Oceanic realistic application of a microplastic biofouling model to the river discharge case.

Marine biofouling is considered one of the major biophysical processes influencing the vertical dynamics of plastic debris in seawater. We numerically implement, for the first time, this mechanism within a fine-resolution, regional model of the Tyrrhenian Sea, in order to simulate the dispersion of microplastics (MPs) released at the mouth of a highly polluting river. Four polymers and three particle sizes are used to quantify algal concentration influence on the trajectories, fates, and accumulation spots of the tracked MPs, by comparing 2002 winter and summer runs encompassing or not biofouling.

High-resolution hydrodynamics and TS structure database of the Brazilian continental shelf and adjacent waters.

This data set was obtained from two ROMS model simulations in the region of Brazil located at 60°W-15°W / 25°S - 15°N. One of the simulations takes into account the tide (obtained from the TPXO7 product) and the other one does not. The rest of the configuration was similar for both simulations, taking bathymetry from ETOPO2 and surface forcings from COADS climatology.

Blue and white light emission from zinc oxide nanoforests.

Blue and white light emission is observed when high voltage stress is applied using micrometer-separated tungsten probes across a nanoforest formed of ZnO nanorods. The optical spectrum of the emitted light consistently shows three fine peaks with very high amplitude in the 465-485 nm (blue) range, corresponding to atomic transitions of zinc. Additional peaks with smaller amplitudes in the 330-650 nm range and broad spectrum white light is observed depending on the excitation conditions.

Achieving succession planning and implementation: one healthcare network's story.

Frequent transitions in leadership can cause inefficiency, inconsistency, and lack of alignment with priorities and strategy. Retaining management talent and collaboratively planning their succession can help ensure organizational survival. Succession planning, in healthcare and other industries, addresses some of these concerns; however, there is a dearth of descriptive articles emphasizing "how to.

Friends of nursing: a community of caring to promote excellence in nursing practice, education, and research.

More than 25 years ago, the name "Friends of Nursing" was adopted by an academic, community Magnet(®) hospital to signify a model for community support of nursing. From inception, the intent was to recruit philanthropic dollars to promote recognition of and excellence in nursing practice, education, and research. Although philanthropy in health care settings is common, what is unique about this program is the long-standing, dedicated conceptual framework for nursing philanthropy and the very significant number of philanthropic dollars from literally thousands of donors to support a diverse range of activities to affect and advance the professional excellence of nurses and the quality of patient care.

Development of a reliable and valid organization-specific professional practice assessment tool.

Purpose: This article describes a study to devise an organization-specific professional practice model (PPM) assessment that reflects actual unit involvement. A secondary study goal is the development of a unit-based index that can be used to conduct comparative analyses in an efficient way.

Design: Each of the 5 elements of the organization's PPM was represented by 1 or more items on an author-developed instrument.

Complex adaptive strategy to produce capacity-driven financial improvement.

Managing capacity in hospitals and emergency departments (EDs) is a global problem. This article demonstrates an efficiency model applied to an acute care hospital facing a budget shortfall as a result of capacity constraints that negatively affected admissions and increased ED diversions. Operating on the hypothesis that reducing inpatient length of stay would allow patients access through all service points and would return the admissions growth rate to budget, a turnaround team was quickly assembled and charged by the chief executive officer to fix the primary cause of financial underperformance--the creeping length of stay--within 60 days.

Becoming a leader in patient satisfaction: changing the culture of care in an academic community hospital.

In the context of the current health care payer system, quality of care standards, financial incentives and consumer choice are not well aligned, yet competition for increased admissions has become a matter of survival. Satisfaction and loyalty are two constructs that are the most meaningful measures in the context of sustaining and increasing admissions. Lehigh Valley Hospital and Health Network (LVHHN) launched an ambitious patient satisfaction improvement initiative in 2001.

Growing organizational capacity through a systems approach: one health network's experience.

Background: Hospitals are reporting unexpected surges in demand for services. Lehigh Valley Hospital challenged its clinical and administrative staff to increase capacity by at least 4% per year using an interdepartmental, systemwide initiative, Growing Organizational Capacity (GOC).

