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Innovations in Leadership Development: Improving Organizational Safety Culture
(2017-10-11)
In this third session of the symposium we will use a case study approach to apply concepts of mindfulness and reflective practice introduced in the sessions 1 and 2. We will use a guided reflective process to identify ...
Enhancing care of vulnerable populations through development of a holistic model to evaluate interprofessional education
(2016-03-21)
Session presented on Saturday, November 7, 2015 and Sunday, November 8, 2015:
This change project was implemented as part of the Experienced Nurse Faculty Leadership Academy (ENFLA) by Rebecca C. Lee (Scholar), in ...
Challenges and opportunities using story guided online deliberate practice to develop critical communication skills
(2017-09-25)
Story guided online deliberate practice intervention is a highly satisfactory and cost effective educational methodology in providing nursing students opportunities to practice critical communications, a high-stakes skill, ...
Developing novice nurse faculty: Finding an authentic leadership voice
(2017-07-17)
Purpose: To describe the impact of a 20-month mentored leadership development program for new nurse faculty with less than five years academic experience.
According to the American Association of Colleges of Nursing’s (AACN, 2015) 2014-2015 report, Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing, nursing schools in the U.S. turned away 68,938 qualified applicants from baccalaureate and graduate nursing programs in 2014 in part due to faculty shortages. A 2014 AACN special survey regarding faculty vacancies reveals a vacancy rate of 6.9% that year.
Anecdotally, some new nurse faculty members find the transition to academic life challenging and leave academia within 2-5 years, extending a shortage of nurse faculty. Further contributing to the existing shortage, the average age of doctorally prepared nurse faculty by rank (professor, associate professor, assistant professor) is 61.6, 57.6, and 51.4 years respectively. With a dramatic wave of retirements expected, fewer faculty will be available to fill the shortage, resulting not only in further shortage but in less experienced faculty, overall.
These factors raise questions of whether nurse faculty are adequately prepared for academic leadership. Research indicates that faculty and administrators in nursing programs in the United States resist accepting positions with greater administrative responsibility; faculty who do accept formal leadership roles are often thrust into positions with insufficient experience or leadership preparation (Young, Pearsall, Stiles, Nelson, & Horton-Deutsch, 2011). The quality of academic leadership sets the stage for the health of the overall work environment (Brady, 2010), which in turn affects faculty satisfaction and retention.
Formal mentoring offers one solution to addressing issues of gaps in leadership skill and numbers of faculty. Mentoring may be one way to facilitate leadership development and increase retention of new nursing faculty. However, despite broad recognition of the importance of mentoring, formal mentoring programs and empirical evidence is limited.
The Nurse Faculty Leadership Academy (NFLA) of Sigma Theta Tau International offers an intense, mentored leadership development experience to faculty with fewer than 5 years of full-time teaching experience. Based on the Kouzes and Posner Leadership model (2012), the NFLA is designed to foster academic career success, promote nurse faculty retention and satisfaction, encourage personal leadership development, and cultivate high performing, supportive work environments in academe. The NFLA is a 20-month mentored leadership experience through which scholars participate in two leadership development workshops, conduct in-depth self-assessment, and design an individualized leadership development plan guided by a Leadership Mentor from another academic institution and a Faculty Advisor from the NFLA core faculty. Together, Scholar, Mentor, and Advisor form a triadic mentoring relationship. Scholars also create, implement, and lead a team project to advance nursing education through which they develop their leadership skills and host two site visits for the triad with their local administrative team.
Methods: The design for the study was qualitative description with human subjects protection approval. Descriptive statistics were employed to describe characteristics of the Scholars, whose responses on their final NFLA report were reviewed and analyzed by four NFLA faculty to identify common patterns and themes. The research team used comparative analysis to reach consensus on the results of their analysis, and an audit trail was maintained to ensure credibility of the findings.
Results: The sample of 14 Scholars comprised 12 females and 2 males with a mean age of 49 years (range 33-58 years). Average number of years in scholars’ current teaching positions was 2.6. The majority of scholar respondents (86%) were Assistant Professors. The over-arching theme emerging from the data was “Finding an authentic leadership voice”. Four sub-themes emerged to characterize this theme: Identifying inner strengths and weaknesses; Increasing focus on others, Increasing self-confidence; and Clarifying aspirations.
Conclusion: The findings of this study contribute to the advancement of the science of nursing education globally by providing empirical evidence for mentored leadership development programs. A greater emphasis on leadership development is needed for nurse faculty during graduate education and in the early years of an academic career. Results from this 20-month program also support the usefulness of a leadership model to guide mentored experiences. Leadership observers in the local institution helped facilitate scholar development by developing self-awareness and situational awareness of others and the environment.
Leadership is an essential component of the academic nurse faculty role. Leadership development is an on-going journey rooted in reflective practices to increase awareness of self, others, and context. For the Scholars in this NFLA cohort, the guided mentoring from NFLA programming contributed to behavioral changes in their leadership trajectory and helped clarify their faculty role amid expanding responsibilities. Finding their authentic voices was a major developmental step in contributing to the organization, learning to work with other faculty, and speaking up to help lead initiatives....
