The Role of the Nurse Scientist and Nursing Research Within a National Integrated Health Care System.

Nursing research provides knowledge that advances nursing science, practice, and health care with the vision to optimize the health and well-being of the population. In a medical center setting or health care organization, nurse scientists are needed to demonstrate new knowledge, innovation, and scholarship. Nursing research in health care organizations or medical centers are led mainly by nurse leaders with a Doctorate in Philosophy (PhD) or a Doctorate in Nursing Practice (DNP).

Regional Transformation: An Integrated System's Approach to Magnet Designation Utilizing High-Reliability Organization Implementation Strategies.

Background: Synergistic opportunity exists between Magnet-aspiring environments and High Reliability Organization (HRO) cultures to elevate safety, quality, new knowledge, continuous improvement, hierarchical flattening, and frontline empowerment.

Local Problem: Variation existed across a region's 15 hospitals regarding Magnet-readiness, leadership engagement, journey strategies, and resource capacity.

Methods: Quality improvement (QI) methodology and a hybrid-hub-spoke-model (HHSM) were used to support region-wide Magnet designation, improve patient outcomes, and advance nursing research.

Associations and Predictive Pathways Between Shared Governance, Autonomy, Magnet Status, Nurse-Sensitive Indicators, and Nurse Satisfaction: A Multisite Study.

Background: Evidence is limited to the effects of shared governance (SG) and autonomy on nurse-sensitive indicators (NSIs).

Purpose: To explore the effects of SG, autonomy, and Magnet status on nurse and patient outcomes.

Methods: A cross-sectional survey study was conducted using a convenience sample of 404 nurses from 4 hospitals.

Nurse Knowledge Exchange Plus: Human-Centered Implementation for Spread and Sustainability.

Background: Kaiser Permanente implemented a new model of nursing communication at shift change-in the bedside nursing report known as the Nurse Knowledge Exchange (NKE) in 2004-but noted variations in its spread and sustainability across medical centers five years later.

Methods: The six core elements of NKEplus were as follows: team rounding in the last hour before shift changes, pre-shift patient assignments that limit the number of departing nurses at shift change, unit support for uninterrupted bedside reporting, standardization for report and safety check formats, and collaboration with patients to update in-room care boards. In January 2011 Kaiser Permanente Southern California (KPSC; Pasadena) began implementing NKEplus in 125 nursing units across 14 hospitals, with the use of human-centered design principles: creating shared understanding of the need for change, minimum specifications, and customization by frontline staff.