Mary Lou Brunell

Evidence-based practice and the role of nursing leadership.

A new term, evidence-based practice, is beginning to appear both in the healthcare literature and at professional, conferences. Its meaning, however, is not always clear, nor is its full implication for nurse administrators explained. This article provides a pragmatic definition of evidence-based practice developed in the nursing division at Baystate Medical Center, Springfield, Massachusetts. It outlines steps required to institutionalize evidence as a routine part of nursing practice and provide examples of its use.

Florida Nurse Leader Survey Findings: Key Leadership Competencies, Barriers to Leadership, and Succession Planning Needs.

OBJECTIVE: This study examined barriers to nursing leadership and succession planning needs for nurse leaders in Florida. BACKGROUND: The Florida Action Coalition responded to the call to prepare and enable nurses to lead change to advance health, through a grant supported by the Robert Wood Johnson Foundation and Florida Blue Foundation. METHODS: This is a nurse leader subset of a 56-item statewide survey of actively licensed RNs and advanced RN practitioners in Florida conducted via a cross-sectional, exploratory descriptive research design. RESULTS: Key findings included a description of leadership competencies, barriers, and succession planning practices. Florida nurse leaders are aging and less diverse than the general population and report limited utilization of succession planning by their organizations. CONCLUSIONS: In Florida, attention must be directed to resources and strategies to develop skilled nurse leaders and plan succession.

Toward standardization (part 1): assessment of state and national nursing workforce data sources.

Despite concerns expressed over the past 25 years, little progress has been made in improving the accuracy, availability, and timeliness of national data on the U.S. nursing workforce. In Part 1 of this two-part series, we review the current national data sources on nurse supply, demand, and education programs. We discuss the advantages that state-level data collection efforts enjoy in many states and propose that national data sets could be easily and cost-effectively built from state-level contributions—if states collected a standardized set of information. As part of a larger effort to standardize state-level data, from July to December 2008, we analyzed surveys and codebooks from 26 states collecting nurse workforce data. We present the results of this data assessment and conclude that data collection practices as of 2008 varied substantially from state to state. Creation and adoption of standardized minimum nursing workforce data sets is suggested to bring states into alignment.

Strategic state-level nursing workforce initiatives: taking the long view.

This article reviews long-range, strategic nursing workforce initiatives developing in 5 states. It also summarizes progress in establishing a national network of state nursing centers for sharing workforce data, and new education, workplace, and policy initiatives being undertaken by and on behalf of the nursing profession.

Toward standardization (Part 2): National nursing minimum data sets consensus building and implementation status.

With the passage of the Affordable Care Act and the development of a National Workforce Commission, multiple entities have increased their interest in collecting standardized health care workforce data at the state and national levels. In a tight budget environment, developing data sets which collect the minimum needed information that is necessary for workforce planning and supply/demand projections has become critically needed. This article represents the second of a two part series describing the work that the Forum of State Nursing Workforce Centers has undertaken during the last 3 years toward standardizing nursing workforce data. Part I described the initial steps that informed the development of national nursing workforce minimum data sets. Part II describes the consensus model used to develop the minimum data sets as well as an update on the implementation of the minimum data sets in individual states including challenges and barriers encountered.

Improving collection and use of interprofessional health workforce data: Progress and peril.

BACKGROUND Policymakers and other stakeholders need robust data to understand how health care system changes affect the health care workforce and the care it provides, evaluate the effectiveness of health care finance and delivery innovations, and build an adequate supply of nurses and other health professionals to care for an aging and diverse population of patients. In 2011, the Institute of Medicine released a report that called for the creation of an infrastructure to collect and analyze interprofessional health workforce data and issued specific recommendations to reach that overarching goal. PURPOSE This paper examines progress toward each of the main data-related recommendations of the Institute of Medicine Committee on the Future of Nursing, and identifies strategies that can achieve further gains in health workforce data collection. METHODS Multiple documents and websites were reviewed to identify the extent to which each of the Institute of Medicines recommendations have been implemented. DISCUSSION There has been little progress toward the Institute of Medicine recommendations regarding data collection, with a few exceptions related to improvements in national data on ambulatory care. This can largely be attributed to a lack of funding. CONCLUSION Although there are active and strong collaborative relationships across many key stakeholders, there have not been sufficient resources dedicated to ensuring that new programs advance. More leadership, advocacy, and resources will be needed to build the robust data infrastructure called for by the Institute of Medicine.

Benefits of Less Restrictive Regulation of Advance Practice Registered Nurses in Florida

BACKGROUND Advanced Practice Registered Nurses (APRNs) provide access to cost-effective, high quality care. APRNs are underutilized in states that restrict their practice. Removing restrictions could expand access to quality health care, cost-effectively relieve the physician shortage, and contribute economically. PURPOSE This study forecasts the health system and economic impacts of reducing practice restrictions for Florida APRNs. METHODS The analysis utilized a number of data sources and IMPLAN software and estimated changes in APRN supply given less restrictive practice laws, and consequential health system and economic benefits. FINDINGS Between 2013 and 2025 APRN full time equivalents could increase an additional 11% with less restrictive practice regulations. This could eliminate or reduce the shortage of different types of physicians. Health care cost-savings could be

Demonstrating the Value of the Advanced Practice Nurse: An Evaluation Model

50 to

Using a Nursing Framework to Establish a Nurse-Managed Senior Health Clinic

493 per resident. There would be a number of general economic benefits. DISCUSSION A number of health system and economic benefits would ensue from less restrictive APRN regulation.