Health beliefs and medication adherence among Omani patients with hypertension
(2017-06-19)
Hypertension (HTN) is a public health concern around the globe, which if not treated will lead to serious cardio and cerebrovascular complications. Antihypertensive medication is central in controlling BP and preventing HTN-related complications. Despite the effectiveness of medications, adherence to antihypertensive medications remains a challenge and less than 50% (WHO, 2013). Plenty of literature has reported different factors contributing to better or worse medication adherence in patients with HTN (AlGhurair, Hughes, Simpson, & Guirguis, 2012). Health beliefs about HTN and its medications are among patient-related factors that significantly related to antihypertensive medication adherence (AlGhurair et al., 2012). For example, stronger beliefs about HTN severity and susceptibility to its consequences, stronger beliefs about necessity of antihypertensive medications, higher self-efficacy, and fewer concerns about medication were associated with higher medication adherence (Kamran, Ahari, Biria, Malpour, & Heydari, 2015). These studies are consistent with the health beliefs model. In Oman, a high-income developing country, HTN prevalence is high and many studies have examined HTN prevalence and risk factors (Al-Maqbali, Temple-Smith, Ferler, & Blackberry, 2013; Al-Mawali, 2015). However, studies examining medication adherence and patients’ beliefs and medication adherence are lacking. It is essential that clinicians assess patients’ beliefs when aiming to improve medication adherence to plan effective and personalized plan of care.
Purpose:
The aim of this study is to examine Omani patients adherence with antihypertensive medications and their beliefs regarding HTN severity, necessity of and concerns about medications, and medication adherence self-efficacy. The study also aims to examine the relationship between 1) patients’ beliefs and medication adherence and 2) medication adherence and blood pressure (BP) control in Oman.
Methods:
This cross-sectional study used descriptive correlation design and was conducted in Oman using 25 primary health care settings in 6 Omani governorates. Participants completed 4 questionnaires in Arabic version to measure medication adherence (Morisky medication adherence scale), beliefs about HTN severity (Brief illness perception questionnaire), beliefs about medication necessity and concerns (Beliefs about medicine questionnaire), and self-efficacy (Medication adherence self-efficacy scale). In this study, high medication adherence is defined as a Morisky scale of ≥ 6.BP values of the day of the study were taken from patients’ electronic medical records. Descriptive and Bivariate and multivariate logistic regression were used to conduct the analyses.
Results:
The study included a total of 215 participants with HTN with a mean age of 54 years (SD=13.1). Study findings showed 68% of participants reported high adherence and 63% have uncontrolled BP. Majority of participants reported stronger beliefs about necessity of medication (mean score = 3.7, SD = 0.9), higher self-efficacy regarding their ability to adhere to medications (mean score = 3.4, SD = 0.7), fewer concerns about medication (mean score = 2.4, SD = 0.8), and believed that HTN is not a severe condition (mean score=25.8, SD = 12.2). Logistic regression analysis showed that higher self-efficacy (OR=2.59; 95% CI 1.54-4.37), stronger beliefs about medication necessity (OR=1.98; 95% CI 1.21-3.23), increased age (OR=1.06; 95% CI 1.03-1.10), and fewer medication concerns (OR=0.34; 95% CI 0.20-0.57) were significantly related to high medication adherence and explained 37% of variation in medication adherence. Furthermore, participants with high medication adherence were less likely to have their BP uncontrolled (OR=0.47; 95% CI 0.24-0.93) and explained 3% in BP control variation.
Conclusion:
Findings regarding the relationship between medication adherence and beliefs about the necessity of and concerns about medication and self-efficacy are consistent with studies among patients with HTN and other chronic conditions. Although we did not find a significant relationship between medication adherence and beliefs about severity of HTN, the direction of the relationship was negative, which is inconsistent with majority of studies that reported a positive relationship. This inconsistency in findings could be related to cultural variation and the influence of unique Islamic beliefs on disease and treatment. Therefore, clinicians and researchers should be aware that beliefs might vary across cultures and/or within cultures.
Results of this study indicated that patients beliefs play significant role in medication adherence, which highlight the significance of assessing and incorporating patients’ health beliefs in clinical practice by the clinicians (e.g., physicians, nurses). Moreover, strategies to improve medication adherence should incorporate beliefs as key component for effective and personalized plan of care for patients with HTN generally and Omani patients specifically....
Deliberate practice: An online method to develop students' interprofessional critical incident reporting skill
(2017-07-18)
Ineffective interprofessional communication contributes to treatment delays and can result in serious patient harms (The Joint Commission, 2015). Communication skills are a part of every nursing curriculum; however, ...
Pain management outcomes: Comparing post-operative patients in the U.S. and China
(2016-03-17)
Session presented on Friday, July 24, 2015:
Purpose: Postoperative pain management has posed a pervasive clinical problem in medical practice. Improving quality of pain management has been a focus for more than 20 years ...
QSEN: Outcomes of a national project to transform education and practice
(2016-03-17)
Session presented on Saturday, July 25, 2015:
The Quality and Safety Education for Nurses (QSEN) project initiated in 2005 and was funded through four phases until 2012 by the Robert Wood Johnson Foundation. Beginning ...
Leadership as influence: Reflective models to create work environments focused on quality and safety
(2013-12-19)
Session presented on: Monday, November 18, 2013:
Nurses must constantly respond to change, in practice, shifting organizational systems, and evolving team relationships. Developing a work place for all to thrive belongs ...
Using story-guided online deliberate practice to develop BSN students' critical incident reporting skill
(2017-07-19)
The use of stories in healthcare education is a teaching-learning strategy used to provide the context of a clinical situation in a way that learners can relate the facts with the concept (Billings & Kowalski, 2016). ...