Methods: Following a systemwide leadership retreat that yielded more than 1,000 ideas, the initiative's principal sponsor convened a cross-functional improvement team.

Developing clinical leadership capability.

Nursing facilities must be committed to ongoing leadership development and to developing and retaining their staff in the increasingly competitive healthcare market. In this article, the authors share the processes involved in creating a focused small group approach to developing clinical leaders. Programmatic approaches to development, clarity of needs of those targeted for development, individual development plans, external expertise partnerships, and small group session dynamics are discussed.

Nonpunitive medication error reporting: 3-year findings from one hospital's Primum Non Nocere initiative.

Objective: To identify underlying practices and attitudes on medication error occurrences and reporting practices.

Background: In response to a hospital-wide quality improvement initiative, a task force was formed to facilitate a nonpunitive culture toward reporting medication errors. To identify underlying practices and attitudes on medication errors and medication error reporting, a baseline survey was conducted.

Lehigh Valley Hospital: engaging patients and families.

Background: Lehigh Valley Hospital (LVH), a 623-bed tertiary care referral center, is one of two hospitals of the Lehigh Valley Hospital and Health Network.

Patient And Family Involvement: Improving patient safety requires active engagement. Many units have collaborative rounds, which family members may join.

Use of a validated model to evaluate the impact of the work environment on outcomes at a magnet hospital.

Using a structural model, we evaluated the impact of leadership, staff stability, resources, workload, work environment, and staff expertise on nurse-sensitive patient outcomes to determine elements that can be modified.

The effects of mindfulness-based stress reduction on nurse stress and burnout: a qualitative and quantitative study, part III.

Part III of the study on mindfulness-based stress reduction (MBSR) describes qualitative data and discusses the implications of the findings. Study analysis revealed that nurses found MBSR helpful. Greater relaxation and self-care and improvement in work and family relationships were among reported benefits.

The effects of mindfulness-based stress reduction on nurse stress and burnout, Part II: A quantitative and qualitative study.

This article is the second in a series reporting on research exploring the effects of Mindfulness-based Stress Reduction on nurses and describes the quantitative data. The third article describes qualitative data. Treatment group participants reduced scores on 2 of 3 subscales of the Maslach Burnout Inventory significantly more than wait-list controls; within-group comparisons for both groups pretreatment and posttreatment revealed similar findings.

The effects of mindfulness-based stress reduction on nurse stress and burnout: a quantitative and qualitative study.

Mindfulness-based Stress Reduction, a stress-reduction program, has increasing empirical support as a patient-care intervention. Its emphasis on self-care, compassion, and healing makes it relevant as an intervention for helping nurses manage stress and reduce burnout. This article describes the implementation of Mindfulness-based Stress Reduction in a hospital system as a way to lower burnout and improve well-being among nurses, using both quantitative and qualitative data.

Work flow analysis: eliminating non-value-added work.

Objective: To evaluate the impact of implemented work environment changes on nursing and support staff roles.

Background: In 1999, the authors identified key drivers of unnecessary work associated with the day-to-day delivery of patient care in their institution and implemented changes based on their results.

Methods: Both quantitative and qualitative methods were used.

First do no harm: integrating patient safety and quality improvement.

Background: Lehigh Valley Hospital's (LVH's; Allentown, Penn) interdisciplinary quality improvement program Primum Non Nocere (PNN), or First Do No Harm, is composed of 12 quality improvement (QI) projects that are a combination of ongoing operations improvement projects and new projects in patient safety. The projects stress delivery of cost-effective medical care while reducing preventable adverse events through improved communication, process redesign, and evidence-based protocol use.

Example: WRONG-SITE SURGERY: In response to an initial alert warning in 1998, LVH developed a policy of marking "yes" on the surgical site and "no" on the other side.

A benchmark project to improve cost and quality outcomes for CABG patients.

Today's health care environment is forcing health care providers to find ways to provide more effective and efficient care. This article describes a collaborative benchmark project that examined acute care for coronary artery bypass graft surgery patients and reduced costs and improved patient outcomes.