Measuring psychological safety and local learning to enable high reliability organisational change.

The ability to measure the extent to which an organisation is highly reliable, or the extent to which reliability may change over time, has not kept up with the development of theory. The paper examines aspects of workplace culture, employee motivation and leadership behaviours that support continuous learning and improvement in an effort to measure the transition to high reliability.To evaluate the effectiveness of its high reliability initiative, one children's hospital sought to build measures that would provide an assessment of progressive movement towards a 'culture of safety', and track the success over time.

Evolution of a Newly Licensed RN Transition-to-Practice Program: Theory and Development Supporting Accreditation.

Nursing leaders have embraced newly licensed registered nurse (NLRN) transition-to-practice programs, which contribute to nursing confidence, competence, work satisfaction, and retention in a complex healthcare environment. We report on the evolution of a Midwest urban pediatric medical center's transition-to-practice program, guided for 2 decades by foundational and emerging theory, research, and evidence that has supported accreditation with distinction as a Practice Transition Accreditation Program (PTAP) by the American Nurses Credentialing Center's Commission in Accreditation. Nursing leaders should use emerging evidence to inform curricular revisions that accelerate NLRN role transition and practice integration, increase organizational commitment, improve patient safety and satisfaction, and achieve PTAP accreditation.

A Professional Nursing Acute Care Practice Curriculum.

Caring for multiple complex patients simultaneously is 1 of the biggest challenges for clinical nurses (CNs) in acute care. We utilized the results of research to develop a 6-hour Professional Nursing Practice Curriculum (PNPC) specifically for CNs who are professionally and legally responsible for providing holistic care to an assigned group of patients on inpatient clinical units in acute care hospitals. The curriculum can be used by faculty to prepare senior nursing students for their 1st professional practice role in an acute care setting.

Impact of Professional Nursing Practices on Patient/Nurse Outcomes: Testing the Essential Professional Nursing Practices Instrument.

Increasing patient and healthcare system complexity and the need to accurately measure the engagement of clinical nurses (CNs) in holistic, professional nursing practice indicates that an update to the Essentials of Magnetism instrument is needed. The purposes of this research were to critique and weight items, assess the value and psychometric properties of the newly constructed Essential Professional Nursing Practices (EPNP) instrument, and establish relationships between EPNPs and CN job, practice, and nurse-assessed patient satisfaction.

The evolution and development of an instrument to measure essential professional nursing practices.

Nursing continues to evolve from a task-oriented occupation to a holistic professional practice. Increased professionalism requires accurate measurement of care processes and practice. Nursing studies often omit measurement of the relationship between structures in the work environment and processes of care or between processes of care and patient outcomes.

Virtual education: is it effective for preparing nurses for a hospital move?

Objective: The objective of this study was to compare the effectiveness of using a virtual environment (VE) versus traditional paper floor plans (FPs) to prepare nurses for wayfinding in a new hospital building.

Background: This study was designed to control for variables such as task complexity and individual ability that have been missed in other media comparison studies.

Methods: Thirty nurses were assigned to the VE or FP condition using a randomized block experimental design.

Changing our lens: seeing the chaos of professional practice as complexity.

Aim: The purpose of this evidence-based management practice project was to analyse dimensions of the Getting my Work Done issue, the only one of seven issues of highest concern for which 907 nurse interviewees were unable to identify effective strategies, formulate a 'best management practice', integrate the practice into clinical settings and evaluate results. METHOD/PROCESS: The evidence-based management practice process was used to identify the major impediment to Getting Work Done-assignment to multiple patients with simultaneous complex needs. Best management practice consisted of class presentation of a clinical-management problem scenario to 144 residents in nine Magnet hospitals, a private action commitment, class discussion and terminal action commitments.

Components and strategies of nurse residency programs effective in new graduate socialization.

Patient needs and practice conditions demand that clinical nurses in acute care hospitals engage in a unique professional practice role-care and management of clinical situations for multiple patients, simultaneously. Nurse Residency Programs (NRPs) facilitate the integration of newly licensed registered nurses (NLRNs) into this professional practice role through competency development in seven management areas. Purpose of this study was to identify effective components and strategies of NRPs in each area.

