Category: Nursing Culture

This article describes a Magnet®-designated, national cancer institute comprehensive cancer center’s quest to restructure the organization’s evidence-based practice (EBP)/performance improvement (PI) framework leveraging the role of the clinical nurse specialist (CNS) as a coach to support staff nurses in EBP/PI initiatives. The support of the CNS is essential in developing effective projects, minimizing barriers, and maintaining a level of engagement in the EBP process from problem identification through dissemination and sustainment of practice changes.

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An organizational culture that reflects distrust, fear of reprisal, reluctance to challenge the status quo, acceptance of poor practice, denial, and lack of accountability creates significant issues in healthcare in relation to employee retention, burnout, organizational commitment, and patient safety. Changing culture is one of the most challenging endeavors an organization will encounter. We highlight that the Magnet Recognition Program® can be implemented as an organizational intervention to positively impact on nursing workplace culture in an international healthcare facility.

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Nursing research is essential to build up evidence-based practice, which improves quality of care, patient outcome, and nurse satisfaction in the workplace. However it is und erused in practice.

Results showed that nurses have positive attitudes towards research. However only few nurses use research results in her daily practice. The barriers and facilitators identified demonstrate a significant need of time and training in research. Recommendations would be to strengthen links between nurses and researchers, to invite nurses to a regular presence and active participation at journal club and conferences.

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The purpose of this project is to describe a process for pairing a restorative just culture into nursing peer review in order to heal, learn, collaborate, retain staff, and improve outcomes for patients. Implications for practice: Organizations are challenged to meet quality outcomes performance standards and are also challenged to nimbly change nursing practice to drive positive outcomes. Peer review integrated with a restorative just culture drives nursing leaders to intervene at the point of care to align individual practice and system designs with standards of care and a healthy work environment.

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This interpretive ethnographic study involved a purposive sample of 10 cases, with each ‘case’ comprising a patient, their closest relative and the nurses who provided their care. Data were constructed through participant observation, interviews and document review. Analysis revealed that the relationships built and sustained between nurses, patients and relatives are central to creating a positive culture of caring, which promotes emotional wellbeing and aids recovery in stroke rehabilitation. The importance of this culture should be more fully acknowledged, both within nursing and the wider multiprofessional rehabilitation team.

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The purpose of this study was to better understand the relationship between nurse-reported safety culture and the patient experience in a multistate sample of nurses and patients, matched by hospital unit/service line and timeframe of care delivery. The results show key variables in the HCAHPS and AHRQ surveys were significantly correlated. Findings highlight the relationship between 3 safety culture domains: teamwork, adequate staffing, and organizational learning on the achievement of a positive patient experience. Study concludes saying modifiable aspects of hospital culture can influence the likelihood of achieving high HCAHPS top box percentages in the nursing and global domains, which directly impact hospital reimbursement.

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The article discusses the ABC Delirium: Fighting the Dysfunction Head On project conducted by the American Association of Critical-Care Nurses (AACN) Clinical Scene Investigator (CSI) Academy at the intensive care unit (ICU) of Fox Chase Cancer Center (FCCC) in Philadelphia, Pennsylvania. It explores the prevalence of delirium among ICU patients, the need for better assessment tools to effectively manage cases of delirium in the ICU, and the survey of nursing staff following the project.

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A US approach to transforming hospital culture by improving quality and safety has been running in the NHS for a year. Five trusts in England have been using the method, which was influenced by Japanese car production techniques.

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Storytelling is an ancient practice that has functioned to maintain history, deepen empathy and understanding, and empower groups and individuals. Unfortunately, nurses are not encouraged to share their stories of contributions to patient care. In this article, 3 nurses share stories about learning to be good nurses, even while going against long-held nursing ideals. The authors argue that narratives can lead to a deeper understanding of nursing as a practice and discipline. The authors also contend that narratives facilitate the empowerment in nurses and patients using narratives; nurses recognize their power and facilitate their patients’ recognition of power.

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Objective of this study was to explore barriers to nurses’ reporting of medication errors and near misses in hospital settings. Concludes that to overcome reported barriers it is necessary to develop a non-blaming, non-punitive and non-fearful learning culture at unit and organizational level. Anonymous, effective, uncomplicated and efficient reporting systems and supportive management behaviour that provides open feedback to nurses is needed. Nurses are accountable for patients’ safety, so they need to be educated and skilled in error management. Lack of research into barriers to reporting of near misses’ and low awareness of reporting suggests the need for further research and development of educational and management approaches to overcome these barriers.

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