Evaluation of Healthcare Quality in Advanced Practice Nursing
Hickey, J.V. and Brosnan, C. A. Springer Publishing Company,New York, 2012, softbound. US $65.00. ISBN 978-0-8261-0766-4
[black small square] Reviewed by:
Karen J. George, DNP, RN, CEN
Nurse III Clinician
James H. Quillen VA Medical Center
Mountain Home, Tennessee
(e-mail: [email protected];
[email protected])
The authors present an excellent resource for advanced practice nurses. The purpose of the book is to serve as a "useful and helpful resource to assist advanced practice nurses (APNs) in assuming responsibility and accountability for competency in the conduct of high level evaluation that will inform decision making for those engaged in health care delivery and practice" (p. xiii).
In four distinct sections, the small, compact, concise, and well-written book takes the reader through a comprehensive journey. Along the way, the authors lead the reader through such points as cost-benefit/cost-effective analysis, benchmarking, standards, research, quality improvement/analysis, logic models, quality models and theories, healthcare policy, populations, processes, and policies. The authors address microsystem, mesosystem, and macrosystem views.
Hickey and Brosnan identify the intended audience as "APN students, practicing APNs at the master's and doctoral levels, faculty teaching evaluators, and others interested in evaluation of health care from a practice and clinical perspective" (p. xi).
Given today's focus on healthcare quality, this book in the field of nursing provides a treasure trove of information. The authors' succinct compilation, clearly written definitions, explanation of concepts, and presented cases in a compact, portable format present an excellent addition to an APN's personal resource library. The reference lists are extensive and valuable.
The authors referenced information from the Organization for Economic Cooperation and Development (OECD) reports; however, no mention was made of the World Health Organization's 2008 report on "Assuring the Quality of Health Care in the European Union." To include evaluation of the costs specifically related to implementation and monitoring of quality in health care as related to health costs per capita among OECD potentially provides another avenue to evaluate. To compare OECD countries without a critical evaluation of educational levels preparation and costs of healthcare personnel in equal and fair comparison potentially creates bias. The absence of implementation of evaluation tools in Lean and Six Sigma approaches was not mentioned.
Although the authors describe the current healthcare system as one which will "add uncertainty to complexity," they follow with what appears as a political bias in support of the Affordable Care Act.
Finally, the question exists: Who will evaluate how the drive to meet quality or performance indicators becomes a mandatory exercise in checking boxes and reporting numbers, which may or may not represent actual patient care? Genuine, accurate, and reality-based evaluation is essential. The authors discuss the challenges presented in recognizing accurate, valid, and reliable data.
This book is easy to carry, easy to read, and comprehensive enough to serve as a quick, succinct reference.
Disclaimer: The contents of this publication do not represent the view of the Department of Veterans Affairs or the United States Government.
The author has disclosed that she has no significant relationships with, or financial interest in, any commercial companies pertaining to this review.
Nursing Leadership for Patient-Centered Care Authenticity, Presence, Intuition, Expertise
Harriet Forman. Springer Publishing Company, New York, 2011, softbound. US $55.00. ISBN:978-082610558-5
[black small square] Reviewed by:
Joel Ottoson, MS, MSN, RN-BC
Nurse Educator
Orlando VA Medical Center
Orlando, Florida
(e-mail: [email protected])
Having been mentored by and worked with several wonderful nurse leaders during my career, I have noticed that one of the qualities these nurse leaders possessed is staff-centered idealism. The author of this book recognizes this quality as well.
The book is written from the phenomenological perspective using vignettes as its medium. There is an emphasis on listening with a "third ear" as one reads the stories presented or listens to staff at work. Through the use of narratives, the author brings to life real situations and successful strategies used to bring resolution to difficult situations.
Praxis or theory applied in practical terms is used throughout the book. There is an emphasis on walking the talk and being present within the organization. There are nuggets of wisdom and truths imbedded in the book, which are not necessarily new information but philosophy brought to life through the use of storytelling. The book is also well researched and uses quotes and references from well-established leaders.
