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Think About It

A forum for discussion of the latest news and ideas in nursing management and healthcare.

Tuesday, November 13, 2018

For nurse leaders in search of current research and perspectives on a wide range of patient care considerations, look no further than Nursing Management’s new Safety Solutions special. As part of our November issue, the annual Safety Solutions guide features the latest on topics ranging from mental health and informatics to medication administration and staffing. Here’s a quick look at this year’s coverage.

Mental health was the focus of the continuing-education feature “Suicide risk assessment and prevention.” This article discusses the importance of ensuring that your nursing team is adequately trained in patient suicide risk assessment and appropriate follow-up prevention, and offers concrete steps you and your staff members can take to reduce the risk of patient suicide attempts.  

Our Informatics article, written by Nursing Management Editorial Board member Joyce Sensmeier, MS, RN-BC, CPHIMS, FHIMSS, FAAN, explores clinical decision support tools that can help clinicians by taking over routine tasks, warning of potential problems, or providing suggestions for the clinical team and patient to consider. We highlight infection control with “Changing practice, saving lives,” which describes one neurosurgical ICU unit’s project to achieve a sustained decrease in catheter-associated urinary tract infections. Medicine administration takes center stage in “Blame: What does it looks like?” This article uses a medication error case study to distinguish between blame and accountability.
Infusion and monitoring topics are also included. “Vascular access: HD patients’ perceived knowledge and practices” reports on a study evaluating patients’ awareness of complications linked with tunneled central venous catheters and their interrelated practices. “Factors associated with falls among hospital inpatients” presents a mixed-methods study, which concluded that most impatient falls can be eliminated or significantly reduced if nursing staff members adhere to high-reliability organization principles.

“Cultural considerations for hepatitis B vaccination compliance” focuses on communication by recounting one hospital’s initiative to increase hepatitis B vaccine administration rates within its Orthodox Jewish patient population. The topic of staffing rounds out the issue in “Hospital staffing technology: Hazard and opportunity risks,” which considers the risks and mitigation strategies associated with deploying a web-based staffing application across an integrated multi-hospital system.

The full issue can be viewed online here.

Friday, October 12, 2018

Attendees, speakers, and organizers gathered September 24-28 in Lake Buena Vista, Fla., for the 39th annual Nursing Management Congress. Brett Culp, a filmmaker whose nonprofit organization The Rising Heroes Project produces documentaries on uplifting, real-life stories to inspire personal growth, highlighted the week on Wednesday morning with a keynote address on leadership. Speaking to about 1,000 nurse leaders, Culp centered his address around what it takes to be a leader and supplemented his message by sharing the inspiring stories of his film subjects.

Activities got underway at Disney's Coronado Springs Resort with a number of pre-conference workshops before Elizabeth Angelo kicked off the conference Tuesday night with an opening session that explored tools for building personal and professional resilience.

Along with dozens of breakout sessions across Wednesday and Thursday, Congress included four additional general sessions. Conference Chairperson Pamela Hunt, MSN, RN, NEA-BC, opened Thursday with a session on the daily work of the nurse leader and the impact of nurse leaders' decisions on patients. Linda Laskowski Jones, editor-in-chief of the Nursing2018 journal, presented a unique session on Friday morning that highlighted leadership lessons we can learn from the behaviors and social hierarchy of wolves, and Linda Stimmel simulated a real trial to demonstrate the pressures and pitfalls of a deposition and trial of a nurse. Faith Brennan Roberts wrapped up the event with a closing presentation that examined the evolutionary process of a nurse from student to practitioner to leader and explored why we do the things we do through the metaphoric use of a Northeastern folktale about a crab bucket.

Congress planners held a ceremony to recognize the winner of the 2018 Richard Hader Visionary Leader Award, Dr. Lori Colineri, DNP, RN, NEA-BC, a CNO who has worked to transform the work environment and improve outcomes for patients and families at hospitals in RWJ Barnabas Health's Southern Region. Organizers also announced this year's NM Congress Poster Award winners. Christie Muza, MSN, RN, CEN, and Kathleen Flinn of UPMC took the contest's top spot with their project, "Overcoming Nurse manager Overload—Building a Resilient Nurse Manager." Lori Parrot and Crista Shronk of Cook Children's Medical Center were the runners-up with their poster, titled, "I'm a New Nurse Manager, Now What?"

