share a unifying feature of impairment at the level of the central auditory system.
To evaluate the effects of narrow band CE-Chirp (NB CE-Chirp) on the amplitudes and latencies in ocular vestibular evoked myogenic potentials (oVEMPs) at 500 and 1000 Hz in comparison with tone burst (TB).
Twenty-one healthy volunteers were included in the study and tested in air conduction with a "belly-tendon" montage. Recording conditions were randomized for each participant and each modality was tested twice to check the reproducibility of the procedure.
NB CE-Chirps at 500 Hz revealed larger n1-p1 amplitudes than 500 Hz TBs (p = .001), which were also larger than NB CE-Chirps and TBs at 1000 Hz (p = .022, p < .001, respectively). Besides, n1 and p1 latencies were shorter in NB CE-Chirp than in TB at 500 Hz (p < .001) and 1000 Hz (p < .001). The older the participants, the lower the amplitudes (p = .021, p = .031) and the longer the n1 (p = .030, p = .025) and p1 latencies (p < .001, p < .001) in 500 Hz NB CE-Chirps and 500 Hz TBs. Interaural asymmetry ratios were slightly higher in 5thy participants and patients with vestibular disorders are required to confirm this hypothesis. The large interindividual variability of interaural asymmetry ratios in NB CE-Chirp and in TB at 500 Hz could be explained by the selected montage.
The asenapine transdermal system (HP-3070) is the first antipsychotic patch approved in the United States for treatment of adults with schizophrenia.
Three phase 1, open-label, randomized studies characterized the pharmacokinetic (PK) profile of HP-3070 by assessing its relative bioavailability compared with sublingual asenapine, its single-/multiple-dose PK and dose proportionality, and the effects of application site, ethnicity, and external heat on bioavailability. Two studies were conducted in healthy subjects, and 1 was conducted in adults with schizophrenia.
During single HP-3070 administration, asenapine concentrations increased gradually over approximately 12 hours and remained steady until the patch was removed 24 hours after application. Asenapine area under the curve values at HP-3070 3.8 and 7.6 mg/24 hours doses were similar to those for sublingual asenapine 5 and 10 mg twice-daily doses, respectively, whereas peak exposure (maximum observed plasma concentration) was significantly lower. Du. HP-3070 showed a predictable absorption profile with limited variability, with an area under the curve similar to that of sublingual asenapine. Based on these PK metrics, HP-3070 steadily delivers asenapine with lower peaks and troughs than sublingual administration of asenapine.
