Implementing small tests of change to improve patient satisfaction.

The Institute of Medicine supports proposed changes in the overall delivery of healthcare and the nurses' work environment to achieve improved patient outcomes and protect the public from unnecessary harm. Allowing nurses to have a voice in decision making and influence over their practice, in an environment that fosters autonomy and interdisciplinary collaboration, enhances nurse satisfaction while improving the quality of patient care. The authors describe how a pediatric medical unit engaged in small tests of change to improve communication and patient satisfaction on an inpatient unit.

Organizational climate and health care outcomes.

Background: Relationships between organizational climate-which reflects the employees' perception of the organizational culture and is easily measured through employee questionnaires-and patient and employee outcomes were examined in a literature review.

Methods: A systematic search was conducted, with the review limited to primary research published between January 1995 and June 2007. An integrative model of organizational climate was used to guide the search and organize evidence.

Organizational climate and nurse health outcomes in the United States: a systematic review.

Increasing interest has been focused on understanding the role working conditions play in terms of the serious issues facing hospitals today, including quality of patient care, nurse shortages, and financial challenges. One particular working condition that has been the subject of recent research, is the impact of organizational climate on nurses' well-being, including occupational health outcomes. To examine evidence-based research on the association between organizational climate and occupational health outcomes among acute-care registered nurses, a systematic review of published studies was conducted.

Children and pain: easing the hurt.

Relief of pain in children is a challenge to the pediatric health care provider. A clear understanding of the various developmental and cognitive levels will help the nurse better assess and manage children in pain. Age-appropriate assessment tools are currently available.