Innovativeness of nurse leaders

Determining the Innovativeness of Nurses Who Engage in Activities That Encourage Innovative Behaviors

BACKGROUND

We sought to understand the innovativeness of nurses engaging in innovative behaviors and quantify the associated characteristics that make nurses more able to innovate in practice. We first compared the innovativeness scores of our population; then we examined those who self-identified as an innovator versus those who did not to explore differences associated with innovativeness between these groups.

METHODS

A cross-sectional survey study of nurses in the US engaging in innovative behaviors was performed. We performed an exploratory factor analysis (EFA) to determine the correlates of innovative behavior.

RESULTS

Three-hundred and twenty-nine respondents completed the survey. Respondents who viewed themselves as innovators had greater exposure to HCD/DT workshops in the past year (55.8% vs. 36.6%, p = 0.02). The mean innovativeness score of our sample was 120.3 ± 11.2 out of a score of 140. The mean innovativeness score was higher for those who self-identified as an innovator compared with those who did not (121.3 ± 10.2 vs. 112.9 ± 14.8, p =< 0.001). The EFA created four factor groups: Factor 1 (risk aversion), Factor 2 (willingness to try new things), Factor 3 (creativity and originality) and Factor 4 (being challenged).

CONCLUSION

Nurses who view themselves as innovators have higher innovativeness scores compared with those who do not. Multiple individual and organizational characteristics are associated with the innovativeness of nurses.

Determination of the effects of innovativeness levels of the elderly on their psychological resilience

PURPOSE

This study was conducted to determine the rate at which the individual levels of innovativeness of the elderly explain their psychological resilience.

DESIGN AND METHODS

This study was conducted with 313 elderly people. The data of the study were collected using the Individual Innovativeness Scale and Psychological Resilience Scale for Adults.

FINDINGS

In this study, a significant relationship was found between individual innovativeness and psychological resilience in the elderly. Demographic variables were related to psychological resilience.

PRACTICE IMPLICATIONS

Within the scope of these results, increasing the individual innovativeness levels of older adults will enable them to be psychologically more resilient.

Original Research: How Magnet Hospital Status Affects Nurses, Patients, and Organizations: A Systematic Review

OBJECTIVE

As the number of Magnet hospitals continues to rise in the United States and abroad, the body of literature regarding various outcomes at Magnet hospitals is increasing also. A systematic review examining and compiling the most recent evidence would be invaluable to those seeking to pursue Magnet recognition for their facility. We conducted this systematic review to investigate how Magnet hospital status affects outcomes for nursing professionals, patients, and health care organizations.

METHODS

In January 2018, the databases CINAHL, ProQuest, PubMed, and La Biblioteca Cochrane Plus were searched for relevant studies. The reference lists of selected articles were also examined to identify additional studies. The PRISMA statement was followed, and established methods for systematic review were used to produce a narrative summary. The quality of the reviewed studies was assessed according to the 22-item Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for observational studies.

RESULTS

Of the 163 studies identified, 21 met the eligibility criteria and are included in this review. On the whole, lower rates of nursing shortages, burnout, job dissatisfaction, and turnover were observed at Magnet hospitals compared with non-Magnet hospitals. The rates of patient mortality, falls, hospital-acquired infections, and pressure ulcers were also lower. Nursing work environments were found to be safer and were associated with a higher quality of care in Magnet hospitals than in non-Magnet hospitals, and Magnet hospitals were found to provide more cost-effective care.

CONCLUSION

This review provides nursing managers and administrators with the most recent evidence demonstrating that Magnet hospitals have better nursing work environments and are associated with better outcomes for nurses, patients, and organizations than non-Magnet hospitals. This evidence should inform future decision-making with regard to pursuing Magnet designation.

Preceptor Criteria Revisited

BACKGROUND

Preceptor selection criteria based on demographic data has been shown to yield inconsistent degrees of success in the role. The purpose of this mixed-methods study was to determine if preceptors with different levels of innovativeness identified different benefits and challenges when implementing the preceptor role.

METHOD

A mixed-methods study was conducted using online surveys to determine each participants' individual level of innovativeness. Interviews were conducted with preceptors from each innovator category to identify benefits and challenges in implementing the preceptor role.

