Christine T Kovner

Abstract

Translation science is the process of transdisciplinary teams accelerating the discoveries and findings from the laboratory, clinic, and community, and moving them into interventions that improve the health of individuals and populations. These discoveries include new forms of diagnostics, novel therapeutics, and innovative medical and behavioral interventions. The role of nurses in translational science is a natural fit, given the transdisciplinary nature of their work, the evolving role of nursing science, and the high-level of patient and family-centered interaction that nurses have as clinicians and scientists. As Clinical and Translational Science Awards were being developed across the nation, nurses felt the need for a stronger and more united voice. In 2010, nurse leaders in this field started the Nurse Scientist-Translational Interest Research Group (NS-TRIG). The group is now in its eighth year and provides a forum for nurse scientists to connect, communicate and collaborate. The purpose of this article is to describe the formation and background of the NS-TRIG, describe our meeting structure and provide examples of content. We also describe a summary of major accomplishments and work products of the NS-TRIG, and consider lessons learned and future directions of the group.

Abstract

Background: The Institute of Medicine (IOM) report, The Future of Nursing, included recommendations to increase nurse diversity, the percent of nurses obtaining a bachelor's degree, and inter-professional education. Purpose: The purpose of this paper is to report the progress toward achievement of these recommendations. Methods: We used a longitudinal, multi-state data from four cohorts of nurses newly licensed in 2004 to 2005, 2007 to 2008, 2010 to 2011, and 2014 to 2015 to examine and compare the trends. Finding: The percentage of males who became licensed increased, from 8.8% in 2004 to 2005 cohort to 13.6% in the 2014 to 2015 cohort. The percentage of white-non-Hispanic nurses who were licensed decreased from 78.9% in 2007 to 2008 to 73.8% in 2014 to 2015. These differences primarily reflect an increase in white-Hispanic nurses. More nurses are obtaining a bachelor's degree as their first professional degree, from 36.6% in 2004 to 2005 cohort to 48.5% in 2014 to 2015 cohort. About 40% of the 2014 to 2015 cohort reported that they learned to work in inter-professional teams. Collegial nurse-physician relations had an upward positive trajectory over time increasing almost 7%. Discussion: The diversity and education of new nurses have increased, but are short of meeting the IOM recommendations.

Abstract

Purpose: Weather-related disasters have increased dramatically in recent years. In 2012, severe flooding as a result of Hurricane Sandy necessitated the mid-storm patient evacuation of New York University Langone Medical Center. The purpose of this study was to explore, from the nurses’ perspective, what the challenges and resources were to carrying out their responsibilities, and what the implications are for nursing education and preparation for disaster. Design: This mixed-methods study included qualitative interviews with a purposive sample of nurses and an online survey of nurses who participated in the evacuation. Methods: The interviews explored prior disaster experience and training, communication, personal experience during the evacuation, and lessons learned. The cross-sectional survey assessed social demographic factors, nursing education and experience, as well as potential challenges and resources in carrying out their disaster roles. Findings: Qualitative interviews provided important contextual information about the specific challenges nurses experienced and their ability to respond effectively. Survey data identified important resources that helped nurses to carry out their roles, including support from coworkers, providing support to others, personal resourcefulness, and leadership. Nurses experienced considerable challenges in responding to this disaster due to limited prior disaster experience, training, and education, but drew on their personal resourcefulness, support from colleagues, and leadership to adapt to those challenges. Conclusions: Disaster preparedness education in schools of nursing and practice settings should include more hands-on disaster preparation exercises, more “low-tech” options to address power loss, and specific policies on nurses’ disaster roles. Clinical Relevance: Nurses play a critical role in responding to disasters. Learning from their disaster experience can inform approaches to nursing education and preparation.

Abstract

Background: Numbering close to 300,000 nurse managers represent the largest segment of the health care management workforce. Their effectiveness is, in part, influenced by their job satisfaction. Purpose: We examined factors associated with job satisfaction of novice frontline nurse managers. Methodology/Approach: We used a cross-sectional, correlational survey design. The sample consisted of responders to the fifth wave of a multiyear study of new nurses in 2013 (N = 1,392; response rate of 69%) who reported working as managers (n = 209). The parent study sample consisted of registered nurses who were licensed for the first time by exam 6-18 months prior in 1 of 51 selected metropolitan statistical areas and 9 rural areas across 34 U.S. states and the District of Columbia. We examined bivariate correlations between job satisfaction and 31 personal and structural variables. All variables significantly related to job satisfaction in bivariate analysis were included in a multivariate linear regression model. In addition, we tested the interaction effects of procedural justice and negative affectivity, autonomy, and organizational constraints on job satisfaction. The Cronbach's alphas for all multi-item scales ranged from.74 to.96. Findings: In the multivariate analysis, negative affectivity (β = -.169; p =.006) and procedural justice (β =.210; p =.016) were significantly correlated with job satisfaction. The combination of predictors in the model accounted for half of the variability in job satisfaction ratings (R2 =.51, adjusted R2 =.47; p