We're thrilled to announce that Nursing Management Congress2019 will take place October 15-19 at the Hyatt Regency in New Orleans! A special thanks to our attendees, speakers, and planners, as well as to Disney and the hotel staff at Coronado Springs for allowing us to host another great conference.

Wednesday, November 16, 2016

Over the past few years, healthcare reform laced with economic unrest may have brought us the feeling that there's something bad looming. And the election process may have accentuated these fears. It doesn't matter if you voted for or against the President-elect, the change that will occur with a new President will affect all of us. And this gives us anxiety about the unknown. The change may be positive or negative – whichever, it's still looming.


I just read an article posted on Fierce Healthcare, which gives us further reason to be anxious. We should prepare for a potential recession that will impact hospitals with even more fiscal uncertainty than is happening now. We're in the middle of healthcare reimbursement changes that result in hospitals and other healthcare organizations sitting on shifting fiscal sand. The future of Obamacare is uncertain and now we have a possible recession to add to the financial unpredictability.


Hospitals will be challenged to deliver low-cost, high-quality care with good outcomes. Being fiscally conservative, tightening belts, and making do with less will be the norm. As nurse leaders, we'll be stretched to care for our patients with fewer resources and less staff. It sounds gloomy, but this new reality may push the nursing profession even more toward creativity and innovation. Our usual care models will be challenged and our processes will require greater efficiency. Nurses have always risen to the challenge and we'll be proactive in creating the best care environment for our patients.


Caryl Goodyear-Bruch, PhD, RN, NEA-BC

Senior Director, Children's Mercy Hospital, Kansas City, Mo.

Nursing Management Editorial Board Member

Monday, September 26, 2016

​I’ve had some really good dialogue lately with clinical nurses in the critical care setting about nurse-patient ratios, staffing assignments, and acuity. In a world where nursing organizations are fighting for safe nurse-patient ratios and standardized staffing laws, we’re faced with increased in-house acuity levels and financial responsibility. How does an organization manage this safety and equitably? How do you empower frontline nurses to manage this in a financially sound, effectively safe, and staff satisfying manner?

I believe the answer lies in acuity-based staffing processes. Staffing by acuity enables bedside nurses and their immediate supervisory staff the ability to decide what their unit needs based on care needs and changing situations. This allows some semblance of control over poor staffing, as well as the ability to make safety-based assignment adjustments as needed using professional judgment and experience as guides. In the past, we’ve struggled nationally with acuity tools and processes that fail to meet validity needs because they’re often subjective in nature (barring tools such as APACHE). What does staffing by acuity mean to you? What does your organization do regarding staffing vs. numbers vs. assignments? Let’s hear from you!

Lisa Lockhart, MHA, MSN, RN, NE-BC
Nurse Manager
KentuckyOne Health, Saint Joseph Health System
Lexington, Ky.

Tuesday, September 13, 2016

I currently work with a CNO that has a true belief in succession planning! I’m excited by this on a professional level because I also believe in succession training and the way it empowers staff members and ensures the strength and unity of nursing’s future. Although our nursing education and organizations support this type of legacy, I’ve rarely seen it in action. Why do you suppose that is? I remember being told once by a respected mentor that a leader’s job is to educate and empower those you lead to the point where you’re no longer needed! Could it be that some of our leaders fear they may encourage, support, educate, and empower themselves out of a job? I think it may actually be that many don’t truly understand what succession training is. It requires empowering future leaders to think for themselves and stand on their own. Your successors will be in various roles throughout the organization, forging ahead to carry the torch of quality, safety, engagement, and empowerment that was instilled in them by igniting their power to think, grow, and develop as professionals. What are your thoughts on and experiences with this topic?

Lisa Lockhart, MHA, MSN, RN, NE-BC
Nurse Manager
KentuckyOne Health, Saint Joseph Health System
Lexington, Ky.