Getting to the root of MEDICATION ERRORS.

Cohen H.

Hedy Cohen is vice-president of the Institute for Safe Medication Practices, a nonprofit organization based in Huntingdon Valley, Pa.

Let\’s work together to improve medication safety.

Cohen H.

Vice-President, Institute for Safe Medication Practices, Huntingdon Valley, Pa.

Caring competencies for safe practice: nurse leaders and regulators collaborate in caring for the nurse who may have compromised practice.

Hudspeth R.

From the Saint Alphonsus Regional Medical Center and the Idaho State Board of Nursing, Boise, Idaho, and Institute of Regulatory Excellence (sponsored by NCSBN, Chicago, Ill).

Caring Communications: How Technology Enhances Interpersonal Relations, Part II.

Part I of this 2-part series about technology\’s role in interpersonal communications examined how humans interact; proposed a caring theory of communication, collaboration, and conflict resolution; and delineated ways that technology-in general-supports this carative model of interpersonal relations. Part II will examine the barriers to adoption of carative technologies, describe the core capabilities required to overcome them, and discuss specific technologies that can support carative interpersonal relationships.

Simpson RL.

From the Nursing Informatics, Cerner Corporation, Kansas City, Mo.

Live a legacy or live a lie: a choice.

This article is about the result of a choice to Live a Legacy or Live a Lie. The choice led to the development and implementation of a clinical practice model (CPM) designed to create a healthy, healing integrated practice culture. The focus is on the foundation of the model that is a unique ongoing process called the Core Belief Review. The purpose of the review is to uncover those things that matter most for both those who give and receive care. The ongoing open communication process provides insights and truths about reality and a sense of direction related to the nature of the work necessary to create and sustain the best places to give and receive care. The results of the review feedback from 2500 providers and recipients of care are correlated to the actions taken to address the complexities of the point-of-care reality and the clinical outcomes reached as a result of collaboration and lessons learned within an International Consortium.

Wesorick B.

From the Clinical Practice Model Resource Center, Grand Rapids, Mich 44509.

Caring for innovation and caring for the innovator.

Innovative individuals can be an annoying source of disruption in the workplace-always asking \”why are we doing this?\” and challenging long-held assumptions. Some individuals have the audacity to make changes believed to improve outcomes with or without support. Their actions and rationale for the actions are based on the belief that they are improving outcomes and adding value because current processes are no longer appropriate. This lack of regard for the status quo may be essential for organizational survival. These creative, innovative, and risky activities can and should be reframed and transformed from the lens of the innovator. Caring theory provides the interface for successful integration of innovative behaviors into the current healthcare culture. As we are students in the first Master of Healthcare Innovation program in the country, our experiences and challenges are shared from the framework of Caring for the Innovator. This article builds a case for enhancing the healthcare culture to recognize and value innovation and subsequently to support and care for the healthcare innovator. A brief discussion of the need for a new approach to innovation, an overview of the concepts of innovation and caring, and caring strategies to support innovation are presented.

Unterschuetz C, Hughes P, Nienhauser D, Weberg D, Jackson L.

Creating a Healing Environment: An Innovative Educational Approach for Adopting Jean Watson\’s Theory of Human Caring.

Current focus on empirical data and evidence-driven nursing practice highlights the need to re-examine the importance of nursing theory to guide practice. The purpose of this article is to describe the rationale, approach, and outcomes of an innovative educational approach to teaching Jean Watson\’s Theory of Human Caring.

Caruso EM, Cisar N, Pipe T.

From the Mayo Clinic Hospital, Phoenix, Ariz.

Illuminating the inner leadership journey by engaging intention and mindfulness as guided by caring theory.

Sustained, high-performance nursing leadership can be effectively guided by caring theory. While much of leadership performance is manifested by external behaviors, highly effective leaders are also grounded by internal work of self-reflection and growth. This article focuses primarily on the inward journey of leadership as guided by Jean Watson\’s Theory of Human Caring. Key elements of the theory are interpreted within the context of the emerging, urgent, high-stakes challenges of the current healthcare environment. The links between self-nurturance and caring-healing leadership of others are explored.

Pipe TB.

From the Mayo Clinic Hospital, Phoenix, Ariz.

Collaboration through clinical integration.

Rising healthcare costs and the nursing shortage have affected the ability of healthcare organizations to provide a collaborative environment for high-quality care. Recent studies show that the nursing shortage has resulted in increased work loads, fewer support resources, and nurse dissatisfaction, resulting in difficulty providing quality care. Henneman cited a lack of collaboration as a contributing factor to the fragmentation of care and poor outcomes which plague our healthcare system. Knaus et al found that hospitals where collaboration was present reported 41% lower mortality than predicted number of deaths. Hospitals where there was a little collaboration exceeded predicted mortality by 58%. Positive collaborative relations have also been tied to a decrease in negative patient outcomes, increased organizational commitment, and nurse satisfaction as well as reduced cost and greater responsiveness for healthcare providers. The aim of this discussion is to introduce the participant to the concept of collaboration and use of the Donabedian structure-process-outcome model to provide a framework for embedding best practice components necessary for multidisciplinary collaboration in an acute care setting. The National Joint Practice Commission recommendations and the work of Schmalenberg et al were utilized to establish structural and process components necessary for a collaborative practice environment. Trinity Regional Health System utilized this information in conjunction with the Center for Case Management to develop a care model and improve patient outcomes. The average length of stay (LOS) decreased from 4.24 to 3.37 days and cost per admission from $6723 to $5919 in just over 1 year.

McKay CA, Crippen L.

From The Trinity Regional Health System, Rock Island, III.

Cultural transformation toward patient safety: one conversation at a time.

Patient safety has become a critical objective for nursing leaders within the healthcare setting. Changing the culture to ensure the highest level of communication and safety is a daunting task. Many of the contributing factors that lead to patient harm are rooted in conflict and ineffective conversations. This article shares the story of how 1 organization agreed to make a cultural transformation and the success it realized one conversation at a time.

Moore ML, Putman PA.

From MaineGeneral Health, Waterville, Maine (Mr Moore); and Center for Professional and Organizational Development, MaineGeneral Health, Augusta, Maine (Ms Putman).