Leadership, health systems and policy: Doctoral education and integrated clinical application.

Scientifically rigorous and readily transferable nursing research as a foundation for development of sound local and national policy can be further delivered into the policy arena by PhD prepared nurse leaders. Core curricular elements in the preparation of nurse scientists to advance the profession must therefore include competencies in leadership, health care systems, health economics, and policy. We present a curriculum model from a university in the southern United States that includes both a theoretical and application approach to incorporate a Leadership in Health Care Systems Course and Field Experience.

Bedside shift report: Nurses opinions based on their experiences.

Background: Nurse bedside shift report (BSR) improves satisfaction, quality and safety. Yet, postimplementation adoption rates remain low in hospitals where BSR has been introduced. Further research is needed to understand what content is most appropriate to discuss during BSR and what facilitators are from the clinical nurses' perspective.

Gerontological nursing: Growth, adaptation and change after John A. Hartford Foundation investments.

This article chronicles the John A. Hartford Foundation (JAHF) funded gerontological nursing initiatives 1996-present. These initiatives, in particular BAGNC, were designed to impact the health of older adults through building gerontological nursing capacity by preparing new and retooling current faculty with expert gerontological nursing competencies, preparing new researchers, developing a knowledgeable nurse workforce with competency in gerontological nursing and prepare leaders in academics and health care systems.

Evaluating the Use of Mobile Health Technology in Older Adults With Heart Failure: Mixed-Methods Study.

Background: Heart failure (HF) is associated with high rates of hospitalizations, morbidity, mortality, and costs. Remote patient monitoring (mobile health, mHealth) shows promise in improving self-care and HF management, thus increasing quality of care while reducing hospitalizations and costs; however, limited information exists regarding perceptions of older adults with HF about mHealth use.

Objective: This study aimed to compare perspectives of older adults with HF who were randomized to either (1) mHealth equipment connected to a 24-hour call center, (2) digital home equipment, or (3) standard care, with regard to ease and satisfaction with equipment, provider communication and engagement, and ability to self-monitor and manage their disease.

Using Virtual Site Visits in the Clinical Evaluation of Nurse Practitioner Students: Student and Faculty Perspectives.

Background: The use of telehealth technology to conduct virtual site visits is an innovative strategy for evaluating the performance of nurse practitioner (NP) students in remote settings. Although there is an abundance of studies on telehealth for the remote monitoring and assessment of patients, there are limited data on its use for evaluating NP students during clinical learning experiences.

Purpose: The purpose of this project was to understand the perspectives of NP students and faculty on the feasibility of using virtual site visits to evaluate the students' performance during clinical experiences.

Psychometric Properties of the Authentic Leadership Inventory in the Nursing Profession.

Background And Purpose: A valid and reliable Authentic Leadership (AL) measurement instrument is paramount as nursing leadership research grows. The purpose of this study was to analyze the reliability and construct validity of the Authentic Leadership Inventory (ALI) among nurses.

Methods: This study was a cross-sectional, prospective design that explored the relationship between registered nurses' (RNs) perceptions of AL qualities in nurse managers in a random sample of RNs working in an acute care setting.

Older Adults' Live Demonstration of Electronic Personal Health Record Use: Factors Mediating Initial Proficiency.

Adoption of electronic personal health records by older adults offers multiple advantages to healthcare and is being encouraged by federal agencies and health associations. However, obstacles have limited older adults' rates of adoption to approximately 10%. This study examined the initial proficiency of older adults at entering 21 standard health elements into an electronic personal health record.

Nursing perception of risk in common nursing practice situations.

As health care organizations seek to be highly reliable, systems that include layers of redundancy have been created to protect patients from harm. Many of these layers of protection are dependent on nurses making a decision to follow or adhere to the human aspects of the process. Because these decisions begin with a perception and identification of risk, understanding what nurses perceive to be a risk to patients is an essential part of designing safer health care systems.

Absenteeism due to Functional Limitations Caused by Seven Common Chronic Diseases in US Workers.

