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A gap was identified in having enough competent charge nurses and shift coordinators on a Family Beginnings unit. To mitigate the gap, immediate evidence-based practice solutions were developed, and a new nurse leadership program was implemented. Literature synthesis identified best practices for achieving competency when transitioning staff nurses into the leadership roles of charge nurse and shift coordinator. Program outcomes included increased self-perceived competence levels and decreased unit turnover. [ J Contin Educ Nurs. 2025;56(1):11-13.] ., Competing Interests: Disclosure: The authors have disclosed no potential conflicts of interest, financial or otherwise.

Nursing advocacy is a critical component of nursing practice. An exemplar of how nurses can advocate for an enhanced quality of nursing work environment and safe staffing is provided. Garnering state and national resources can assist in impacting statewide change. [ J Contin Educ Nurs. 2024;55(11):520-522.] .

The knowledge domain of professional identity in nursing is the analysis and application of information derived from experiences, critical reflection, and scientific discovery from nursing and other disciplines. Knowledge guides role clarity, decision-making, and advocacy. Key concepts described in this column include mindset, innovation, clinical judgment, and reflection. [ J Contin Educ Nurs. 2024;55(7):328-330] .

A crucial domain of professional identity in nursing is the area of values and ethics. Comprising a set of core values and principles, values and ethics are used to guide nurse conduct. Professional development specialists can use the nursing code of ethics and organizational structure and examples to teach nurses the values and ethics domain of professional identity in nursing. [ J Contin Educ Nurs . 2024;55(6):279-281.] .

Nurses in all settings need the clinical judgment ability to care for clients with fluid and electrolyte imbalances. An educational activity was developed using the Clinical Judgment Measurement Model to provide nursing professional development specialists with a tool to support the competency of nurses caring for these clients. [ J Contin Educ Nurs. 2024;55(2):59-61] .

The nurse as leader is a critical pillar of nursing professional identity to support ongoing development of nurses in a safe, effective, and healthy work environment. Defined as "inspiring self and others to transform a shared vision into reality" (University of Kansas School of Nursing, 2023), the Nurse as Leader Pillar is developed throughout a nurse's career. Starting with nursing school, students must learn nursing leadership skills and develop and integrate leadership characteristics into their practice. Professional development specialists must embed these characteristics into nursing education, as all nurses are leaders. Current nurses in practice must set the stage and model leadership in their environment as new nurses are introduced into the profession. [ J Contin Educ Nurs. 2023;54(11):497-500.] .

Professional comportment is critical to the development of professional nurses. An essential component of professional identity, professional comportment should be integrated into lifelong learning. Defined as a nurse's professional behavior, it is "demonstrated through words, actions, and presence" (University of Kansas Medical Center). Students must learn professional comportment, and practicing nurses will need to become knowledgeable to meet the needs of the new generation of nurses. [ J Contin Educ Nurs. 2023;54(5):204-207.] .

After a needs assessment for care of patients with altered airways was performed, gaps in educational materials were identified and hospital learning management system educational resources were created/updated. Frontline nurses and clinical and administrative leaders developed four modules to enhance the care of patients with altered airways. This article describes how professional development specialists could teach nurses how to develop clinical educational modules for specialized populations. [ J Contin Educ Nurs . 2023;54(4):153-156.] .

The COVID-19 pandemic has required close examination of workforce-related stressors that over decades have contributed to widespread burnout, negative health outcomes, including mental health outcomes, and the loss of the well-educated professionals who are the future of the nursing profession. In the United States and globally, evidence points to factors known to diminish well-being, including inequities, issues of minority status, persistent discrimination, and demanding work environments. The American Academy of Nursing (AAN), dedicated to organizational excellence, nursing leadership and evidence-based policy, develops statements reflecting its mission and those of its nursing affiliates and corporate member, The American Nurses Association. Within nursing, despite the efforts of its members toward advancement, professional fulfillment is often constrained by the systems in which nurses practice and workplace factors over which they have little control. Action by key organizations to initiate changes at systems levels in workplace safety, to increase professional mobility, and propel policies that increase access to health care resources could improve nurse well-being. This paper proposes recommendations from the AAN Expert Panels on Building Health Care System Excellence, Psychiatric Mental Health and Substance Use, and Global Health Expert Panels for the American Academy of Nursing to leverage related policy in the arenas of government and professional/healthcare organizations. Transforming health care work environments and advancing nurse well-being and equity can be accomplished through key, innovative policy changes. These will be achieved through collaboration among associations, organizations, nonprofit groups, and with the public and the media., (Copyright © 2023. Published by Elsevier Inc.)

