Transforming nursing through knowledge

Professional Accountability: Leadership

Leadership - is a shared responsibility with other nursing leaders and reflects both current and future decision making related to strategic and operational issues.
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    Best Practice Spotlight Organizations (BPSOs) are health-care and academic organizations selected by the Registered Nurses’ Association of Ontario (RNAO) through a request for proposals process to implement and evaluate the RNAO's best practice guidelines.

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    A cross-national study of the role of leadership in health-system redesign. The team's goal was to identify ways to foster leadership for health-system redesign in Canada and, using a participatory-action research approach, to eplore the dynamics of leadership in the particular health-system redesign effort each sub-team was studying.

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    Nursing leaders are indispensable in creating positive nursing work environments that retain an empowered and satisfied nursing
    workforce.
     
    Positive and supportive leadership styles can lower patient mortality and improve nurses’ health, job satisfaction, organizational commitment, emotional exhaustion, and intent to stay in their position.
     
    The results of this study support the role of positive leadership approaches that empower nurses and discourage workplace incivility and burnout in nursing work environments.
     
    The findings also provide empirical support for the notion of resonant leadership, a relatively new theory of relationship-focused leadership approaches. 
     
    This research adds to the growing body of knowledge documenting the key role of positive leadership practices in creating healthy work environments that promote retention of nurses in a time of a severe nursing shortage.

     

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    The theme of this Editorial issue is ‘Global Nursing Leadership’. The terms ‘global’ or ‘globalisation’ are not new, but have been used increasingly since the mid-1980s, forexample, in the newspapers and media. How often do we stop and think: what do these really mean? What is globalisation? Today it is easy to ‘Google’ everything and find from the internet that… ‘Globalisation is the process of international integration arising from the interchange of world views, products, ideas, and other aspects of culture…
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    In this month’s column, Stephanie Ferguson, PhD, RN, FAAN, Director, International Council of Nurses’ (ICN) Leadership for Change Programme; Facilitator, ICN Global Nursing Leadership Institute; ICN Consultant for Nursing and Health Policy; and World Health Organization Consultant, provides a perspective on the importance of global nursing excellence and highlights the American Nurses Credentialing Center’s strategic global quest for nursing excellence.
     
    The global quest for nursing excellence is a priority for all nurse leaders, managers, and nurses. Whether delivering healthcare, teaching the next generation of nurses and midwives, engaging in research aimed at strengthening nursing practice, or being active in health policy, excellence is the collective goal.

     

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    This literature synthesis strengthens our understanding of the elements that influence staff mix decision-making, including patient, provider and organizational factors. In addition, it provides further evidence to support the evaluation framework (CNA et al., 2005) that is broadly structured using those three components. While some progress has been made toward the development and implementation of tools and processes to inform staff mix decision-making, substantial gaps in this area remain. In effect, this represents the ‘uptake’ or ‘utilization’ of the research linking nursing staff mix to clinical outcomes.
     
    Overall, the evaluation framework provides one organizing model that settings can use to apply staffing research to practice environments. While researchers continue to produce literature in this field that contains variable findings, the results can be used to broadly inform decisions around nurse staffing. As such, administrators and researchers must continue to measure outcomes in a meaningful and consistent manner to enhance evidence regarding safe and effective nurse staffing practices.
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    In this four-year program of research, we studied the emergence and spread of evidence-informed models of nursing across the healthcare system. We defined these evidence-informed models as transformative models for health services delivery, primarily delivered by or involving the work of nurses. Introducing these models, which can cross sectors, takes multiple strategies with support from decision-makers at organizational, regional and system levels. Promoting rapid uptake of evidence-based practices by practitioners and organizations entails focused implementation strategies within and between organizations.
     
    Our objectives were to understand how evidence-based best practices are developed and diffused across the healthcare system; what cost drivers and benefit levers accompany the development, diffusion and spread of a best practice; and what factors support, sustain or impede intra-and inter-organizational system change. We took a whole-systems change perspective in our work, envisioning the innovations as multi-level, non-linear and multi-directional, with sustainable system adaptations.

     

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    A conceptual framework has been developed that takes a public health perspective. This framework has been developed by a working group of public health professionals and scholars, in consultation with a broad range of individuals in public health. This dicussion paper describes the proposed framework.

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    The Blueprint for Action for Community Health Nursing in Canada outlines a national framework and action plan for the current and future development of community health nursing in Canada. This Blueprint is the product of collaboration and is intended to provide diverse stakeholders including educators, policy-makers, leaders in health services administration, researchers and community health nurses, among others, with a framework to guide decisions and activities that promote and protect the health of Canadians. 
     
    It will be used as an advocacy tool, and as a guide to direct coordinated action to manage the strategic changes and actions essential to promoting, protecting and restoring the health of all Canadians. The framework is a living document − a starting place for discussion and continued interprofessional and intersectoral collaboration. Different communication strategies and tools will eventually emanate from the Blueprint to address concerns and issues of various partners in action.
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    The ability to influence others is a required competency  for nurse executives trying to achieve positive patient/organizational outcomes. The Adams Influence Model (AIM) is a framework for understanding the factors, attributes, and process of influence. The AIM is grounded in nursing and organizational literature and provides nurse leaders with a road map for developing an effective strategy to achieve influence with individuals and/or groups. The authors describe the AIM and present a case study illustrating  its application by a chief nurse executive.