Abstract

Purpose: Superstorm Sandy forced the evacuation and extended shutdown of New York University Langone Medical Center. This investigation explored how nurses were impacted by the disasters and how they can best be supported in their nursing responsibilities. Design: Sequential mixed methods were used to explore the psychosocial issues nurses experienced throughout the course of this natural disaster and its lingering aftermath. Methods: In-depth interviews were conducted from April to June 2013 with a subsample of nurses who participated in the evacuation deployment (n = 16). An anonymous, Internet-based cross-sectional survey sent to all registered nurses employed at the hospital at the time of the storm explored storm impact and recovery. Between July and September 2013, 528 surveys were completed. Findings: The qualitative data revealed challenges in balancing professional obligations and personal concerns. Accounts described dealing in the immediate recovery period with unexpected job changes and resultant work uncertainty. The storm's lingering aftermath did not signify restoration of their predisaster lifestyle for some, but necessitated coping with this massive storm's long-lasting impact on their personal lives and communal loss. Conclusions: Nurses working under the rapidly changing, uncontrolled, and potentially dangerous circumstances of a weather-related disaster are also experiencing concerns about their families’ welfare and worries about personal loss. These multiple issues increase the psychosocial toll on nurses during a disaster response and impending recovery. Clinical Relevance: Awareness of concerns and competing demands nurses experience in a disaster and aftermath can inform education and services to enable nurses to perform their critical functions while minimizing risk to patients and themselves.

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Abstract

Nurses are often recognized for their volunteer efforts following disasters and international humanitarian crises. However, little attention is paid to the activities of nurses who promote a culture of health in their communities through local volunteer work. In this article, we describe nurses’ perceptions of how they promote health in their communities through formal and informal volunteer work. Using 315 written responses to an open-ended question included in a 2016 survey of the career patterns of nurses in the U.S., we utilized conventional content analysis methods to code and thematically synthesize responses. Two broad categories of nurse involvement in volunteer activities arose from the participants’ responses to the open-ended question, “Please tell us what you have done in the past year to improve the health of your community”: 17% identified job-related activities, and 74% identified non-job-related activities. 9% of respondents indicated they do not participate in volunteer work. Job-related activities included patient education, educating colleagues, and “other” job-related activities. Non-job-related activities included health-related community volunteering, volunteering related to a specific population or disease, family-related volunteering, church activities, health fairs, raising or donating money, and travelling abroad for volunteer work. Nurses are committed to promoting a culture of health in their communities both at work and in their daily lives. Leveraging nurses’ interest in volunteer work could improve the way nurses engage with their communities, expand the role of nurses as public health professionals, and foster the social desirability of healthful living.

Abstract

Background: Preventable harm continues to be one of the leading causes of patient death. Each year about 400,000 patients die from sepsis, hospital acquired infections, venous thromboembolism, and pulmonary embolism. However, as shown in the recent reduction in hospital acquired infections, the number of deaths could be reduced if healthcare providers used evidence-based therapies, which are often included in clinical practice guidelines (CPGs). Purpose: The purpose of this integrative review is to appraise and synthesize the current literature on barriers to and facilitators in the use of clinical practice guidelines (CPGs) by registered nurses. Design: Whittemore and Knafl integrative review methodology was used. Primary quantitative and qualitative studies about the nurses' use of CPGs and published in peer-reviewed journals between January 2000 and August 2015 were included. Methods: The Critical Skills Appraisal Program (CASP) was used to critically appraise the quality of sixteen selected quantitative and qualitative studies. Results: Internal factors were attitudes, perceptions, and knowledge whereas format and usability of CPGs, resources, leadership, and organizational culture were external factors influencing CPG use. Conclusion: Given each barrier and facilitator, interventions and policies can be designed to increase nurses' use of CPGs to deliver more evidence based therapy. In order to improve the use of CPGs and to ensure high quality care for all patients, nurses must actively participate in development, implementation, and maintenance of CPGs.

Abstract

The authors regret: In Table 5 the reference group for “hold an additional job for pay” that is currently “yes” should be “no”. On page 259, first full paragraph in left column, third line, ‘holding more than one job for pay’ should be deleted. The abstract is correct. The authors would like to apologise for any inconvenience caused.

Abstract

Background: Registered nurse job turnover is an ongoing problem in the USA resulting in significant financial costs to both organizations and society. Most research has focused on organizational turnover with few studies about internal or unit-level turnover. Turnover of new nurses in hospitals has particular importance as almost 80% of new nurses work in hospitals and have higher turnover rates when compared to experienced nurses. This paper focuses on new nurses' unit-level turnover rates in hospitals. Objectives: The purpose of this study is to: (1) identify factors that predict new nurses staying in the same units, positions, and job titles to inform unit-level retention strategies, and (2) examine the changes in work environment perceptions over time between nurses who remain in the same unit, position, and title to those who changed unit, position and/or title. Study design: A panel survey design was used to analyze changes over time. Participants: Participants were newly licensed registered nurses who were licensed for the first time between August 1st, 2004 and July 31st, 2005. The nurses came from metropolitan statistical areas or rural areas that were nested to reflect a nationally representative USA sample (58% response rate). The analytic sample for this study was 1335. Data sources: Data were collected in January 2006 and 2007 following the Dillman total design approach. All potential respondents received paper surveys and non-responders received repeated mailings. Results: Using multinomial regression the five variables with the largest effects on unit retention were (1) variety (positive), (2) having another job for pay (negative), (3) first basic degree (having a bachelors or higher degree increased the probability of staying), (4) negative affectivity (positive), and (5) job satisfaction (positive). Nurses who changed unit, and/or position, and/or title reported more positive change scores on a variety of work attitudes. Discussion: Almost 30% of new nurses working in hospitals leave their unit, and/or position, and/or title during their first year of work. Our results point to the variables on which managers can focus to improve unit-level retention of new nurses. Although participants were from a nationally representative sample of nurses who were newly licensed in 2004-2005, with the geographical shifts in the USA population in the last 10 years the sample may not be geographically representative of new nurses who graduated in 2015.