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Maggie SilerEvidence Based Practice ProposalFerris State UniversityNURS 324Evidence Based Practice ProposalArticle Annotation 1Weston, M. J. (2010, January 31). Strategies for enhancing autonomy and control over nursing practice. The Online Journal of Issues in Nursing, 15. doi: 10.3912/OJIN.Vol15No01Man02 Marla Weston is a doctoral prepared nurse leader with over thirty years of management experience. She is the Chief Executive Officer of the American Nurses Association. For years her work has centered on enhancing autonomy and control in the practice of nursing. This article is well organized and easy to read. It asserts that increasing autonomy and control over the practice of nursing allows each nurse the power to best contribute nursing specific knowledge and expertise to the benefit of all: nurses, patients and the health care system. Achieving the goal of nursing autonomy requires structure and processes which are outlined by the author in this article. Enhanced autonomy can lead to improved professional engagement and ownership for each nurse in their practice. The final outcome is to improve the health of the work environment thus positively impacting the quality of patient care, organizational function, and professional nursing satisfaction.Article Annotation 2Kramer, M., & Schmalenberg, C. (2008, April 1). Confirmation of a healthy work environment. Critical Care Nurse, 28(2), 56-63. Retrieved from Marlene Kramer RN, PhD is vice president for nursing at Health Science Research Associates in Tahoe City, California and Claudia Schmalenberg RN, MSN is a research associate for the same company. Together they have studied healthy work environments for nurses in depth, and published several articles on the topic both cooperatively as well as individually. In this informative, easy to read article the author’s review the importance of a healthy work environment for nurses. Individual attributes that help compose that setting are considered. Four different healthy work environment models are compared. The eight essential qualities of magnet hospitals are evaluated. The importance of each staff nurse's confirmation of the presence of these attributes is underscored as frequently staff and leadership nurses perceptions vary. The Essentials of Magnetism is presented as a tool that can be used to both establish baselines and evaluate the effectiveness of any interventions made in the nursing environment.Article Annotation 3Shirey, M. (2006, May 1). Authentic leaders creating healthy work environments for nursing practice. American Journal of Critical Care, 15, 256-267. Retrieved from Maria Shirey is a doctoral prepared nurse who has received the AACN Circle of Excellence award twice and is the immediate past chair of the AACN Certification Corporation. She is an associate professor at the University of Southern Indiana’s College of Nursing and Health Professions. She is a frequent contributor to multiple prestigious nursing journals. In this well written article she describes authentic nursing leadership as the “glue” which holds a healthy work environment together. Authentic leadership is among the six standards set forth by the AACN to create a healthy work environment. This article helps define and guide authentic leadership. There has been very little research on exactly what comprises authentic leadership. In this article there is a proposed agenda to further investigate, understand, and develop authentic leadership. This could lead to great benefit not only for nursing, but the entire healthcare system.Article Annotation 4Vollers, D., Hill, E., Roberts, C., Dambaugh, L., & Brenner, Z. (2009, September 1). AACN’s healthy work environment standards and an empowering nurse advancement system. Critical Care Nurse, 29(6), 20-27. doi: 10.4037/ccn2009263 The authors of this article are all experienced professional nurses and educators who have written several articles on healthy work environments for the AACN, including this continuing education article for nurses. They are all proponents and participants of nursing clinical advancement systems (CAS). They view CAS as one method through which a healthy work environment for nurses can be established and maintained. This well written document reviews the general concept of CAS as well as the authors own experience with CAS at their institution. The authors describe how clinical advancement systems tie in to and support each of the concepts of a healthy work environment (effective communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition, and authentic leadership). It also addresses how clinical advancement systems can expand opportunities for professional nurses. This article describes how a nurse advancement system can facilitate behaviors that encompass and encourage a healthy work environment.Elements of Reasoning for Evidence Based Practice Proposal; Healthy Work Environments1) PurposeA healthy, relationship centered work environment allows all nurses to practice the art of nursing to the best of their ability. Healthy work environments benefit patients, nurses and organizations.2) Question at issue or central problemHealthy work environments improve patient safety. They also benefit improved quality of care by the retention and recruitment of highly skilled, experienced nurses. 3) Point of viewUnhealthy work environments add to stress levels, errors and less than optimal outcomes. In this day of payment based on evidence based care and positive outcomes, the principle of healthy work environments cannot be ignored.4) InformationSince 2001 the AACN has been researching and promoting healthy work environments utilizing evidence based care and relationship centered principles. In this proposal I have provided only four of the many available scholarly references as evidence of the importance of a healthy work environment.5) Concepts and ideasA set of six standards have been set forth by the AACN to be used as a foundation to continue work toward the implementation of a healthy work environment for all nurses. These standards include: effective communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition, and authentic leadership.6) AssumptionsThe continued support for, research on, and implementation of healthy work environment standards is a critical component of improving every nurse’s job satisfaction. In the long run this affects the safety of each and every patient. Ultimately the goal of a healthy, respectful work environment for all will have a positive effect on the entire healthcare system. 7) Implications and consequencesBy utilizing and incorporating the strategies proposed by the AACN and magnet hospitals a healthy work environment for all nurses can ensue. That will lead directly to a safe, healing, respectful environment for patients, families and nurses. 8) Inference and interpretationI conclude that there is a growing body of evidence supporting the importance of a healthy work environment for all nurses. The successful achievement (or even approach to) this goal can have many far reaching positive effects on our entire healthcare system. It can directly result in happier, more competent nurses. This will lead to improved, safety, and more cost effective care for each patient. ................
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