Kimberly S. Glassman

Measuring practice patterns among acute care nurse practitioners.

Objective This initiative was designed to develop a reliable instrument to measure the activities of acute care nurse practitioners (ACNPs). A sound, standardized method for measuring ACNP productivity will assist nursing leaders and administrators to demonstrate the effectiveness and productivity of ACNPs in and across institutions and systems. Background data Current research on ACNPs uses many different methodologies and research designs, and fails to provide standard definitions to measure practice patterns, making it difficult to generalize across settings. Methods Advisory groups from 2 New York academic health science centers developed a survey that covered the demographic, educational, and employment characteristics of ACNPs, and a 20-item classification of advanced practice nursing activities. Sixty-one ACNPs completed surveys, a 58% response rate. Results The survey found strong similarities at both institutions. ACNPs spend most of their time in 5 activities involving direct care and 4 activities within indirect care. Strong Cronbach alphas confirmed that the instrument was reliable. Conclusions/implications The availability of a reliable instrument for measuring ACNP practice patterns provides administrators with a powerful tool to demonstrate the contributions of their ACNPs. In addition, a standardized method for data collection can contribute to healthcare workforce policy discussions.

Developing a leadership laboratory for nurse managers based on lived experiences: a participatory action research model for leadership development.

OBJECTIVE: The aim of the pilot study was to design an innovative model of leadership development, Leadership Laboratory (LL), grounded in the lived experiences and peer best practices of 43 cross-disciplinary nurse managers. BACKGROUND: The Institute of Medicine/Robert Wood Johnson Foundation study, The Future of Nursing, reinforces the need to prepare nurses for leadership positions. METHODS: A 1-year participatory action research study was designed to develop 3 LLs involving nurse managers as participants, co-creators, and evaluators of the unique learning format. RESULTS: Analysis of qualitative and quantitative data revealed consistent and significantly positive results in leadership skill areas in all 3 LLs. Participants identified elements that distinguished LLs from traditional seminars and trainings sessions, including opportunities to gain from peer-to peer consultation, strategies, and support. CONCLUSIONS: Participants in the 1-year pilot demonstrated significant learning based on postsession and postproject assessments of the LLs. Data also described the unique attributes of a peer-driven approach to leadership development.

The Attending Nurse: An Evolving Model for Integrating Nursing Education and Practice

The discipline of nursing continues to evolve in keeping with the dramatic expansion of scientific knowledge, technology, and a concomitant increase in complexity of patient care in all practice settings. Changing patient demographics require complex planning for co-morbidities associated with chronic diseases and life-saving advances that have altered mortality in ways never before imagined. These changes in practice, coupled with findings from sophisticated nursing research and the continuous development of new nursing knowledge, call for realignments of the relationships among academic faculty in schools of nursing, advanced practice nurse administrators, and staff nurses at the forefront of practice. This article offers a model designed to bridge the gaps among academic settings, administrative offices and the euphemistic “bedsides” where staff nurses practice. Here we describe the nurse attending model in place at the New York University Langone Medical Center (NYULMC) and provide qualitative data that support progress in our work.

Developing and Implementing a Professional Practice Model

Professional practice models guide nursing practice by giving meaning to the work of nurses. They elevate the practice from tasks to theory, from skills to knowledge, and remind us that the patient and family are at the center of our practice. Professional practice models are one of the foundations of the Magnet Recognition Program. The purpose of this paper is to describe the development and implementation of a professional practice model in a healthcare system, which includes three hospitals and over 80 ambulatory practices in the New York City region.

The Long-term Effect of a Nurse Residency Program, 2005-2012: Analysis of Former Nurse Residents.

OBJECTIVE: Research on nurse residency programs (NRPs) typically focuses on retention within the 1-year NRP or perhaps an additional year beyond. Few have evaluated the long-term impact of NRP, and none have adopted a longitudinal approach to follow cohorts over time. This study, conducted in a large urban academic medical center (AMC), examines the effects of the NRPs on former nurse residents (NRs) in 8 cohorts (2005-2012) and compares those who left the institution with those who remain. BACKGROUND: Nurse residency programs have increased from home-grown programs to a standardized 1-year curriculum from national models designed for different types of RNs. Evidence exists that NRPs reduce attrition among new graduates and the Institute of Medicine recommends that all new RNs have access to NRPs. METHODS: Using data from human resources, administrative data, and online survey of former NRs, this is a retrospective, longitudinal study of former NRs in 1 AMC. Nine hundred eighty-seven new graduates completed the NRP from 2005 to 2012; 646 (63.5%) have stayed (stayers) at the institution. A total of 425 stayers responded to survey (65.8%), and 108 surveys were completed by former NRs who had left (leavers) (62.4%). RESULTS: On average, leavers stay for 2.18 years at the institution; stayers typically remained for 4.86 years, suggesting that retention beyond 2 years is dependent on complex set of circumstances beyond the “treatment effect” of the NRP program. Regardless of staying or leaving, respondents hold positive attitudes about the program; achieve high levels of certification, advanced education, and professional accomplishments; and report ”transitioning from beginner to competent RN” and “senior staff support” as most valuable aspects of NRP. CONCLUSIONS: Retention among new graduates has improved significantly with the introduction of NRPs at this institution. Former NRPs report favorable assessments of the NRP, regardless of number of years since completion of the program and regardless of whether the individual remains employed in the institution. In addition, former NRs report high levels of professional accomplishments and commitment to nursing. However, without additional research, we cannot definitively tie these outcomes to the NRP.

Assessing the perceptions and attitudes among geriatric resource nurses: Evaluating the NICHE program at a large academic medical center

ABSTRACT The national Nurses Improving Care for Healthsystem Elders (NICHE) program and the geriatric resource nurse (GRN) model promote training a geriatric nursing workforce to serve in hospitals and elsewhere. Literature exists on the NICHE program but this is the first to study the opinions, attitudes, and perceptions of GRNs in practice. Our organization’s hybrid GRN model, first adopted in 1999, combines materials from national NICHE program with homegrown resources and has GRNs practicing in a wide range of clinical specialties. This descriptive study, using survey design and administrative data, examined GRNs trained prior to 2017 to assess their (i) demographic, employment, and other characteristics; (ii) satisfaction with components of training program; (iii) ability to apply new knowledge and skills in practice; (iv) perceived support from leadership; and (v) perceived barriers encountered. Program outcomes, such as completion rates and workplace satisfaction, as well as areas for improvement and recommendation for future research, are also discussed.