Marianne Ditomassi

The value of collaborative governance/staff empowerment.

Objective Collaborative governance is the decision-making process that places the authority, responsibility, and accountability for patient care with the practicing clinician. Background Collaborative governance was introduced as one of nine structures within the patient care services’ professional practice model to facilitate communication and optimize staff participation in decision-making across disciplines. The concept of empowerment was used to evaluate the impact of the collaborative governance structure on members. Methods The purpose of the current study was to compare empowerment and power scores for both members and nonmembers of collaborative governance over a 3-year period. Results Initial survey data (baseline) from 136 staff from across disciplines was returned prior to beginning work on a committee. Study results were based on survey returns from 657 staff over a 3.5-year period. There were no significant differences between collaborative governance members and nonmembers on some demographic variables such as age, but there were significant differences on variables such as work status and education. All empowerment scores were significantly higher at the 2nd and 3rd measurement periods for collaborative governance members as compared to nonmembers. Conclusions Findings suggest that membership on a collaborative governance committee increased staff sense of empowerment and fostered self-growth and organizational development.

Why not nursing

Does nursing have an image problem that scares off potential nursing students? Heres what high-school students and adult career-switchers think about nursing as a potential career choice.

A multi-instrument evaluation of the professional practice environment.

This study identified organizational characteristics that are highly correlated with the work satisfaction of RNs using 2 practice environment measurement tools. In the sample, the organizational characteristics of autonomy, control over practice, and internal work motivation are critical to RNs’ sense of work satisfaction. As care redesign efforts ensue, the need to preserve and strengthen the professional practice environment remains a priority for nurse executives.

Professional practice model: strategies for translating models into practice.

In the current health care climate, economic and cultural conditions have created an optimal opportunity to envision a new direction for nursing as a profession. Nurses find themselves at the formative stages of charting this new direction. The articulation of a professional practice model provides a framework for setting this new direction and thus the achievement of exemplary clinical outcomes. In this article, the authors describe the evolution of the professional practice model at the Massachusetts General Hospital and how the model continues to be evaluated and modified over time by the nurses within the system.

Mentoring the minority nurse leader of tomorrow.

Diversity is crucial to the future of nursing. And fortunately, a shift in the composition of the nursing workforce so that it more accurately mirrors the composition of Americas patient population is already taking place. However, this emerging multiculturalism brings an important issue to the forefront—the leadership tier in healthcare organizations must also reflect the ethnic and cultural changes taking place. Movement in this direction makes prominent the importance of the mentor role in the life of the minority nurse seeking a leadership career path. Acknowledging the present demographics of the profession, it is most unlikely that the mentor and mentee will be a cultural or ethnic match. The good news is that this should not be viewed as an automatic barrier. This article describes the 5 Cs of mentoring a minority nurse professional, that is, candor, compromise, confidence, complexity, and champion—the specific competencies that promote a mentor-mentee relationship focused on career success.

Identification of the psychometric properties of the leadership influence over professional practice environments scale.

This study uses the qualitatively developed Adams Influence Model© (AIM) and concepts from the psychometrically validated Revised Professional Practice Environment scale to guide the development of the Leadership Influence Over Professional Practice Environments Scale. Nurse executives and others can use this scale individually or in conjunction with instruments targeting staff or patient perceptions of their influence as part of health services research, leadership development, and professional practice environment enhancement strategy.

Interdisciplinary Institute for Patient Care: advancing clinical excellence.

Healthcare leaders are searching for ways to create new synergies and efficiencies in todays complex health environments to enhance patient care, education, and research and nurture collaborative and rewarding professional practice environments. The authors discuss how the creation of a multidisciplinary Institute for Patient Care is an important innovation that is helping us achieve these aims.

Development and Psychometric Evaluation of the Professional Practice Work Environment Inventory

OBJECTIVE The purpose is to examine the psychometric properties of the professional practice work environment inventory (PPWEI). BACKGROUND Derived from the Professional Practice Environment (PPE) and the Revised PPE scales, the PPWEI was designed to measure 8 components of the PPE that can be used to assist nurse administrators in decision-making. METHODS A psychometric evaluation was undertaken with 874 nurses who were providing direct care to patients at the Massachusetts General Hospital and who provided no missing data on the newly developed 72-item PPWEI. RESULTS Cronbach’s &agr; internal consistency reliability of the total score was .93, with 61 items having factor loadings more than .50, the factor loading cutoff used to define the component subscales. Principal component analyses with varimax rotation and Kaiser normalization demonstrated 8 components, explaining 64.6% of variance. Cronbach’s &agr; reliability coefficients of the PPWEI subscales ranged from .82 to .93. CONCLUSION The multidimensional PPWEI is a psychometrically sound measure of several components of the PPE in the acute care setting and sufficiently reliable and valid for use as independent subscales in healthcare research.

Why research is vital.

Innovation Research informs innovation, while evaluating initiatives in care delivery provides data on their effectiveness. From multiple sources, such data can highlight organisational successes and areas for improvement. Viewing electronic patient records, for example, can enhance the research agenda for clinicians and leaders. Healthcare organisations with nursing research agenda become known as learning environments where research, practice and knowledge each inform the others. Nursing research creates possibilities for multi-site investigations and attracts other academic and international bodies to participate in clinical investigations. Meanwhile, education and professional advancement foster readiness for research and development. Nursing research provides measures of quality and safety that generate evidence for excellence in care delivery. All interventions used in practice should be measured and outcomes documented. By engaging in research, nurses improve patient care and contribute knowledge to nursing science. A strong research agenda can help create a platform for dialogue across disciplines, as well as opportunities for service development. Research also helps to change the image of nurses from care providers and users of knowledge to scientists who develop, implement and translate new knowledge into practice. By participating in research, nurses can elevate their role and reveal their practice as integral to care delivery. An environment rich in nursing research is essential to generate the scientific base for nursing and interprofessional practice. Using research as a lever in professional environments can advance practice, strategy, innovation, use of technology, education, quality and safety and the image of nursing itself.

Benefits of a narrative culture.

LOOKING BACK over the past 20 years, the healthcare challenges we faced then are similar to those we face now. They may be heightened, but they still concern quality and safety, healthcare equity, cost constraints, and regulatory requirements.