Evidence-based practice can provide a guideline for teaching evolving information and guidelines related to communicable diseases. Teaching nurses with technology and the social constructivism framework allows for the transmission of knowledge and identification of knowledge limitations. The current health care challenges related to infectious diseases have provided opportunities for expanding how nurses are educated about evolving guidelines. This article provides an example of teaching nurses using the chain of infection. [ J Contin Educ Nurs. 2023;54(2):58-60.] .

Evidence-based practice (EBP) is foundational to nursing practice, but initiatives can be challenging to implement and sustain. A strategic process framework can successfully guide EBP initiatives. This column describes how nursing professional development specialists can teach nurses how to use a strategy process framework to guide an EBP initiative. [ J Contin Educ Nurs . 2022;53(11):483-485.] .

Teaching nurses how to create a personal and professional development plan is important to help them structure measurable, obtainable personal and career goals. Meaningful goals and metrics for career growth are critical to nurses' professional development. As nurses learn about creating a personal and professional development plan, they can personalize their nursing journey. This column describes how professional development specialists can teach nurses to create a personal and professional development plan. [ J Contin Educ Nurs . 2022;53(10):438-441.] .

Engaging clinical nurses in nursing research requires value for the nurses and a structured process. One way to involve nurses in research is through development of a research compendium. A professional development specialist can lead the creation of a research compendium. Identifying key stakeholders, developing a technologic infrastructure, piloting the compendium, gaining feedback, and identifying outcomes that will be evaluated are key. [ J Contin Educ Nurs . 2022;53(3):106-108.] .

The ability to perform an organizational assessment is a valuable skill for nurses to have as we continue to equip nurses to lead in organizations. Organizational assessments are used to assess an organization before any change. This column discusses how to prepare and lead nurses to perform an organizational assessment. [ J Contin Educ Nurs . 2021;52(12):550-553.] .

Background: Incivility results in nurse burnout, decreased job performance, and decreased patient safety. Leaders of an academic-practice partnership developed educational activities promoting organizational civility during the COVID-19 pandemic. The purpose of this article is to describe an educational activity about civility that was transitioned to a virtual platform and participants' comfort engaging in and responding to incivility., Method: Face-to-face education was converted to a synchronous online event, supporting 75 nurses, nursing students, and other health care professionals in attendance. Activities consisted of cognitive rehearsal techniques, breakout rooms, simulation videos, group debriefs, and panel discussions delivered via Zoom and Mentimeter software., Results: Workplace Civility Index results were significantly different from pretest to post-test. Seventy-two percent of participants were not comfortable gossiping about others, but only 30% were comfortable responding to incivility., Conclusion: Promoting civility awareness through a virtual education platform using cognitive rehearsal techniques and reflection can provide support for current and future nurses. [ J Contin Educ Nurs . 2021;52(12):575-580.] .

Participatory design can involve, empower, and facilitate those stake-holders (health care providers, nurses, professional development experts, patients, and patients' families) who can positively impact patient falls through the design process. Participatory design can help participants identify effective solutions to prevent patient falls and solve other health care problems. This article guides professional development specialists on how to use participatory design to solve health care problems with a focus on fall reduction. [ J Contin Educ Nurs . 2021;52(8):359-361.] .

To continue nursing leadership development experiences in a virtual world requires planning and perseverance. Given the current landscape of health care, a view toward healthy work environment experiences is critical to maintain participant engagement while meeting educational objectives. This article outlines the steps and key points important in developing healthy work environment nursing leadership experiences. [ J Contin Educ Nurs . 2021;52(7):309-311.] .

Health care professionals must be adept at conducting and using evidence-based practice (EBP). No best method to teach EBP to health care providers exists. This article outlines the steps and key points found to be important when developing and teaching EBP to interprofessional executive health care teams. [ J Contin Educ Nurs . 2021;52(5):214-216.] .

