Ready, willing, able? Staff competence in workplace redesign

Ready, Willing, and Able: A Framework for Improving the Public Health Emergency Preparedness System

Every society is exposed periodically to catastrophes and public health emergencies that are broad in scale. Too often, these experiences reveal major deficits in the quality of emergency response. A critical barrier to achieving preparedness for high-quality, system-based emergency response is the absence of a universal framework and common language to guide the pursuit of that goal. We describe a simple but comprehensive framework to encourage a focused conversation to improve preparedness for the benefit of individuals, families, organizations, communities, and society as a whole. We propose that constructs associated with the well-known expression “ready, willing, and able” represent necessary and sufficient elements for a standardized approach to ensure high-quality emergency response across the disparate entities that make up the public health emergency preparedness system. The “ready, willing, and able” constructs are described and specific applications are offered to illustrate the broad applicability and heuristic value of the model. Finally, prospective steps are outlined for initiating and advancing a dialogue that may directly lead to or inform already existing efforts to develop quality standards, measures, guidance, and (potentially) a national accreditation program.

(Disaster Med Public Health Preparedness. 2010;4:161-168)

The New Grad

The new graduate nurse is a fragile commodity to the healthcare system and should be handled carefully to create a smooth transition to competent staff nurse. A primary role of the staff development nurse is to plan an orientation program that not only provides direction for success but is also flexible enough to meet the individual nurse's needs when problems arise. Second, having an understanding of the significance of the coach-orientee relationship is equally important in ensuring a successful orientation.

Nurse internship pathway to clinical comfort, confidence, and competency

The purpose of this article is to report the outcomes of a nurse internship program initiated at a U.S. Navy hospital designed to increase new graduate nurses' clinical competence, confidence, and comfort. Using a quasi-experimental design, the experimental group scored significantly higher on organizational core competencies than the control group. These nurses were more comfortable with their leadership and management roles following the intervention. Organizations may wish to consider a nursing internship program as a means of improving the work environment.

Lightening the burden for preceptors: consider adding a "Faculty Model" week to orientation

The physical and emotional stress on preceptors creates a conundrum as hospitals expand and/or experience higher rates of nursing staff turnover. When chosen well, preceptors are an excellent way to integrate and teach new nurses. However, being a preceptor can often be an added burden in a busy hospital climate. Creating innovative systems, within new nurse orientation, that respect the preceptor role and provide some relief have much merit in today's bustling hospital environment. The creation of such a system in a large tertiary care hospital in Boston, MA, entitled the Faculty Model Pilot Program, seems to be both supporting the overworked preceptors and providing a comprehensive standardized practice week for newly hired medical/surgical nurses. The pilot program appeared to increase not only their knowledge of the hospital itself but also the standards of patient care throughout the hospital. This added week seemed to provide a good understanding of general nursing practice prior to the acquisition of the unit-based, specific knowledge; thus, lightening the burden for unit preceptors.

The use of LPNs in Ohio home care agencies

A rapid rate of change in the home care arena has been widely documented and many more changes are likely to continue. This article presents the results of a descriptive study to characterize the use of licensed practical nurses (LPNs) within Ohio home care agencies. Among the findings were that that agencies use LPNs primarily in medical-surgical cases and that the use of LPNs is expected to increase.