Changing nursing practice: letting go of the nursing history on admission.

In this project, 2 performance improvement (PI) methodologies were used to evaluate the process of nursing admission and history collection. Nurses have a responsibility to methodically assess bedside care, ensuring that practice changes do not merely add on to an often inefficient workload but add value. This article illustrates the use of PI to modify the initial nursing inpatient admission assessment process.

Negotiating safety when staffing falls short.

Adequate nurse staffing is inextricably linked to patient outcomes and, although optimal staffing levels for inpatient hospital units are widely debated, staffing standards for critical care areas such as intensive care units may be less variable. Even established staffing levels cannot guarantee adequate staffing. The nursing workforce shortage has affected all areas of nursing practice, but perhaps no area more severely than critical care.

Supporting the learning curve for contemporary nursing practice.

Contemporary patient care demands expert nurses with advanced clinical judgment and reasoning abilities. Expertise develops for an extended experiential learning process of 5 years or more and cannot be accomplished through educational preparation alone. Current approaches to orientations, residencies, and care delivery do not support the learning curve to expert practice.

Achieving quality and fiscal outcomes in patient care: the clinical mentor care delivery model.

Contemporary patient care requires sophisticated clinical judgment and reasoning in all nurses. However, the level of development regarding these abilities varies within a staff. Traditional care models lack the structure and process to close the expertise gap creating potential patient safety risks.

Mandatory influenza immunization for health care workers--an ethical discussion.

Influenza is a serious vaccine-preventable disease affecting 20% of the U.S. population each year.