Veenema Tener Goodwin, Deruggiero Katherine, Losinski Sarah, Barnett Daniel
Johns Hopkins School of Nursing, Center for Humanitarian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Veenema); Johns Hopkins International, Johns Hopkins Medicine, Baltimore, Maryland (Dr Deruggiero); Johns Hopkins School of Nursing, Baltimore, Maryland (Ms Losinski); and Department of Environmental Health & Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Barnett).
Nurs Adm Q. 2017 Apr/Jun;41(2):151-163. doi: 10.1097/NAQ.0000000000000224.
Strong leadership is critical in disaster situations when "patient surge" challenges a hospital's capacity to respond and normally acceptable patterns of care are disrupted. Activation of the emergency operations plan triggers an incident command system structure for leadership decision making. Yet, implementation of the emergency operations plan and incident command system protocols is ultimately subject to nursing and hospital leadership at the service- and unit level. The results of these service-/unit-based leadership decisions have the potential to directly impact staff and patient safety, quality of care, and ultimately, patient outcomes. Despite the critical nature of these events, nurse leaders and administrators receive little education regarding leadership and decision making during disaster events. The purpose of this study is to identify essential competencies of nursing and hospital administrators' leadership during disaster events. An integrative mixed-methods design combining qualitative and quantitative approaches to data collection and analysis was used. Five focus groups were conducted with nurse leaders and hospital administrators at a large urban hospital in the Northeastern United States in a collaborative group process to generate relevant leadership competencies. Concept Systems Incorporated was used to sort, prioritize, and analyze the data (http://conceptsystemsinc.com/). The results suggest that participants' institutional knowledge (of existing resources, communications, processes) and prior disaster experience increase leadership competence.
在“患者激增”挑战医院应对能力且正常可接受的护理模式被打乱的灾难情况下，强有力的领导至关重要。应急行动计划的启动触发了用于领导决策的 incident command system 结构。然而，应急行动计划和 incident command system 协议的实施最终取决于服务和科室层面的护理及医院领导。这些基于服务/科室的领导决策结果有可能直接影响员工和患者安全、护理质量以及最终的患者结局。尽管这些事件至关重要，但护士领导者和管理人员在灾难事件期间接受的关于领导和决策的教育却很少。本研究的目的是确定灾难事件期间护理及医院管理人员领导的基本能力。采用了一种综合混合方法设计，将定性和定量方法结合用于数据收集和分析。在美国东北部一家大型城市医院，与护士领导者和医院管理人员进行了五个焦点小组讨论，采用协作小组流程来生成相关的领导能力。使用 Concept Systems Incorporated 对数据进行分类、排序和分析（http://conceptsystemsinc.com/）。结果表明，参与者的（现有资源、沟通、流程方面的）机构知识和先前的灾难经验会提高领导能力。