Primary care (PC) nurses have challenges and barriers to professional development. This article describes how a Doctor of Nursing Practice Executive Leader Student Consulting Team identified PC nurses' challenges to engaging in professional development opportunities in a clinic at Eskenazi Health. The authors spotlighted and made suggestions for modifications of the professional development opportunities for PC nurses in the health care organization. Key points include how the team assessed for challenges, identified stakeholders for the process, and identified and tailored professional development opportunities for the PC nurses. [ J Contin Educ Nurs . 2021;52(4):165-167.] .

The impact of the COVID-19 pandemic on nursing professional development has spurred innovative teaching efforts by educators. The application of new technology provided innovative support for participant engagement and allowed for evaluation of civility education learning outcomes. A technology expert provided necessary support in a live virtual environment. A planned dress rehearsal prior to the live event ensured the functionality of the virtual platform. The versatility of the new technology allowed breakout rooms and interactive software applications. Nursing professional development practitioners can use these tips to reimagine other face-to-face educational activities into a virtual platform. [J Contin Educ Nurs. 2021;52(1):11-12.]., (Copyright 2021, SLACK Incorporated.)

The patient-reported outcomes measurement information system (PROMIS) offers standardized assessment measures of clinically relevant patient-reported outcomes. This study evaluated the reliability and validity of select PROMIS measures with U.S. military veterans following orthopedic surgery. Data for the current study were collected as part of a pilot randomized control trial assessing the efficacy of a 1-day Acceptance and Commitment Therapy workshop on persistent postsurgical pain in at-risk veterans undergoing orthopedic surgery. Sixty-seven participants completed surveys 3 months after surgery. Participants completed the following PROMIS instruments: PROMIS Anxiety Short Form 8a, PROMIS Depression Short Form 8b, and PROMIS Pain Interference Short Form 8a. PROMIS measures were compared to the Generalized Anxiety Disorder 7-Item Scale, the Patient Health Questionnaire 9-Item Scale, and the Brief Pain Inventory Pain Interference subscale, respectively. All three PROMIS measures demonstrated excellent internal consistency (Cronbach's αs ranged from .93 to .96) and each loaded onto a single factor. The PROMIS measures were moderately correlated with their respective comparison measures ( r = .69 to .76). The PROMIS anxiety and PROMIS depression measures were highly correlated to one another ( r = .91). Findings highlight the potential utility of these PROMIS measures in veterans following orthopedic surgery and the overlap between the PROMIS depression and anxiety measures in this sample.

Identifying process breaks that increase risks to patient safety in hospitals results in the need for educational interventions. These interventions must be effective to meet the needs of a diverse nursing staff. Finding ways to best reach nursing staff and overcome challenges requires creative solutions to keep a large, diverse nursing staff up-to-date on current and best practices. Strategies include blended learning, electronic distribution, and educational flyers to provide a variety of formats to meet the educational needs within the organization. [J Contin Educ Nurs. 2020;51(11):498-500.]., (Copyright 2020, SLACK Incorporated.)

Specimen labeling errors in health care are costly. Using multiple educational interventions reduced specimen labeling errors and cost. Strategies included collaborative development of educational posters, compelling specimen mislabeling error stories, posting labeling results monthly, and providing real-time charge nurse notification of mislabeled/unlabeled specimens. Nurse educators can easily teach staff to implement these strategies. [J Contin Educ Nurs. 2020;51(10):450-452.]., (Copyright 2020, SLACK Incorporated.)

Providing nursing professional development and continuing education during a pandemic or when participants are only distance accessible may necessitate a shift to online teaching. Shifting requires mindful preparation-meeting the nurses where they are, understanding and practicing using the technology, using effective virtual communication techniques, providing feedback, and evaluating the outcomes. [J Contin Educ Nurs. 2020;51(8):355-358.]., (Copyright 2020, SLACK Incorporated.)

