Introducing the official leadership Journal of the Magnet Recognition Program®

In this monthly department, sponsored by the Magnet Recognition Program, updates will be provided on news and initiatives, research findings, Magnet Model components, and best practices among Magnet hospitals. This month, the author provides an overview of the Magnet Recognition Program.     

Improving the CellSearch® system

Introduction: The CellSearch® CTC test enumerates tumor cells present in 7.5 ml blood of cancer patients. improvements, extensions and different utilities of the cellsearch system are discussed in this paper.

Areas covered: This paper describes work performed with the CellSearch system, which go beyond the normal scope of the test. All results from searches with the search term ‘CellSearch’ from Web of Science and PubMed were categorized and discussed.

Expert commentary: The CellSearch Circulating Tumor Cell test captures and identifies tumor cells in blood that are associated with poor clinical outcome. How to best use CTC in clinical practice is being explored in many clinical trials. The ability to extract information from the CTC to guide therapy will expand the potential clinical utility of CTC.     

A comparative of Magnet® organizations and accountable care organizations

While Magnet? is a commitment to excellence and thus recognition, the accountable care organization (ACO) focus is to quality and reimbursement. Each can be built on a model of shared characteristics that in the end will prove a source of success for the creation of an organization that is both an ACO and Magnet. In an effort to align strategic initiatives as synergistic processes, not competing priorities, 10 shared characteristics of Magnet organizations and ACOs are presented.     

Is employee discipline the solution for patient safety?

Explore alternative solutions to discipline and address ways to achieve patient safety without penalizing employees.     

Mandates for patient safety: are they enough to create a culture of civility in health care?

In challenging economic times, nurse educators must successfully justify the return on investment for every educational intervention. This column provides tips related to regulatory and financial justification.     

Application of the Donabedian Model to Guide Virtual Magnet® Site Visit Preparations During a Pandemic

Application of the Donabedian Model of Quality can support successful American Nurses Credentialing Center virtual Magnet® site visit preparation. The integration of structures and processes into a comprehensive project plan provided the infrastructure to meet key outcomes. Site visit preparation strategies were adapted to meet new challenges posed by the COVID-19 pandemic. Purposeful structures and processes were designed to engage nurse leaders at all levels in bidirectional communication and collaboration. The implementation of an appreciative process of purposeful reflection related to proudest accomplishments resulted in an enhanced appreciation for professional nursing practice across the organization and successful Magnet redesignation.     

The interaction of Geliperm® and cells in culture

The polyacrylamide agarose wound dressing Geliperm® may exert an effect upon cells and may have potential as a tissue culture support material. These two aspects were examined: (a) the ability of the Geliperm to support growth of attachment-dependent and attachment-independent cells; (b) the effect upon cell growth and division in vitro. HeLa and Hep 2, peripheral blood mononuclear and gingival epithelial cells were innoculated onto hydrated Geliperm previously placed into tissue culture trays. Millipore® filters were seeded with HeLa and Hep 2 cells, overlaid with hydrated Geliperm, placed on rings and immersed in tissue culture medium in petri dishes. The cultures were examined at 24-hour intervals for up to five days by light and scanning electron microscopy; cell counts and viability were also determined. None of the cell types seeded on to the Geliperm remained at 24 hours and growth, continuing beneath the Geliperm was significantly impaired in terms of viability and total count for cells examined. Cells cultured on Millipore filter, beneath gel, were of improved appearance compared to cells not covered by Geliperm; cell counts and viabilities at each time were higher in the presence of the Geliperm. It would appear that Geliperm favourably affected the growth of the cells examined when grown in vitro beneath the Geliperm and on a Millipore filter.     

Improving the patient’s environment: the ideal intensive care unit

Recent medical literature has been reporting the effects of intensive care unit (ICU) design on patients’ and family members’ well-being, safety, and functionality. Features of ICU design linked to the needs of patients and their family are single rooms, privacy, quiet surrounding, exposure to daylight, views of nature, prevention of infection, a family area, and open visiting hours. Improving the ICU environment is shown to increase the patients and family members’ satisfaction while reducing the duration of delirium. An organization based on the respect of the needs of the patients and their family is mandatory in designing a new ICU. The main aims in the design of a new ICU should be patient-centered care and future-proof concept.     

Team communications in surgery – creating a culture of safety

Abstract

As a key department within a healthcare organisation, the operating room is a hazardous environment, where the consequences of errors are high, despite the relatively low rates of occurrence. Team performance in surgery is increasingly being considered crucial for a culture of safety. The aim of this study was to describe team communication and the ways it fostered or threatened safety culture in surgery. Ethnography was used, and involved a 6-month fieldwork period of observation and 19 interviews with 24 informants from nursing, anaesthesia and surgery. Data were collected during 2009 in the operating rooms of a tertiary care facility in Queensland, Australia. Through analysis of the textual data, three themes that exemplified teamwork culture in surgery were generated: “building shared understandings through open communication”; “managing contextual stressors in a hierarchical environment” and “intermittent membership influences team performance”. In creating a safety culture in a healthcare organisation, a team’s optimal performance relies on the open discussion of teamwork and team expectation, and significantly depends on how the organisational culture promotes such discussions.