Ryan Rosemary W, Harris Karen K, Mattox Lisa, Singh Olivine, Camp Melanie, Shirey Maria R
University of Alabama at Birmingham, University Hospital, Birmingham, Alabama (Mss Ryan, Harris, Mattox and Camp); UF Health Shands at the University of Florida, Gainesville, Florida (Ms Singh); and Clinical and Global Partnerships, University of Alabama at Birmingham, School of Nursing, Birmingham, Alabama (Dr Shirey).
Nurs Adm Q. 2015 Jul-Sep;39(3):229-38. doi: 10.1097/NAQ.0000000000000111.
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.
医疗保健领域存在着通过护理领导力来提高质量和优化资源配置的机会。美国国内生产总值中估计有18%用于产出不佳的医疗保健服务体系。本文旨在描述质量改进和实施科学举措如何利用护理领导力策略来提升成效,这些策略在协调关键同事以推动协作过程中发挥着不可或缺的作用。对文献进行了批判性评估,这支持了循证实践改进、协作变革过程以及护理领导力专业角色的重要性。关于护理领导者在单位层面实施可持续变革以成功实现资源配置的实践策略,相关证据有限。建议采用基于罗杰斯创新扩散理论的策略来弥补文献中的空白。这些策略旨在增加有意义的知识或“原因”,创造一个临界点,并从结果出发实施可持续变革。护士领导者是推动单位层面协调和实施变革的核心要素。所描述的循证策略的应用对护理实践、教育和学术研究具有启示意义。