<p> Within the health care system, patient safety outcomes have been criticized for many years. Medical malpractice, common errors, and nosocomial infections (i.e., hospital-acquired infections) are safety concerns, and represent a public health problem. Since the Institute of Medicine (1999) published To Err is Human: Building a Safer Health System in 1999, changes have been made to improve the use of technology and leverage advancements in research that improve patient safety. Nurse leaders can also help to facilitate process improvements in the patient safety culture. The purpose of this capstone project was to explore the nursing leader role in improving patient safety in a hospital setting. The method utilized for this study was a literature review. Prominent articles identifying the role of nursing leadership were included. Seven drivers of patient safety were identified (Sammer, Lyken, Singh, Mains, &amp; Lackan (2011), and subsequently informed this project. The targeted populations were patients, families, nurses, nurse administrators, and medical personnel. Findings regarding the nurse leader role, patient improvements, and barriers to improvements were reviewed. Nurse leaders were found to be of critical importance to patients, medical personnel, and the health care system. The limitations of this review and implications for policy and practice are discussed. </p>

<p> Home care nurses (HCNs) have reported a high rate of exposure to work-related injuries (WRIs). Nurses are challenged by the multidimensional problems associated with home care safety. These contextual risk factors increase the physical and social health problems of health care workers and of community suffering as a whole. This quantitative, cross-sectional study was designed to examine the relationship between the organization-related factors (ORFs) and the environment-related factors (ERFs) and their influences on safety behaviors (SBs) and the WRIs of HCNs. The PRECEDE framework was used to guide the study. Self-reported data were obtained from 74 home health care (HHC) nurses using the Safety Home Care Nursing questionnaire. A linear regression model was applied to determine the nature of the association between the independent variables and dependents variables. Findings showed the ORFs demonstrate a stronger effect on the SBs than the impact of the ERFs. The management commitment and the home-based care significantly affected the SBs. The supervisory support and safety access to a client's home were decreasing the WRIs. Therefore, the integration of efforts: The management and leadership of the health organization, the health care providers, and the clients&rsquo; family would improve safety of HHC. This study is expected to help develop safety strategies for home care and thus attempt to minimize WRIs among HCNs. Nurses free of injuries are able to provide a quality of care and improve patients&rsquo; health outcomes that in turn have an effect on reducing community suffering and financial costs.</p><p>

<p> Patients and families play an important role at the bedside, and that is making sure the transition of care among providers is safe and effective. Bedside shift report (BSR), a type of patient and family engagement, is a process where patients, families, and health care providers work together as partners to improve the quality and safety of hospital care. In 2010, TJC developed and revised the standards for patient-centered care, which were designed to improve the safety and quality of care for patient and family involvement. The purpose of this quantitative descriptive study with a causal-comparative design was to compare two dependent variables of patient and nurse satisfaction from the pre-and post-implementation of BSR as a patient and family engagement strategy and determine if BSR resulted in a positive return on investment for a health care organization. This quantitative descriptive study employed Donabedian&rsquo;s structure-process-outcome (SPO) approach model. This model is a foundation for modern health care quality measurement, studying the structures of process and outcome, and the means to an end of a relationship. The data analysis utilized both descriptive and inferential statistics. The mean and standard deviation were calculated on two dependent variables, nurse satisfaction and patient satisfaction. Both research questions were measured using Chi-square to compare the difference in the yearly data for patient satisfaction and nurse satisfaction pre-and post-implementation of BSR as a patient and family engagement strategy on a surgical unit. The dependent variable patient satisfaction is statistically significant and the dependent variable nurse satisfaction is not statistically significant. Each year, post-implementation BSR for both dependent variables had a positive trend.</p><p>

<p> Inefficiencies in leadership and limited leadership strategies in hospitals contribute to delayed hospital discharges and an increased financial burden on a hospital. Three administrators from 2 hospitals who are part of a hospital conglomerate in Chicago, Illinois were selected for interview in this qualitative multiple case study to explore how hospital discharge strategies reduce delayed hospital discharges and improve profitability. Contingency was the primary theoretical theory for this study. The purposive sampling consisted of the selections of individual who were knowledgeable and had experience to organize, manage, and implement processes in an organization. Data collection occurred using face-to-face semistructured interviews, direct observation, and a review of discharge documents. Data analysis took place using the modified van Kaam method. Two emergent themes were identified relating to strategies for efficient communications and facilitating effective leadership. Implications for positive social change include the potential to improve health services within the community where access to health care is limited or the need exists for additional hospital beds. Positive leadership strategies in hospitals tend to contribute to the success and wellbeing of employees, patients, communities, and the economy.</p><p>

Extreme professional nurse shortage exerts stress upon the conventional recruitment and retention efforts of administrators in health care institutions, causing administrators to seek alternative solutions, including the recruitment and hiring of foreign nurses. The productivity of the foreign nurse alternative, as evidenced by pass rates on registered nurse licensure examination and by retention of the recruited nurses at sponsoring institutions is low, raising questions about factors that contribute to lack of success and promulgate improvement of foreign nurse recruitment and orientation initiatives. This study describes and analyzes an attempt to assimilate Filipino nurses at a medical center in western Massachusetts of just under 1000 client beds during an 18% professional nurse position vacancy crisis, occurring in the mid 1980's. The initiative, involving the recruitment and socialization of a group of 37 graduate nurses from the Philippines to fill staff nurse position vacancies on a variety of clinical service units, is summarized in a case description. This study identifies significant factors to be considered by administrators who have responsibility for the planning and implementation of similar initiatives. The literature review relates cultural information in two areas necessary to understand the transcultural socialization of a Filipino nurse, the pre professional socialization and the professional socialization contexts. The literature review of the professional socialization area discusses important contextual factors in Filipino nurse employment, nursing practice and nursing education. The Wolf-Welsh Linkage Methodology and the Wolf Knowledge Diffusion/Utilization Inventory provided the framework for the study. The seven interrelated parts of the Methodology provided the basis for data collection and ex post facto analysis of the case data. Data sources included the researcher's own participant observations, available medical center documents, and interviewed persons. Periodicals and external reports supplemented these data. The analysis clarified key characteristics of the Filipino nurse socialization and related linkage activities that might have contributed to greater success in the medical center case. Nineteen recommendations for successful linkage in future foreign nurse initiatives comprise the concluding chapter of the study.

Thesis (M.N.)--Memorial University of Newfoundland, School of Nursing, 1998. / Typescript. Bibliography: p. 108-114.

Thesis (Ph.D.) -- University of Adelaide, Dept. of Clinical Nursing, 2003. / "September 2002" Includes bibliographical references (leaves 301-318).

Thesis (M.N.)--Memorial University of Newfoundland, School of Nursing, 2002. / Typescript. Bibliography: leaves 180-188.

Thesis (M.N.)--Memorial University of Newfoundland, School of Nursing, 2002. / Typescript. Bibliography: leaves 216-228.