Background: As the issues of incivility, lateral and horizontal violence, and bullying continue in nursing, strategies are needed to address these disruptive behaviors. Educational activities raise awareness of these issues and can improve the ability to reduce the frequency and overall impact of incivility., Method: This study used a pretest/posttest quasiexperimental mixed-methods design to improve dialogue and interpersonal engagement and to create behavioral change. The Workplace Civility Index (WCI) was used to measure interventional success., Results: WCI scores improved significantly (p < .00001) for the experimental group postintervention. In contrast, the WCI scores decreased significantly for the control group (p = .000227). Within the experimental group, all participants noted the successful use of a positive conflict management strategy after the educational intervention., Conclusion: Although further research is recommended, this study provided evidence to support the efficacy of an asynchronous provider-directed, learner-paced e-learning educational activity in decreasing incivility and increasing perceived comfort level during critical conversations between nurses. [J Contin Educ Nurs. 2020;51(3):138-144.]., (Copyright 2020, SLACK Incorporated.)

A year-long Nurse Leadership Institute (NLI) for emerging leaders in primary care clinics and acute care environments was developed, implemented, and evaluated. The NLI's goal was to foster empowerment in interprofessional collaborative practice environments for nurses in the three cohorts of NLIs. The NLI was framed around the Five Leadership Practices of modeling the way, inspiring a shared vision, challenging the process, enabling others to act, and encouraging the heart. To create a professional learning environment, foster community, and enhance leadership skills, the Lean In Circle materials developed by Sandberg were adapted for content reorganization and discussion. Minimal literature exists specifically addressing nursing leadership professionals' development based on Sandberg's Circle materials. The findings of the three NLI cohorts reported in this article begin to fill this existing knowledge gap. Participants reported a significant increase in leadership skills. Recommendations for refinement of future NLI offerings are provided. J Contin Educ Nurs. 2018;49(2):61-71., (Copyright 2018, SLACK Incorporated.)

The purpose of this article is to describe the business case framework used to guide doctor of nursing practice (DNP) program enhancements and to discuss methods used to gain chief nurse executives' (CNEs) perspectives for desired curricular and experiential content for doctor of nursing practice nurses in health care system executive roles. Principal results of CNE interview responses were closely aligned to the knowledge, skills and/or attitudes identified by the national leadership organizations. Major conclusions of this article are that curriculum change should include increased emphasis on leadership, implementation science, and translation of evidence into practice methods. Business, information and technology management, policy, and health care law content would also need to be re-balanced to facilitate DNP graduates' health care system level practice., (Copyright © 2017 Elsevier Inc. All rights reserved.)

The current study aimed to examine the relationships between movement and resting pain intensity, pain-related distress, and psychological distress in participants scheduled for total knee arthroplasty (TKA). This study examined the impact of anxiety, depression, and pain catastrophizing on the relationship between pain intensity and pain-related distress. Data analyzed for the current study (N = 346) were collected at baseline as part of a larger Randomized Controlled Trial investigating the efficacy of TENS for TKA (TANK Study). Participants provided demographic information, pain intensity and pain-related distress, and completed validated measures of depression, anxiety, and pain catastrophizing. Only 58% of the sample reported resting pain >0 while 92% of the sample reported movement pain >0. Both movement and resting pain intensity correlated significantly with distress (r s  = .86, p < .01 and .79, p < .01, respectively). About three quarters to two thirds of the sample (78% for resting pain and 65% for movement pain) reported different pain intensity and pain-related distress. Both pain intensity and pain-related distress demonstrated significant relationships with anxiety, depression, and catastrophizing. Of participants reporting pain, those reporting higher anxiety reported higher levels of distress compared to pain intensity. These findings suggest that anxious patients may be particularly distressed by movement pain preceding TKA. Future research is needed to investigate the utility of brief psychological interventions for pre-surgical TKA patients.

Complications involving short peripheral catheters (SPCs) can significantly affect health care costs, patient quality of life, morbidity, mortality, and treatment expense, especially when the hospital stay is lengthened. This article examines the relationship between SPC dwell time and the incidence of phlebitis and potential bacteremia. The literature is replete with most studies supporting SPCs remaining in situ until a clinical reason warrants catheter removal. Removing and not routinely restarting unneccessary intravenous catheters can help prevent catheter-related infections and other vascular complications and reduce cost.

