Victoria L. Rich

Collaboration to partnerships.

Partnerships are at the center of the Hospital of the University of Pennsylvania Nursing Excellence Professional Practice (HUP-NEPP) model. Through the use of collaboration, skilled communication, and respectful workplace, partnerships can be formed, leading ultimately to world-class patient care. At HUP, interdisciplinary partnerships are evidenced by the clinical nurses through shared governance. This article describes the components necessary to form successful partnerships.

Transformation of a nursing culture through actualization of a nursing professional practice model.

Leading and effecting meaningful change in a nursing division culture, such as the type required to achieve Magnet designation, entails senior nurse executives to be well-acquainted not only with the facts and figures of their business but also with the nuances, myths, and cultures that either enable or block a change from occurring. Expert nurse leaders embrace the story being told by data on dashboards and the quality outcomes achieved and look beyond those points of information out to the edges of their division. These nurse executives also seek to understand the pivotal, perhaps seemingly inconsequential things (notions, beliefs, cultural beliefs, and stories) that will block or tip a culture to change and achieve success. At the Hospital of the University of Pennsylvania (HUP), a Magnet-designated organization, the road to Magnet was not straightforward. Instead, the path was a winding, learning journey. Through authentic leadership and the conception and actualization of a professional practice model, the HUP Nursing Excellence in Professional Practice (HUP NEPP) model, Magnet designation was achieved and a nursing culture was transformed.

Nurse executive practice: creating a new vision for leadership.

Creating the future for practice calls for a new view of leadership and the evidence to support it. Gathering practice and research stakeholder to clarify the frame for research and the future of practice is critical to building a preferred future. Focusing on gathering leaders and providing a frame for their dialogue and interaction around executive practice for the future is important to creating the appropriate skills and role characteristics to lead the profession into it.

How we think about medication errors: a model and a charge for nurses.

AJN ▼ March 2005 ▼ Supplement http://www.nursingcenter.com ple), professional transactions (interaction among physician, pharmacist, and nurse), and clinician– patient (medication administration, patient education, and discharge instructions). Because of this lack of nursing research, no evidence-based review of the state of the science of patient safety has been undertaken in the nursing arena. As several authors have indicated, 7-10 physicians and pharmacists are generally the ones defining practice as it relates to preventing medication errors, without involving nurses. It’s imperative that nurses develop theoretical models, undertake research, and incorporate the findings into practices and processes that improve patient safety. It’s also paramount in the nursing profession that investment be made in both independent and multidisciplinary research. Nurses must investigate why so many medical errors involve medication administration and determine what can be done about it. Research into the state of the science on patient safety presents a relatively uncharted course to nurses. From the nursing perspective, models can be developed that explore medication actions and interactions as well as outcomes. The role of the patient and the nurse–patient interaction in medication error, such as compliance with discharge instructions, should be investigated as well. Patient-safety research that is directed by nurses would afford opportunities to investigate various age-specific populations, disease states, and medical settings. In the National Quality Forum a number of factors associated with a greater risk of medication errors were identified, any of which would serve as an excellent subject of nursing research, including the impact of diagnostic technologies, patient acuity, and clinical environments on patient safety.

Advancing diversity leadership in health care.

IN 2011, the search firm Witt/Kieffer1 conducted a survey of US health care leaders to gain an inside view of the challenges and success factors to increasing leaders who are ethnically diverse from white. Four hundred sixty-six people answered the survey for an 11% response rate. The demographics were as follows: 18% white, 55% black, 10% Hispanic, 13% Asian, and 4% other as shown in the Figure. The Figure identifies the differences in perceptions of white as compared with minority respondents as to why more minorities are not health care leaders.

News from the front.

I n 2006, Institute of Medicine (IOM) convened the Roundtable on Value and Science-Driven Health Care. The roundtable members are health care leaders from government agencies, pharmaceutical companies, industry, academic, and medicine, and a nurse professional, Mary Naylor, PhD, RN, FAAN, Professor and Director of the Center for Transitions in Health, University of Pennsylvania. The charter and vision of the roundtable is to help transform the way evidence on clinical effectiveness is generated and used to improve health and health care. Participants have set a goal that by 2020, 90% of the clinical decisions will be supported by accurate, timely, and up-to-date clinical information, and will reflect the best evidence. The roundtable assessments are reported in the 11 volumes of the IOM Learning Health System Series published by National Academic Press. The volume entitled Redesigning the Clinical Effectiveness Research Paradigm: Innovation and Practice-Based Approaches