COMPARATIVE ISSUES IN AVIATION AND SURGICAL CREW RESOURCE MANAGEMENT: (1) ARE WE TOO SOLUTION FOCUSED?

Although the published work in health care increasingly promotes aviation as a high-reliability industry to be emulated, there is little empirical research to justify equating the dynamics of health care's operating environment with that of aviation. This article examines some of the potential key areas of difference between the two professional groups with respect to crew resource management. The risks of implementing crew resource management training in health care without an evidential basis are discussed.     

A critical engagement with the concept of advancing nursing practice

AIM: This paper aims to elucidate the concept of advancing nursing practice by engaging critically with developments in policy in the UK and ongoing debates in the international literature. BACKGROUND: Advancing practice to the outer edges of nursing's scope of practice is a challenge for the profession both in the UK and elsewhere. However, defining what advancing nursing practice is and what it might become remains problematic. EVALUATION: Critical analysis of published papers and policy documents pertaining to the concept of advancing nursing practice. KEY ISSUE: Advancing nursing practice as a concept offers enormous potential for nurses and has been the subject of numerous debates over the last 25 years. Previous history of advanced practice offers no imperative practice and informs us little about the future roles of advanced nurse practitioners. CONCLUSION: Current understanding about the role of advanced nurse practitioner and the nature of advanced practice remains unclear. Measuring the impact and outcome of the complex advanced practice nursing roles remains a challenge. IMPLICATIONS FOR NURSING MANAGEMENT: While it is difficult to articulate succinctly what constitutes advancing nursing practice, defining the activities nurses engage in, the skills and competencies involved and the qualities and attributes required help reduce the ambiguities of the role.     

Managing the clinical setting for best nursing practice: a brief overview of contemporary initiatives

BACKGROUND: Leadership strategies are important in facilitating the nursing profession to reach their optimum standards in the practice environment. AIM: To compare and contrast the central tenets of contemporary quality initiatives that are commensurate with enabling the environment so that best practice can occur. KEY ISSUES: Democratic leadership, accessible and relevant education and professional development, the incorporation of evidence into practice and the ability of facilities to be responsive to change are core considerations for the successful maintenance of practice standards that are consistent with best nursing practice. CONCLUSION: While different concerns of management drive the adoption of contemporary approaches, there are many similarities in the how these approaches are translated into action in the clinical setting. IMPLICATIONS FOR NURSING MANAGEMENT: Managers should focus on core principles of professional nursing that add value to practice rather than business processes.     

The state of the science of emotional intelligence related to nursing leadership: an integrative review

akerjordet k. & severinsson e. (2010) Journal of Nursing Management 18, 363–382
The state of the science of emotional intelligence related to nursing leadership: an integrative review Aim To explore the state of the science of emotional intelligence (EI) related to nursing leadership and its critiques. Background The phenomenon of EI has emerged as a potential new construct of importance for nursing leadership that enhances educational, organizational, staff and patient outcomes. Nevertheless, important questions and critical reflections related to exaggerated claims, conceptualizations and measurements exist. Method A literature search was conducted using international databases covering the period January 1999 to December 2009. A manual search of relevant journals and significant references increased the data. Results Critical reflection seems to be associated with the unsubstantiated predictive validity of EI in the area of nursing leadership. In addition, important moral issues are called into question. Conclusions It is important to possess in-depth knowledge of EI and its scientific critique when integrating the concept into nursing research, education and practical settings. More attention to the nature of emotion in EI is necessary. Implications for nursing leadership The dynamics of EI should be explored in the context of both the surrounding environment and individual differences, as the latter can be adaptive in some settings but harmful in others.     

Feeling the cold: implications for nurse managers arising from the financial pressures in health care in England

Hewison A . (2010) Journal of Nursing Management 18 , 520–525
Feeling the cold: implications for nurse managers arising from the financial pressures in health care in England Aim The purpose of this short paper is to identify some of the implications and opportunities nurse managers in England face as a result of the current global economic recession. Background Government borrowing and poor global economic conditions have combined to create a £175 billion budget deficit in the UK. The National Health Service in England will be required to make substantial savings in order to help offset this shortfall. Key issues This is a brief critical commentary which examines some of the challenges and opportunities for nurse managers in England. It draws on a number of sources to identify key issues concerning nursing management arising from the financial pressures facing health care. Conclusion The next few years are going to be very difficult for nurses and their managers, however, the current situation also presents opportunities to advance the contribution and influence of nursing and nursing management. Implications for nursing management What nurse managers do next will be crucial in shaping the NHS response to the financial storm and the future nature of health care in England.     

The Role of a Computerised Case-based Testing Procedure in Practice Performance Assessment

Introduction: For postgraduate training of doctors there is a need for valid and reliable instruments to assess their daily performance. Various instruments have been suggested, some of which use incognito simulated patients (SPs). These methods are resource intensive. Computerised Case-based testing (CCT) is logistically simpler and may still predict performance well. The research question was to evaluate the predictive validity of CCT for performance.Methods: Seventeen rheumatologists were each visited by eight incognito SPs presenting various rheumatological complaints, and scoring the performance of the rheumatologists using a predefined checklist. From this checklist a panel of experts identified essential items. In addition the rheumatologists sat a CCT test containing 55 cases with a total of 121 items.Results: Negative correlations were found between the SP scores and the CCT scores. This was unexpected. Therefore, background variables on experience were used to compare both methods. The correlation between these and CCT were high and positive and with the SP scores high and negative. This pattern did not differ when using the essential items of the checklist. Reliabilities of the SP scores were markedly high.Discussion: Although CCT was not predictive of SP scores, it was related to working experience. There are good reasons to assume that although SP-scores were more authentic, they were less valid than CCT scores, mainly because they focussed more on thoroughness than on efficiency in data gathering. The results underpin the assumption that for valid performance assessment the most important issue is what information about the candidate is collected and now how authentic the method is.