Joanne Comi McCloskey

Current issues in nursing

Definitions of nursing nursing knowledge changing education changing practice health care quality governance health care reform health care costs personal and professional assertiveness role conflict cultural diversity ethics concluding notes and future directions.

Evaluating nursing administration instruments

OBJECTIVE To identify and evaluate available measures that can be used to examine the effects of management innovations in five important areas: autonomy, conflict, job satisfaction, leadership, and organizational climate. BACKGROUND Management interventions target the context in which care is delivered and through which evidence for practice diffuses. These innovations need to be evaluated for their effects on desired outcomes. However, busy nurses may not have the time to locate, evaluate, and select instruments to measure expected nursing administration outcomes without research-based guidance. Multiple and complex important contextual variables need psychometrically sound and easy-to-use measurement instruments identified for use in both practice and research. METHOD An expert focus group consensus methodology was used in this evaluation research to review available instruments in the five areas and evaluate which of these instruments are psychometrically sound and easy to use in the practice setting. RESULTS The result is a portfolio of measures, clustered by concept and displayed on a spreadsheet. Retrieval information is provided. The portfolio includes the expert consensus judgment as well as useful descriptive information. CONCLUSIONS The research reported here identifies psychometrically sound and easy-to-use instruments for measuring five key variables to be included in a portfolio. The results of this study can be used as a beginning for saving time in instrument selection and as an aid for determining the best instrument for measuring outcomes from a clinical or management intervention.

Standardizing the language for nursing treatments: An overview of the issues*

The development and use of standardized language in nursing marks the development of a new era of nursing science. It will assist the professional nurse to communicate with colleagues in her or his own facility and across the world. Being able to clearly articulate what it is we do makes visible what previously has been invisible about nursing. When we use standardized language to document the care we give, then we can build large databases, which will articulate with those of other health providers, that can be used to demonstrate the effectiveness of nursing care. As we move into the 21st century, the use of standardized nursing language will become one of the hallmarks of the profession.

Nursing Interventions Core to Specialty Practice

Abstract A Nursing Interventions Classification monograph identifying nursing interventions that are core to each clinical specialty is now available. The identification of such interventions promises to be very useful in the development of nursing information systems, staff education programs and competency evaluation, referral networks, certification and licensing examinations, educational curricula, and research and theory construction.

Are Preceptors for Orientation of New Nurses Effective

The intent of this secondary analysis of a large data set was to provide empirical data on the benefits of preceptorship programs for orientation. Do nurses with preceptors have more satisfaction, social integration, and professionalism; less turnover; and better performance? The subjects were newly employed nurses, 177 were assigned to preceptors, and 98 did not have preceptors. The subjects completed questionnaires at three time periods: during the first few weeks on the job and at 6 and 12 months after employment. Data were analyzed by students t test and chi square analysis. On average, nurses with preceptors and less education and experience and were more involved with family. They worked on units with sicker patients. Nurses with preceptors were more satisfied with social and psychological rewards initially and had more of a feeling of self-regulation. Previously employed nurses with preceptors reported more social integration at 6 and 12 months. The study provides beginning evidence that preceptors are beneficial for nurses who have limited education and experience.

The Medical Outcomes Study: a nursing perspective

The authors analyze the Medical Outcomes Study framework as a means of measuring the effectiveness of a multidimensional, interdisciplinary health care delivery system. The potential for this model to measure outcomes resulting from the interventions of nurses is demonstrated. The similarities between variables in the Medical Outcomes Study (MOS) framework and in research in nursing are presented. Modifications in the framework are suggested that would represent the collaboration among physicians, nurses, and allied health practitioners and the influence of their interaction on patient outcomes. The authors also suggest adding the domain of societal outcomes to include such outcome variables as cost. These modifications will enhance future health outcomes research based on the MOS conceptual framework and will encourage investigations of the interactive effects of health care providers on patient outcomes.

Nursing Interventions Classification: A Comparison with the Omaha System and the Home Healthcare Classification

Standardized languages for nursing practice are required to meet the needs of the profession and the patients we serve. The authors review and compare three classifications of nursing interventions: Nursing Interventions Classification (NIC), the Omaha System, and the Home Healthcare Classification (HHC). The information will help users make the best selection for their agency and client population.

What is the study of nursing service administration

In the past decade, forces such as prospective payment systems, cost containment, increased competition, corporate mergers, and alternative care delivery systems have converged upon health care organizations. In a climate of uncertainty and rapid change, it is imperative that nurse administrators be well prepared. In the past few years nursing service administration as a field in itself has regained popularity. Many people still have questions, however, about the nature and need for this specialty area within nursing. This article outlines the study of nursing service administration and differentiates it from business administration and health administration. Curricular issues that nursing service administration faculty need to address are raised.

Using the Nursing Interventions Classification to implement Agency for Health Care Policy and Research guidelines

The mandate for establishing guidelines for assessing effectiveness has been given to the Agency for Health Care Policy and Research (AHCPR). This agency has published 10 practice guidelines for practitioners to use. The present task for practitioners is to establish how effectively use these guidelines. Nurse researchers at the University of Iowa have provided a practical standardized language of nursing interventions that will help nurses demonstrate and communicate current nursing practice. This Nursing Interventions Classification (NIC) will allow nurses to implement the guidelines, demonstrate nursing input for patient care, and make nursing visible to consumers and other health care providers.