Registered Nurses Leading Innovative Changes.

As innovators, all registered nurses (RNs) act as agents of change to drive processes and policy and leverage technology to prove better, more affordable care for individuals and the community. The authors consider examples of RNs leading innovative ideas and practices to create new knowledge; develop healthcare policies and practices; improve the quality of care; and advance health information technology. This article describes a number of key innovation goals identified by the American Nurses Association Professional Issues Panel, Barriers to RN Scope of Practice, discusses relevant literature related to overcoming barriers to innovation, and identifies recommendations for leading innovative change to achieve innovation goals.

The protectors and the protected: what regulators and researchers can learn from IRB members and subjects.

Clinical research is increasingly conducted in settings that include private physicians' offices, clinics, community hospitals, local institutes, and independent research centers. The migration of such research into this new, non-academic environment has brought new cadres of researchers into the clinical research enterprise and also broadened the pool of potential research participants. Regulatory approaches for protecting human subjects who participate in research have also evolved.

An error by any other name.

Recent reports from the Institute of Medicine and other sources have shown that far too many avoidable medical errors occur; other research has shown a strong association between patient outcomes and characteristics of nursing staff. The authors of this paper present findings from multimethod research conducted over three years in 29 small rural hospitals in nine Western states. They examined the organizational processes used to recognize medical errors and assign responsibility for them to resolve patient-safety issues.