RESULTS

Preceptors who scored lower in innovativeness identified challenges that were not discussed by preceptors who scored higher in innovativeness. Conversely, preceptors who scored higher in innovativeness identified benefits that were not common to preceptors with lower levels of innovativeness.

CONCLUSION

Opportunities for nurse educators and facility nurse leaders were presented to meet the diverse needs of the preceptor and provide for more consistent implementation of the preceptor role. [J Contin Educ Nurs. 2020;51(9):425-432.].

Personal and organizational factors related to initiative behavior among psychiatric nurses

PURPOSE

To identify the degree of personal initiative (PI) among psychiatric nurses and to examine the influence of personal and organizational characteristics on their PI.

DESIGN AND METHODS

Ninety-seven nurses completed a questionnaire on PI, work climate, self-efficacy toward initiatives and innovations, nursing work environment, and actual initiative at work.

FINDINGS

Differences in actual initiative at work according to the level of education, and negative association between PI and age were found. Self-efficacy and work climate explained 56% of PI; self-efficacy, work climate, and age explained 30% of initiative behavior.

PRACTICE IMPLICATIONS

Investing in young nurses, fostering higher education, and creating supportive work environment can help in conversion of innovative vision into actual initiatives.

Levels of Innovativeness Among Nurse Leaders in Acute Care Hospitals

OBJECTIVE

The purposes of the study were to describe levels of innovativeness in nurse executives, clinical directors, and nurse managers in acute care settings in the United States and to compare innovativeness between the groups.

BACKGROUND

Nurse leaders must navigate the complex ever-changing landscape of healthcare. New strategies are necessary for managing resources and improving patient outcomes.

METHODS

A survey was posted in the American Organization of Nurse Executives newsletter using the Scales for Measurement of Innovativeness to measure innovativeness. The sample included 137 nurse leaders in executive and management positions in acute care settings.

RESULTS

The largest percentage of nurse leaders across all leadership roles fell into the innovativeness category of early majority. Of the total sample, only 2 individuals were categorized as innovators, and only 15 as early adopters. Fifty-one individuals were early majority; 49 were in the late majority; and 20 individuals were at the lowest category of innovativeness, that of laggards. Both nurse executives and clinical directors had significantly higher levels of innovativeness compared with nurse managers. Graduate-level education and certification were not associated with higher levels of innovativeness.

CONCLUSIONS

Understanding the levels and components of innovativeness may assist nurse leaders to affect change in themselves and their organizations.

Disruption Ahead: Navigating and Leading the Future of Nursing

"Innovation" has become a ubiquitous term in the business of health care. The concept of disruptive innovation adds a new complexity to this popular notion. The emergence of artificial intelligence, virtual reality, and venture capitalists generates excitement, doubt, and curiosity for stakeholders across health care organizations. As companies such as Amazon, Apple, CVS, and JP Morgan enter this sector, disruptions will emerge that aim to improve the quality of care while reducing overall cost. The purpose of this article is to differentiate the concepts of innovation and disruptive innovation, explore their significance to the nursing profession, and outline 3 key roles nurse leaders can occupy as they navigate the future ever-changing trajectory of health care.

First line nurse managers' experiences of opportunities and obstacles to support evidence-based nursing

AIM

The aim was to explore first line nurse managers' experiences of opportunities and obstacles to support evidence-based nursing.

DESIGN

A qualitative study with a phenomenographical approach.

METHOD

Data were collected through focus group interviews with 15 first line nurse managers' in four settings.

RESULTS

The results are presented in four categories of description headed: Manage the everyday work vs. evidence-based nursing; Uncertainties about evidence-based nursing and nursing research; Time as a reality, as an approach; and Shaping awareness-towards an active approach to evidence-based nursing. The overarching category of description has been formulated as follows: The internal relation-how active leadership influences evidence-based nursing. The outcome space is presented as: The individual path-how to make vision and reality become a working entity around evidence-based nursing.

Health-promoting leadership: An integrative review and future research agenda

AIM

To provide a synthesis of the evidence of health-promoting leadership related to nursing by exploring definitions, core attributes and critical conditions.

