Background The Institute of Medicine's Future Nursing report identifies the clinical nurse leader as an innovative new role for meeting higher health-care quality standards. However, specific practices influencing documented outcomes remain unclear. Lack practice clarity limits ability to articulate, implement and measure leader-specific outcomes. Purpose methods Interpretive synthesis design grounded theory analysis were used develop a theoretical understanding that can facilitate...

Jacqueline Fawcett's nursing metaparadigm-the domains of person, health, environment, and nursing-remains popular in curricula, despite having been repeatedly challenged as a logical philosophy nursing. Fawcett appropriated the word "metaparadigm" (indirectly) from Margaret Masterman Thomas Kuhn devise that allowed her to organize then-current areas interest into philosophical "hierarchy knowledge," thereby claim inquiry practice rigorously "scientific." Scholars have consistently rejected...

To explore the feasibility and acceptability of a clinical nurse leader (CNL) role to improve interdisciplinary collaboration (IC) within fragmented acute-care microsystem. Fragmented patient care is associated with preventable adverse healthcare outcomes. IC decreases fragmentation improves quality. The CNL theorized provide necessary leadership competency skill base impact at optimal organizational level, point where most decisions are made. This study used descriptive non-experimental...

Current health policy calls for greater use of evidence based care delivery services to improve patient quality and safety outcomes. Care is complex, with interacting interdependent components that challenge traditional statistical analytic techniques, in particular when modeling a time series outcomes data might be "interrupted" by change method delivery. Interrupted (ITS) robust quasi-experimental design the ability infer effectiveness an intervention accounts dependency. standardized...

Attempting to implement evidence-based practices in contexts for which they are not well suited may compromise their fidelity and effectiveness or burden users (e.g., patients, providers, healthcare organizations) with elaborate strategies intended force implementation. To improve the fit between contexts, implementation science experts have called methods adapting tailoring strategies; yet, considering dynamic interplay among practices, remain lacking. We argue that harmonizing three can be...

Diffusion magnetic resonance imaging (MRI) is commonly used in acute stroke, but not considered diagnostic ischemic optic neuropathy. This study evaluates the presence of diffusion restriction patients with visual loss by analyzing diffusion-weighted images (DWI).A retrospective all who clinically presented and underwent MRI DWI between January 2011 May 2012 were evaluated. Patients suspected brainstem ischemia as a control group. Two neuroradiologists evaluated for within nerve.In all, 34...

Chronic obstructive pulmonary disease (COPD) and heart failure (HF) are chronic diseases that impart significant health care costs to the patient system. Limited access services affects severity functional status. Telemonitoring has shown promise in reducing acute utilization for patients, but benefit underserved not been determined. We evaluated outcomes following an event of a 90-day transitional program integrating telemonitoring technology home visits COPD HF patients.Patients were...

Healthcare settings and systems have been slow to adopt implement many effective cancer prevention control interventions. Understanding the factors that determine successful implementation is essential accelerating translation of interventions into practice. Many scholars studied determinants implementation, much this research has guided by Consolidated Framework for Implementation Research (CFIR). The CFIR categorizes at five levels (characteristics intervention, inner setting, individual,...

The current fragmented healthcare system, characterized by a lack of collaborative, patient-centered care processes, creates significant barriers to providing quality patient care. clinical nurse leader (CNL) is theorized provide leadership at the point-of-practice maintain cross-disciplinary collaborative processes that lead integrated care.The aim this study was assess impact CNL integration into an acute microsystem on quality, as measured satisfaction with care.A short interrupted time...

Concentrations of POMC-derived neuropeptides are reduced in hypothalami aged rodents, whereas levels POMC products the pituitary usually either unchanged or increased. Whether these changes reflect altered synthesis processing expression gene has not been established. We, therefore, measured mRNA and pituitaries young (7-month-old), middle-aged (15-month-old), old (31-month-old) female mice, using slot blot hybridization total RNA to riboprobes synthesized from cloned DNA fragments. poly(A)...

Objective Health-related quality of life (HRQoL) and self-reported outcome measures have a relevant impact on the medical decision-making process. They capture either current status allow for multiple prospective evaluations in course treatment or rely retrospective comparison health patients before after an intervention to assess its benefit. Importantly, these patient-assessed may be influenced by psychological factors. We compared HRQoL perceived benefit surgical vestibular schwannoma...

BACKGROUND: The Clinical Nurse Leader™ (CNL) initiative is in its 2nd decade. Despite a growing theoretical and empirical body of CNL knowledge, little known about CNLs themselves or where how their competencies are being integrated into care delivery across the country. OBJECTIVE: aim this study was to describe certified characteristics roles as part larger validating model for practice. METHODS: This used descriptive analysis survey data from national sample CNLs. RESULTS: Survey response...

Theories and models are not equivalent. I argue that an orientation towards as a primary carrier of nursing knowledge overcomes many ongoing challenges in philosophy science, including the theory-practice divide paradoxical pursuit predictive theories discipline is defined by process commitment to non-reducibility health/care experience. Scientific describe explain dynamics specific phenomenon. This distinct from theory, which traditionally propositions and/or predict world. The...

Nursing has a rich knowledge base with which to develop care models that can transform the ways health is promoted and valued. However, theory linking environment domain of nursing metaparadigm real-world environments where nurses practice patients experience their tenuous. Practice used foreground generative role in producing care, providing basis for relational proposition explicitly domains. A theoretical empirical focus on significance dynamics promote healing will strengthen present...

Abstract Purpose Clinical nurse leader TM (CNL)‐integrated care delivery is a new model for organizing master's‐level nursing clinical leadership at the microsystem level. While there growing evidence of improved patient quality and safety outcomes associated with CNL practice, organizational implementation characteristics that influence success are not well characterized. The purpose this study was to identify organization factors perceived integration into models. Methods A survey...

To empirically validate a conceptual model of Clinical Nurse Leader integrated care delivery.There is limited evidence frontline delivery models that consistently achieve quality patient outcomes. promising nursing with growing record success. However, theoretical clarity necessary to generate causal effectiveness.Sequential mixed methods.A preliminary practice was refined and survey items developed correspond domains, using focus groups Delphi process multi-professional expert panel. The...

The delivery and assessment of quality health care is complex with many interacting interdependent components. In terms research design statistical analysis, this complexity interdependency makes it difficult to assess the true impact interventions designed improve patient outcomes. Interrupted time series (ITS) a quasi‐experimental developed for inferring effectiveness policy intervention while accounting temporal dependence within single system or unit. Current standardized ITS methods do...

Communication errors are a leading cause of adverse events in the acute and ambulatory healthcare setting. We now understand that communication within across professions patients is complex achievement with numerous barriers, including cultural, educational, structural hurdles. Improvisation has been identified as an approach great potential to develop skills for multi-disciplinary students.We report on interdisciplinary conceptualization, operationalization, effectiveness testing novel...