The organizational transformative power of nurse residency programs.

Residency programs for newly licensed registered nurses (NLRNs) have been strongly advocated by the Institute of Medicine, American Organization of Nurse Executives, and other professional organizations. Their cost-effectiveness as well as their impact on NLRN retention, job and practice satisfaction, improved performance, and reduction in environmental reality shock has been demonstrated. This qualitative study sought answers to the question: what people, components, processes and activities of Nurse Residency Programs (NRPs), and the work environment are instrumental in the transition and integration of NLRNs into the professional practice role and into professional communities? In the course of interviewing 907 nurses-NLRNs, experienced nurses, managers, and educators-practicing on clinical units with confirmed "very healthy work environments" in 20 Magnet hospitals, it became evident that not only did NRPs positively impact the professional socialization of NLRNs, they led to transformative changes in the organization and in the practice of other health care professionals.

Impact of healthy work environments and multistage nurse residency programs on retention of newly licensed RNs.

The objective of the study was to examine effects of nurse-confirmed healthy unit work environments and multistage nurse residency programs (NRPs) on retention rates of newly licensed RNs (NLRNs). Establishing a culture of retention and healthy clinical nurse practice environments are two major challenges confronting nurse leaders today. Nurse residency programs are a major component of NLRN work environments and have been shown to be effective in abating nurse turnover.

Impact of residency programs on professional socialization of newly licensed registered nurses.

Do Nurse Residency Programs (NRPs) reflect the professional socialization process? Residency facilitators in 34 Magnet hospitals completed Residency Program Questionnaires constructed to reflect the goals, themes, components, and strategies of the professional socialization process described in the literature. NRPs in 4 hospitals exemplified the complete two-stage (role transition and role/community integration) process. In 14 hospitals, NRPs were of sufficient length and contained components that reflected the professional socialization process.

Job embeddedness factors and retention of nurses with 1 to 3 years of experience.

An aging work force, predictions of job growth in health care, and an eventual economic recovery suggest that the current reprieve from the national nursing shortage is temporary. New graduate nurses are an important part of the work force and are needed to replace nurses who will retire in the next decade. Organizational leaders can address the forecasted work force demand by proactively investing in programs for workplace development and retention.

Supporting nursing professional development: a magnet hospital's story.

Leadership vision, strategy, and commitment are vital for the promotion of nursing professional development. In this article, the author describes the process of executing a vision for innovative professional development programs at a 270-bed academic pediatric medical center. A proactive nursing education department expanded to build broad-based career programs for pediatric nurses.

The organizational impact of a new graduate pediatric nurse mentoring program.

Successful mentoring programs for new graduate nurses are designed to provide professional supports to ease the transition of these newcomers from student to practicing nurse. In the financially constrained health care environment, a resource-intensive program can be sustained only by leaders who see quantitative evidence of organizational impact over time. A descriptive study was undertaken at a pediatric academic medical center to compare the job satisfaction and retention rates of two cohorts of new graduate nurses: one before and one after the implementation of a Pediatric RN Internship Program.

The impact of a blended learning approach on instructor and learner satisfaction with preceptor education.

To further enhance satisfaction and effectiveness, six pediatric hospitals created a blended learning approach to preceptor role preparation. In this blended approach, foundational content was delivered via online learning, allowing the classroom instructors to focus more on experiential learning activities. Both preceptor-learners and classroom instructors were asked to complete an evaluation of their experiences.

A magnetic strategy for new graduate nurses.

With the shortfall of nurses, more health care organizations are actively recruiting new graduate nurses. To translate active recruitment to successful retention, however, these newest nurses need support to make the adjustment from the security of a protected academic environment to the demands of a professional nursing career. Nursing turnover occurs when their role transition is unsuccessful.

Graduate nurse perceptions of the work experience.

Findings from a longitudinal study on the perceptions of the work environment and job satisfaction for new graduate nurses in the first 18 months of employment at a Magnet Midwestern urban academic pediatric medical center are described. The findings indicated that orientation assisted the new graduate to become confident in his/her clinical competence and work management. By 18 months, the new graduate felt satisfied with access to resources and the ability to participate in professional development opportunities.