Aim: Clinical nurse specialist (CNS) students at an urban Midwestern university participated in a study to describe their satisfaction with civic engagement (CE) learning activities., Methods: A descriptive and cross-sectional study design housed a faculty-developed CE learning module with four learning activities: (a) gaining interprofessional collaborative practice leadership experience in a mock incident command experience; (b) identifying, researching, and writing a legislative letter about an area of public and/or health policy concern; and (c) developing a professional online network LinkedIn account with experienced CNSs; (d) identifying potential mechanisms for achieving board membership on a civic or professional nursing organization. Faculty developed an online survey to determine student satisfaction through quantitative and qualitative data. Participants completed the survey at the end of the course., Results: Satisfaction with CE learning activities ranged from a mean of 6.07 to 6.75 on a 7-point Likert scale, with higher scores indicating more satisfaction. The overall mean score for CE activities was 6.27 (SD = 0.61) and mean score for course objectives' satisfaction was 6.55 (SE = 0.70). Students reported high satisfaction with their learning as a result of the CE activities., Conclusions: CNS students perceived high satisfaction with learning from the CE activities in this study., (© 2016 Wiley Periodicals, Inc.)

Purpose: The purpose of this article is to describe a business case framework that can guide clinical nurse specialists (CNS) in clinical intervention development., Background: Increased emphasis on cost-effective interventions in healthcare requires skills in analyzing the need to make the business case, especially for resource-intensive interventions. This framework assists the CNS to anticipate resource use and then consider if the intervention makes good business sense., Business Case Framework: We describe a business case framework that can assist the CNS to fully explore the problem and determine if developing an intervention is a good investment. We describe several analyses that facilitate making the business case to include the following: problem identification and alignment with strategic priorities, needs assessment, stakeholder analysis, market analysis, intervention implementation planning, financial analysis, and outcome evaluation. The findings from these analyses can be used to develop a formal proposal to present to hospital leaders in a position to make decisions. By aligning intervention planning with organizational priorities and engaging patients in the process, interventions will be more likely to be implemented in practice and produce robust outcomes., Conclusion: The business case framework can be used to justify to organization decision makers the need to invest resources in new interventions that will make a difference for quality outcomes as well as the financial bottom line. This framework can be used to plan interventions that align with organizational strategic priorities, plan for associated costs and benefits, and outcome evaluation., Implications for Cns Practice: Clinical nurse specialists are well positioned to lead clinical intervention projects that will improve the quality of patient care and be cost-effective. To do so requires skill development in making the business case.

Seasoned nurses frequently resign from their positions due to burnout. An innovative idea that could support nurse retention is nurse sabbaticals. Balanced scorecards with strategy maps can display financial benefit, positive customer experience, and operational and human capital development required to initiate and sustain a professional nurse sabbatical. A balanced scorecard with strategy map is an effective tool that demonstrates connection between the organizational mission and the outcomes of a nurse sabbatical program.

Background/Significance of Problem. Nurse-to-nurse lateral violence (NNLV) has been internationally reported for greater than two decades and results in new nurse turnover and serious negative outcomes. Clinical Question/Project Objective. Will NNLV and cognitive rehearsal (CR) education result in a decrease in perceived nurse-to-nurse lateral violence in a critical access hospital (CAH)? The scope of this project was to determine perceived extent and increase awareness of NNLV through an educational project about NNLV and CR. Clinical Appraisal of Literature/Best Evidence. Trends of NNLV were assessed through an extensive literature review from Health Source, CINAHL, ProQuest Health, and Medical Complete. An educational forum about NNLV with CR was advocated for newly licensed nurses and current nurses (potential perpetrators of NNLV) with the goal of liberation of oppressed individuals. Integration into Practice/Discussion of Results. An interventional study with one group and pre-/postintervention was used to determine NNLV and CR education on perceived levels of lateral violence. Evidence-based measurement occurred through use of the Nurse Workplace Scale and the Silencing the Self-Work Scale. Outcomes were analyzed quantitatively through independent t-tests. Awareness of NNLV was increased. Evaluation of Evidence-Based Practice/Implications. Organizations must learn to eliminate NNLV. With increased levels of awareness of NNLV, nurses requested additional assistance in dealing with inappropriate behavior.

Practice-based acute care nurses experience a high incidence of burnout and dissatisfaction impacting retention and innovation and ultimately burdening the financial infrastructure of a hospital. Business, industry, and academia have successfully implemented professional sabbaticals to retain and revitalize valuable employees; however, the use is infrequent among acute care hospitals. This article expands upon the synthesis of evidence supporting nursing sabbaticals and suggests this option as a fiscally sound approach for nurses practicing in the acute care hospital setting. A cost-benefit analysis and human capital management strategies supporting nursing sabbaticals are identified.