Objective: The study examined the relationship between functional limitation due to chronic diseases and absenteeism among full-time workers. The studied chronic diseases include arthritis/rheumatism, cancer, diabetes, heart disease, hypertension, lung disease, and stroke.

Methods: We analyzed data from the 2011 to 2013 National Health Interview Survey.

Gerontological nursing leadership in the Advancing Excellence Campaign: moving interdisciplinary collaboration forward.

Nursing was not a part of the coalition of multiple nursing home stakeholders at the roll out of the Advancing Excellence Campaign (AEC). In January 2007, several nurse organizations proactively approached the AEC leadership, were welcomed and immediately began to volunteer for leadership positions such as committee chairs and conference coordinators. This paper presents an exemplar of how a proactive stance, even when not initially included, allowed nurses to secure chairs at the decision making table of this quality campaign and contribute to improved resident outcomes.

Building a state coalition for nursing home excellence.

Purpose Of The Study: This article describes the successful evolution of a state coalition for nursing home excellence that brought together organizations that had once worked in silos to improve the quality of care through the implementation of culture change for Arkansas' 240 nursing homes with 27,700 residents.

Design And Methods: The Coalition was established in 2004 when stakeholders were invited to participate in a retreat to explore how they could come together with a common goal to improve the care of older Arkansans. These stakeholders were encouraged to bring their organization's perspectives to the Coalition and determine ways to work with others.

Early exposure to geriatric nursing through an externship program.

The Summer Geriatric Extern Program was developed in 2004 to provide nursing students between the junior and senior year an opportunity to learn more about careers in geriatric nursing.This full-time, eight-week commitment provides students with a stipend and a faculty mentor in their area of interest. Of the 24 externs since the inception of the program, seven have enrolled in graduate programs.

Aging issues: nursing imperatives for healthcare reform.

The people of the United States sent a clear message in November 2008 that they wanted a change in the nation's priorities, including healthcare. The question is whether healthcare reform will extend to the care of older adults, especially in the face of complex needs in the last years of their lives. This article addresses this question by examining the demographics of the older adult population, the eldercare workforce, and the current inadequate patchwork of financing.

Senior health clinics: are they financially viable?

Are hospital-based outpatient interdisciplinary clinics a financially viable alternative for caring for our burgeoning population of older adults in America? Although highly popular, with high patient satisfaction rates among older adults and their families, senior health clinics (SHCs) can be expensive to operate, with limited quantifiable health outcomes. This study analyzed three geriatric hospital-based interdisciplinary clinics in rural Arkansas by examining their patient profiles, revenues, and expenses. It closely examined the effects of the downstream revenue using the multiplier effect and acknowledged other factors that weigh heavily on the success of SHCs and the care of older adults.

The Arkansas aging initiative: an innovative approach for addressing the health of older rural Arkansans.

The Donald W. Reynolds Institute on Aging at the University of Arkansas for Medical Sciences in Little Rock is addressing one of the most pressing policy issues facing the United States: how to care for the burgeoning number of older adults. In 2001, the Institute created the Arkansas Aging Initiative, which established seven satellite centers on aging across the state using $1.

A method for analyzing the financial viability of a rural provider-based geriatric clinic.

Little is known about the financial impact of rural provider-based geriatric outpatient clinics on their parent hospitals since the implementation of the outpatient prospective payment system. In this study, systems theory was used to develop a methodology for determining the financial viability of one such clinic in a rural hospital using data commonly found in rural hospital financial systems. Formulas were developed to identify the overall financial viability and a case-study model was utilized to test the formulas; however, this hospital did not track a key data element, resulting in an incomplete analysis.

Needs assessment of rural communities: a focus on older adults.

High-quality community needs assessments can help focus limited resources on the needs of a rapidly expanding population-older Americans. Based on such assessments, organizations and communities can effectively plan and deliver cost-effective, appropriate health promotion/wellness programs and health/social services to targeted populations. This article, which describes the Arkansas Aging Initiative's (AAI) use of a community needs assessment to identify its constituents' top health needs, provides specific background information for communities with demographics similar to those in Arkansas and offers assessment strategies for communities throughout the US.