BACKGROUND

Increasing pressure in healthcare settings due to efficiency requirements, population ageing with complex illnesses and projected global shortage of nurses, is a potential threat to nurses' health and job satisfaction, and patient quality of care and safety. New ways of thinking about nursing leadership and evidence-based human resource management are required to improve nursing environments.

DESIGN

Integrative literature review.

DATA SOURCES

Eight databases were searched: Academic Search Premier, CINAHL, Emerald, ERIC, Web of Science, MEDLINE, Psychinfo and Science Direct. Included papers were published between 2000-2016.

REVIEW METHODS

Of 339 papers, 13 were eligible for inclusion: eight qualitative and five quantitative. Studies were assessed for quality using standardized checklists. Framework-based synthesis was used, allowing for themes identified a priori to be specified as coding categories. This method also allows new themes to emerge de novo.

RESULTS

Four themes were identified. There are multiple definitions of health-promoting leadership, along with description of the non-health-promoting leader. The health-promoting nurse leader engages in employees' health promotion, and takes responsibility for actions and maintains open communication, accommodating nurses' participation in change processes. Through competence development, the health-promoting organization builds capacity.

CONCLUSION

Health-promoting leadership may be a promising path to optimizing nursing outcomes through holistic thinking, which emphasizes the importance of context. Accumulated research is required to build a stronger line of international research, with attention to underlying mechanisms, limiting conditions and behaviours known to health-promoting leadership.

Self-organizing Development Teams for Innovative Nursing Care

The purpose of this study was to describe the participation of nurses and nurse leaders in self-organizing teams formed to develop innovative nursing care. The theoretical perspective combines Bondas' caritative theory on nursing leadership with Waterman's and Dolan's work on ad hoc organizations. Seven self-organizing teams participated in a 2-year action research project. Data were collected through fieldwork, formal and informal individual and group interviews, and diaries. Analytical abstraction methodology described by Miles et al was used. The metaphor "overcoming the jet lag of bureaucracy" is based on 5 themes: struggling to design the new team; investing time and self; needing research and leadership support; evolving collegial collaboration, professional growth, and pride; and growing professional security and the will to continue education as a result of learning.

The CNO and Leading Innovation: Competencies for the Future

Although innovation is critical to success in today's tumultuous environment, health care is slow to embrace it, and there is significant variability in strategic adoption of innovation across organizations. Nurse leaders do not need to be innovators themselves but must engage in, and have the ability to create, an organizational culture of innovation. Twenty-six leadership behaviors specific to innovation leadership were identified through a Delphi study to develop competencies as well as the knowledge, skills, and attitudes that support nurse leaders in acquiring or expanding the capability of nurse leaders to create a culture of innovation. It was demonstrated that nursing innovation experts were able to differentiate between general leadership behaviors and innovation leader behaviors. In addition, the need to acquire basic leadership competencies before mastering innovation leader competencies was identified. Five strategies to initiate or expand a culture of innovation in organizations were identified, including (1) assessment of organizational capacity for innovation; (2) acknowledgement of the responsibility of all leaders to create an innovation-rich environment; (3) provision of education, skill building, and coaching; (4) encouragement of an ongoing practice of innovation, even in the face of failure; and (5) development of a sustainable culture of innovation.

An Exploratory Descriptive Study of Registered Nurse Innovation: Implications for Levels of Adoption

PURPOSE

The aims of this study were to describe registered nurses' levels of personal innovativeness and registered nurses' perceived organizational innovativeness and determine the relationship between these 2 variables.

BACKGROUND

There is limited research to describe the levels of innovation of nurses within a hospital. The levels of innovation can determine the likelihood of adoption of evidence-based practices at the bedside. As change agents, clinical nurse specialists can determine successful implementation strategies tailored to nurse levels of innovation.

DESCRIPTION

This was a descriptive study at a midwest, urban, teaching, 408-bed Magnet hospital.

OUTCOMES

Surveys were completed by 217 nurses. The participants reported high personal innovativeness ((Equation is included in full-text article.)= 32.1; SD, 6.4), and the institution was perceived as innovative, with 90.3% of scores categorized as positive innovativeness. The statistically significant correlation was in the medical-surgical unit (r = -0.52, P < .01). There is no correlation between personal innovativeness and organizational innovativeness except for medical-surgical nurses (P = .03). They are likely to perceive the organization more innovative than themselves.

