Moreen Donahue

Shared Governance and Empowerment in Registered Nurses Working in a Hospital Setting

Empowerment of registered nurses through professional practice models inclusive of shared governance has been proposed as essential to improve quality patient care, contain costs, and retain nursing staff. The purpose of this study was to determine the relationship between perceptions of governance and empowerment among nurses working in acute care hospital units in which a shared governance model had been in place for 6 to 12 months. The 158 nurses who participated perceived themselves to be moderately empowered and in an early implementation stage of shared governance. There was a statistically significant positive relationship between perceptions of shared governance and empowerment. Recommendations for professional practice and future research are included.

A Leadership Initiative to Improve Communication and Enhance Safety

The EMPOWER project was a collaborative effort to promote a culture of patient safety at Danbury Hospital through an interdisciplinary leadership-driven communication program. The “EMPOWER” component includes Educating and Mentoring Paraprofessionals On Ways to Enhance Reporting of changes in patient status. Specifically, the EMPOWER program was designed to prepare paraprofessional staff (PPS) to communicate changes in patient status using SBAR (situation, background, assessment, recommendations) structured communication. The specific project goals included (a) translation of SBAR structured communication methods for use with PPS, (b) reduction of cultural and educational barriers to interdisciplinary communication, and (c) examination of the effect of the EMPOWER intervention on the PPS communication practices and perceptions of the patient safety culture. Results of the project indicate a change in the use of SBAR throughout the institution, with particular improvement in communication from PPS to professional staff.

Medication Administration Process Assessment : Applying Lessons Learned From Commercial Aviation

Medication administration is a major safety issue for patients and providers. The authors describe a commercial aviation-based system safety assessment conducted on the medication administration process for a community teaching hospital in the northeast United States. Processes on 2 medical units and 1 surgical unit were assessed. A sampling of qualitative outcomes is presented in a risk prioritization framework, along with practical recommendations predicated on the valuable lessons learned in commercial aviation.

The EMPOWER Project: An Initiative to Educate and Mentor Paraprofessional Staff

This column describes a new program designed to enhance patient safety by teaching paraprofessional staff (PPS) how to communicate changes in patient status to professional staff. Phase 1 of the project included assessment of PPS perceptions of the patient safety culture at the hospital through survey and focus group discussions. Results from Phase 1 and plans for Phase 2 are described.

Phase 2 of the EMPOWER project: enhancing communication for paraprofessionals.

This column describes a project that was implemented to enhance the communication skills of hospital paraprofessional staff. One of the primary goals was to enhance the communication between paraprofessional (nursing assistants) and professional (nurses and physicians) staff.