In hospitals, the cost to replace 1 registered nurse (RN) can be quantified by considering costs in recruitment, hiring, and onboarding processes. Though the mean replacement cost of 1 RN will vary depending on geographic location and professional specialization, some have estimated this cost at $56 000. In addition to these direct costs, high turnover also contributes to broader organizational challenges, including disrupted communication, teamwork, and patient care.
View Article and Find Full Text PDFNurses are uniquely positioned to significantly impact organizational and system improvement through improving quality and reducing costs. Using an evidenced based tool to identify costs and the financial benefit involved in any quality improvement project is invaluable in developing and evaluating proposals and allocation of resources to support the organization's financial health and viability. The return on investment analysis is an essential accounting tool that will provide nurse leaders with critical information quantifying costs and benefits of both financial and nonfinancial metrics to identify the feasibility, efficacy, risk or efficiency of a proposed project.
View Article and Find Full Text PDFNurs Ethics
December 2024
Background: Unit-based critical care nurse leaders (UBCCNL) play a role in exemplifying ethical leadership, addressing moral distress, and mitigating contributing factors to moral distress on their units. Despite several studies examining the experience of moral distress by bedside nurses, knowledge is limited regarding the UBCCNL's experience.
Research Aim: The aim of this study was to gain a deeper understanding of the lived experiences of Alabama UBCCNLs regarding how they experience, cope with, and address moral distress.
Nurs Crit Care
July 2024
Background: Moral distress (MD) occurs when clinicians are constrained from taking what they believe to be ethically appropriate actions. When unattended, MD may result in moral injury and/or suffering. Literature surrounding how unit-based critical care nurse leaders address MD in practice is limited.
View Article and Find Full Text PDFMoral distress (MD) is well-documented within the nursing literature and occurs when constraints prevent a correct course of action from being implemented. The measured frequency of MD has increased among nurses over recent years, especially since the COVID-19 Pandemic. MD is less understood among nurse leaders than other populations of nurses.
View Article and Find Full Text PDFSuccessful organizations depend on strategic thinkers who understand strategic planning and strategic management. These strategic leaders can proactively manage the constant environmental changes to position their organizations for a competitive advantage and avoid acting in a reactive and defensive manner. However, while organizations are often adept at developing extensive strategic plans, implementation of the plan is often poor or without a definitive strategy.
View Article and Find Full Text PDFHealth care is a highly competitive environment where managers must compete for finite resources. The Centers for Medicare & Medicaid Services-directed reimbursement models such as value-based purchasing and pay-for-performance heavily focused on quality improvement and nursing excellence are having a major impact on financial reimbursement for health care services in the United States. As such, nurse leaders must function in a business-focused environment where decisions regarding resource allocation are driven by quantifiable data, the potential return on investment, and the organization's ability to provide quality patient care in an efficient manner.
View Article and Find Full Text PDFIn March 2021, the American Association of Colleges of Nursing (AACN) endorsed and published a report that included a reenvisioned framework for nursing education. This report introduced innovative and bold ideas for transforming nursing education and pedagogy from a concept-based model to a competency-based model of nursing education. This new model of nursing education establishes a core set of expectations and standards of competency-based nursing curricula common to all nursing educational programs moving forward.
View Article and Find Full Text PDFObjective: The aim of this study was to assess the influence of 3 variables on unit-based nurse managers' self-perception of business and financial competence in patient care: 1) educational degree; 2) participation in leadership development continuing education; and 3) prior nursing management experience.
Background: Nurse managers must develop business acumen to support patient care and the nurses who provide care. Successful managers must become fluent in the language of finance and must understand how to use it.
A business case plan (BCP) provides a structured framework for evidence-based, transparent business decisions. It is an essential tool that when written well will provide you with the means to translate the cost and benefits of nursing practice proposals, often related in anecdotal terms, into quantifiable, evidence-based terms outlining return on investment and business advantages of investing in nursing initiatives. The BCP should include an analysis of the problem and associated needs, the proposed solutions with options, goals for success, implementation, and evaluation plans, as well as a risk-adjusted cost-benefit analysis.
View Article and Find Full Text PDFAn organization's financial statements reflect their financial well-being and determine their ability to meet the health care needs of the citizens in their community. It is imperative that nursing leadership recognize the key components of an organization's annual consolidated financial statements, the balance sheet and income statement, and know how to interpret them to provide efficient, high-quality health care and to be successful in their role as nurse leaders. This article provides exemplars of these key documents with detailed instructions for the interpretation and understanding of the organization's financial statements, which will enable the reader to accurately and adeptly interpret their own organization's financial statements, as well as the statements from other organizations.
View Article and Find Full Text PDFObjectives: Explore critical care nurses' personal perceptions of expertise, expert performance and transition from novice to expert performer in clinical practice.
Design: Following constructivist approach to grounded theory this investigation used qualitative open-ended interviews focused on the social construction of expertise in critical care nursing and the experiences of clinical practice that define that process.
Setting: A multi-site urban area in the southeastern United States.
Background: Effective participant recruitment strategies are crucial to the success of research studies. A targeted, well-designed recruitment plan provides researchers with a rich bed of information to fully explore research questions and achieve statistically significant responses.
Aim: To discuss the importance and methodology of participant recruitment in achieving reliability and validity, and to provide an example of a recent study that used Facebook to recruit participants and achieve statistically significant findings.
Background: New graduate nurses are expected to function autonomously and be practice-ready upon graduation. However, transitioning from the role of student to one of leadership in the professional nurse's role is a complex experience.
Problem: Concerns for safety and liability in an increasingly complex health care environment may limit the availability of relevant clinical experiences for nursing students to develop leadership skills.
The purpose of this article is to describe an educational process designed to accelerate skill acquisition for new nurse graduates through deliberate practice and situated learning experiences. The concept of deliberate practice provides the framework for authentic learning experiences based on real-life situations that incorporate targeted outcomes for success while pushing their limits beyond what was previously achieved. Through deliberate practice, new graduate nurses are given the opportunity to gain valuable practical experiences that otherwise would have taken years to accomplish in a clinical practice.
View Article and Find Full Text PDFCritically ill patients have increased metabolic requirements and must rely on the administration of nutritional therapy to meet those demands. Yet, according to research almost half of all hospitalized patients are not fed, are underfed, or are malnourished while in the hospital. This article demonstrates the importance of early feedings in critical care unit, and the available options open to nurses supporting initiation and management of early feedings.
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