"Where You Feel Like a Family Instead of Co-workers": a Mixed Methods Study on Care Teams and Burnout.

Background: Physicians and nurses face high levels of burnout. The role of care teams may be protective against burnout and provide a potential target for future interventions.

Objective: To explore levels of burnout among physicians and nurses and differences in burnout between physicians and nurses, to understand physician and nurse perspectives of their healthcare teams, and to explore the association of the role of care teams and burnout.

A scoping review of new implementations of interprofessional bedside rounding models to improve teamwork, care, and outcomes in hospitals.

Poor communication within healthcare teams occurs commonly, contributing to inefficiency, medical errors, conflict, and other adverse outcomes. Interprofessional bedside rounds (IBR) are a promising model that brings two or more health professions together with patients and families as part of a consistent, team-based routine to share information and collaboratively arrive at a daily plan of care. The purpose of this systematic scoping review was to investigate the breadth and quality of IBR literature to identify and describe gaps and opportunities for future research.

Leadership Principles to Decrease Psychological Casualties in COVID-19 and Other Disasters of Uncertainty.

Coronavirus disease (COVID-19) is a "disaster of uncertainty" with ambiguity about its nature and trajectory. These features amplify its psychological toxicity and increase the number of psychological casualties it inflicts. Uncertainty was fueled by lack of knowledge about the lethality of a disaster, its duration, and ambiguity in messaging from leaders and health care authorities.

Development and Evaluation of a Nurse Leadership Succession Planning Strategy in an Academic Medical Center.

Absence of nurse manager succession planning in an academic medical center necessitated a quality improvement project to identify, select, and enroll emerging leaders into a development program. The authors used organizational competencies and an evidence-based approach to effectively identify barriers, select future nurse leaders, and discover opportunities for process improvement.

Triggers Contributing to Health Care Clinicians' Disruptive Behaviors.

Objectives: This study's objective was to explore the possible triggers of clinicians' disruptive behavior and to consider whether the type of trigger resulting in disruptive behavior differed by type of clinician, clinician characteristics, professional role, and ethnic background.

Methods: Using data collected from 1559 clinicians working at an urban academic medical center in the United States, we examined intrapersonal, interpersonal, and organizational triggers. In addition, we measured 3 subscales of disruptive behavior including incivility, psychological aggression, and violence.

Do Clinician Disruptive Behaviors Make an Unsafe Environment for Patients?

The magnitude of negative consequences of clinician disruptive behaviors on patients and clinicians was examined using data collected from 1559 clinicians working at an urban academic medical center in the United States. For the impact of disruptive behavior on patient safety, psychological aggression as caused by disruptive behavior or incivility increased the likelihood of patient harm as well as job dissatisfaction and physical symptoms.

Heavy Metal Ion Regulation of Gene Expression: MECHANISMS BY WHICH LEAD INHIBITS OSTEOBLASTIC BONE-FORMING ACTIVITY THROUGH MODULATION OF THE Wnt/β-CATENIN SIGNALING PATHWAY.

Exposure to lead (Pb) from environmental sources remains an overlooked and serious public health risk. Starting in childhood, Pb in the skeleton can disrupt epiphyseal plate function, constrain the growth of long bones, and prevent attainment of a high peak bone mass, all of which will increase susceptibility to osteoporosis later in life. We hypothesize that the effects of Pb on bone mass, in part, come from depression of Wnt/β-catenin signaling, a critical anabolic pathway for osteoblastic bone formation.

Development and validation of the Johns Hopkins Disruptive Clinician Behavior Survey.

Although the negative impact of disruptive clinician behavior on quality health care delivery has gained attention recently, little systematic effort to address this issue has been reported. To facilitate empirical research to reduce disruptive clinician behaviors, an assessment tool (Johns Hopkins Disruptive Clinician Behavior Survey [JH-DCBS]) with 5 discrete subscales was developed using a 2-step design. First a pool of items was generated from focus group studies and the literature, and then a psychometric evaluation of the survey was conducted with a sample of clinicians (N = 1198) practicing in a large urban academic medical center.

A clinical academic practice partnership: a clinical education redesign.

The clinical academic practice partnership (CAPP), a clinical redesign based on the dedicated education unit concept, was developed and implemented by large, private school of nursing in collaboration with 4 clinical partners to provide quality clinical education, to explore new clinical models for the future, and to test an innovative clinical education design. An executive steering committee consisting of nursing leaders and educators from the school of nursing and the clinical institutions was established as the decision-making and planning components, with several collaborative task forces initiated to conduct the work and to accomplish the goals. This article will describe methods to initiate and to organize the key elements of this dedicated education unit-type clinical model, providing examples and an overview of the steps and elements needed as the development proceeded.

An organizational assessment of disruptive clinician behavior: findings and implications.

This study investigated registered nurses' (RNs) and physicians' (MD) experiences with disruptive behavior, triggers, responses, and impacts on clinicians, patients, and the organization. Using the Disruptive Clinician Behavior Survey for Hospital Settings, it was found that RNs experienced a significantly higher frequency of disruptive behaviors and triggers than MDs; MDs (45% of 295) and RNs (37% of 689) reported that their peer's disruptive behavior affected them most negatively. The most frequently occurring trigger was pressure from high census, volume, and patient flow; 189 incidences of harm to patients as a result of disruptive behavior were reported.

Hospital RNs' experiences with disruptive behavior: a qualitative study.

Disruptive behavior in healthcare has been identified as a threat to quality of care, nurse retention, and a culture of safety. A qualitative study elicited registered nurse experiences with disruptive clinician behavior in an acute care hospital. A conceptual framework was developed to provide a structure for organizing and describing this complex construct that includes 4 primary concepts: disruptive behaviors and its triggers, responses, and impacts.

An evaluation framework for faculty practice.

Faculty practice is promoted in schools of nursing for the purposes of strengthening the clinical expertise of faculty, maintaining clinically relevant curricula, fostering student learning, and generating revenue. For clinical faculty, this practice often provides the foundation for academic scholarship. The integration of this scholarship into the traditional academic triad of education, research, and service has proved difficult.

Quest for the ideal: a redesign of the medication use system.

Medication use systems in hospitals are complex and prone to error. A redesign of the system using idealized design methodology is a starting point in preventing patient harm from medication errors. An interdisciplinary team identified system properties, proposed and gathered feedback on an ideal design, and established a structure to plan changes in the system and monitor their impact.

Postoperative complications: does intensive care unit staff nursing make a difference?

Objective: The purpose of this study was to examine the association between intensive care unit nurse (ICU) staffing and the likelihood of complications for patients undergoing abdominal aortic surgery.

Design: The study is a retrospective review of hospital discharge data linked to data on ICU organizational characteristics.

Setting: Research took place in ICUs in non-federal, short-stay hospitals in Maryland.