CONCLUSIONS

Determining adopter characteristics can be valuable to the clinical nurse specialist by adapting strategic interventions to advance nursing practice. Exploring levels of adoption can be an innovative strategy to transform nursing at the bedside and throughout the organization.

Nursing Leader Collaboration to Drive Quality Improvement and Implementation Science

Nursing leadership opportunities to improve quality and align resources in health care exist. An estimated 18% of United States gross domestic product is spent on health care delivery systems that produce poor outcomes. The purpose of this article was to describe how quality improvement and implementation science initiatives enhance outcomes using nursing leadership strategies that play an integral role in aligning key colleagues to drive the collaborative process. A critical appraisal of the literature was conducted, which supports the importance of evidenced-based practice improvement, collaborative change process, and professional role of nursing leadership. Limited evidence exists related to practice strategies for nursing leaders to implement sustainable change at the unit level for successful alignment of resources. Strategies based on Rogers' Diffusion of Innovation Theory are recommended to address the gap in the literature. The strategies aim to increase meaningful knowledge or the "why," create a tipping point, and implement sustainable change starting with the end in mind. Nurse leaders are a central component for driving alignment and implementing change at the unit level. Uses of the described evidenced-based strategies have implications for nursing practice, education, and scholarship.

Magnet nurse administrator attitudes and opportunities: toward improving lesbian, gay, bisexual, or transgender-specific healthcare

OBJECTIVE

This study explored Magnet® hospital chief nursing officers' (CNOs') attitudes toward gays and lesbians and the impact that these attitudes have on providing advocacy for lesbian, gay, bisexual, or transgender (LGBT) patients and staff.

BACKGROUND

Homonegativity encompasses both heterosexism and homophobia and has profound effects on the health of LGBT populations. Little has been reported about the attitudes of CNOs toward LGBT populations and how these might impact advocacy for LGBT healthcare.

METHODS

Surveys were electronically mailed to 343 Magnet CNOs. The Modern Homonegativity Scale was used to assess attitudes, and additional statements were developed to assess the comfort level of the respondent in advocating for LGBT populations.

RESULTS

Attitudes among CNOs toward LGBT populations and comfort with advocating for LGBT populations were positively correlated. Those demonstrating less homonegative attitudes were more likely to feel comfortable advocating for LGBT patients and staff.

CONCLUSIONS

Recognizing and addressing bias among nurse leaders through education are important to ensure equitable healthcare for patients and employees.

A new HIV prevention network approach: sociometric peer change agent selection

Internationally, the Peer Change Agent (PCA) model is the most frequently used conceptual framework for HIV prevention. Change agents themselves can be more important than the messages they convey. PCA selection is operationalized via heterogeneous methods based upon individual-level attributes. A sociometric position selection strategy, however, could increase peer influence potency and halt transmission at key network locations. In this study, we selected candidate PCAs based upon relative sociometric bridging and centrality scores and assessed their attributes in comparison to one another and to existing peer educators. We focused upon an emerging HIV epidemic among men who have sex with men in Southern India in 2011. PCAs selected based on their bridging score were more likely to be innovators when compared to other centrally-located PCAs, to PCAs located on the periphery, and to existing peer educators. We also found that sociodemographic attributes and risk behaviors were similar across all candidate PCAs, but risk behaviors of existing peer educators differed. Existing peer educators were more likely to engage in higher risk behavior such as receiving money for sex when compared to sociometrically selected peer changes agents. These existing peer educators were also more likely to exhibit leadership qualities within the overall network; they were, however, just as likely as other non-trained candidate peer change agents to report important HIV intravention behavior (encouraging condoms within their network). The importance of identifying bridges who may be able to diffuse innovation more effectively within high risk HIV networks is especially critical given recent efficacy data from novel HIV prevention interventions such as pre-exposure prophylaxis. Moreover, while existing peer educators were more likely to be leaders in our analysis, using peer educators with high risk behavior may have limited utility in enacting behavior change among sex worker peers or male clients in the network.