Purpose: To review and examine the literature supporting a professional sabbatical, a potentially viable and innovative change strategy that could renew, revitalize, and retain nursing staff practicing in the acute care setting., Method: A literature search was completed using multiple search engines to procure articles that could answer the question: What is the evidence related to professional sabbaticals in nursing?, Findings: The search yielded 19 articles: one historical document, eight scholarly business articles, and 10 nursing publications. The literature review revealed most sources described sabbaticals using anecdotal data and 14 of the 19 articles were labeled as expert opinion or consensus., Conclusion: Borrowing from the successes in academia and other non-nursing professions, a human capital investment opportunity exists to design and test nursing sabbaticals. The authors identified a nursing sabbatical as a viable option, which can enhance nursing retention and revitalization., (© 2011 Wiley Periodicals, Inc.)

The literature confirms that much confusion exists regarding the terms quality improvement (QI), evidence-based practice (EBP), and research. A multifaceted approach was used to provide clarity regarding these three equally important concepts. First, the authors present a synthesis of the literature that discusses differences between QI, EBP, and research. Second, the authors introduce a newly created comparative table that synthesizes current literature and showcases differences between QI, EBP, and research. Finally, the authors highlight uses of the comparative table within multiple settings., (Copyright 2011, SLACK Incorporated.)

Purpose: The purpose of this paper is to examine the concept of nurse-to-nurse lateral violence (LV)., Source: Published literature--LV among nurses is significant and results in social, psychological, and physical consequences, negative patient and nursing outcomes, and damaged relationships. An extensive review of literature through Health Source, Cumulative Index to Nursing and Allied Health Literature (CINAHL), ProQuest health, and Medical Complete was used to determine agreement and disagreement across disciplines and emerging trends., Conclusion: This concept analysis demonstrates that nurse-to-nurse LV is nurse-to-nurse aggression with overtly or covertly directing dissatisfaction toward another. Origins include role issues, oppression, strict hierarchy, disenfranchising work practices, low self-esteem, powerlessness perception, anger, and circuits of power. The result of this analysis provides guidance for further conceptual and empirical research as well as for clinical practice. Organizations must learn how to eliminate antecedents and provide nurses with skills and techniques to eradicate LV to improve the nursing work environment, patient care outcomes, and nurse retention.

Health-related quality of life (HRQL) instruments have been used to measure HRQL in heart failure patients, but how different instruments compare in the same groups of patients is not known. The purpose of this study was to compare the reliability and validity of three HRQL measures in 211 heart failure patients recruited from clinics affiliated with an urban hospital. Two disease-specific instruments, the chronic heart failure questionnaire (CHQ) and the living with heart failure questionnaire (LHFQ), and one generic instrument, the short-form 12 (SF-12), were administered. Patients reported moderate to low HRQL scores. Floor or ceiling effects were noted in the disease-specific instruments. Internal consistency reliabilities of the CHQ and LHFQ were satisfactory. Construct, convergent, and discriminant validity were supported for each instrument. Each scale and subscale, except for the SF-12 mental component scale, differentiated between patients with New York Heart Association (NYHA) class I, II, and III plus IV; the LHFQ physical subscale was the only measure to differentiate between patients with NYHA class III and IV. All three instruments were satisfactory for measuring HRQL, but the disease-specific instruments were preferable to the generic instrument. The decision of which instrument to use depends on the purpose of the study.

Heart failure is a major health problem in the United States leading to high rates of mortality and morbidity and impaired quality of life. Assisting patients to improve compliance with their self-care regimen, including medications, dietary sodium restrictions, and self-monitoring (daily weights, edema assessment), may improve these poor outcomes. This article describes the development and initial evaluation of Heart Messages, a theory-based, tailored message intervention to improve compliance with the self-care regimen recommended for patients with heart failure. The project involved four phases, each of which is described in this article. The Heart Messages tailored message intervention program is available in both printed and Web-based formats. In a pilot study and clinical evaluation project, the program was found to be useful for patient education and feasible for implementation. Larger randomized trials are now warranted to evaluate the effectiveness of the intervention in improving compliance with the self-care regimen and thereby improving outcomes among patients with heart failure.