Forman believes that healthcare organizations should be viewed as concentric rather than linear, with the patient being in the center. In this model, staff members are internally centered on the patients and laterally focused on teammates. This concept then moves out to what is referred to as a reflective relationship between management and staff. Forman uses the term "reformational leadership" to define the style, which includes management by walking around, and discourages practices such as having new or least-experienced staff working off shifts because of their lack of seniority.
A very informative chapter on labor and management provided practical, ethical, and common sense approaches to a novice manager on dealing with union issues. As with all the content of the book, the chapter focused on patient- and staff-centered loyalties, explaining conflicts that can arise through the use of vignettes. At times, the author even related incidents where the nurse executive believed it was necessary to resign rather than conform to unethical practice or at least that practice not consistent with the nurse executive's moral values.
Forman also includes a chapter on personality traits. She discusses various models such as Myers-Briggs', Carl Jung's, Carl Rogers', Freud's, and even neurolinguistic programming. Many of us have been tested using one of the many tools described. Most of the information is not dealt with again, except perhaps for personal use, once we leave the classroom. By contrast, the author is a proponent of using this information when selecting individuals for assignments and building effective teams.
Unlike some other nurse leadership books, Forman includes chapters on topics such as dealing with diversity issues, spirituality, grief, and ethics of power. Forman uses praxis in all areas such as using Elisabeth Kubler-Ross's work in unlikely places as in an example of poor performance appraisal. She considers M. Scott Peck's stages of spiritual growth when dealing with staff and patient relationships. The book promotes self-discovery and self-reflection on all levels.
There was some redundancy and repetition of the vignettes in story or theme either to stress a point or encourage looking at the situation from another angle. The book is consistent in patient care theme throughout its 10 chapters.
This book offers insights for current and future leaders to think about their thinking and management style to improve and provide staff- and patient-centered care. The message is clear about the need for leadership to be supportive, problem oriented, spontaneous, empathetic, and egalitarian. Although the author introduces many outside opinions and theories, it is the author's belief system that radiates everywhere in the pages and is most evident in the epilogue-summed up for this reviewer as "no task is too demeaning when patient care and well-being is at stake."
Disclaimer: The author has disclosed that she has no significant relationships with, or financial interest in, any commercial companies pertaining to this review.
The Resilient Nurse: Empowering Your Practice
Margaret McAllister and John B. Lowe. Springer Publishing Company, New York, 2011, softbound. US $40.00. ISBN 978-0826105936
[black small square] Reviewed by:
Janice Pastuszak, MS, ACNS-BC, FNP-BC
Nurse Educator, VA Central Western
Healthcare System
Leeds, Massachusetts
(e-mail: [email protected])
The editors used 19 contributing writers in producing The Resilient Nurse. The preface identifies that there is an additional instructor "companion" resource for teaching this format in the collegiate setting. The book's intention is to explain resilience and how it applies to the evolving practice of nursing. It is designed in a case study format followed by discussion or options in applying the concepts of resilience. At the end of each chapter, there are learning activities, exercises, and references. The 12 chapter titles are arranged from the beginning of nursing practice to the most sophisticated leadership role. This book is presented from the Australian point of view. There is one chapter, "Now it's my turn" that is devoted entirely to looking back at Australian nursing profession leaders and their impact on the growth of the profession within Australia.
On first impression, the book would appear to be a primer for developing and maintaining strategies in adapting to the daily challenges in clinical nursing, but it leans toward an academic exercise for those teaching resilience in a classroom setting. The case studies, although sincere, are not in tempo with the advancement of nursing within the United States. One example is a nurse who enters the professional nursing field bringing her own baggage to work and then is confronted by stressful situations with little opportunity to adapt to the setting. Although there is some reality in that circumstance, it is stereotypic. The reviewer believes it is used to start a discussion.
The book chapters are set up in a distracting manner. There is the introduction, the case study story, an evidence-based philosophical discussion, an application or explanation of the framework of resilience, and parenthetical statements or paragraphs offering strategies to cope with the stress of the nurse in the case study. It is the reviewer's belief that the case study story allows the reader the freedom to think about ways to deal with the practice problem. But, given so many options within the chapter, the reader is visually distracted trying to determine what should be read first. What is important here? The eyes are drawn to the parenthetical item first.
The writing style throughout the book consists of long complicated sentences with multiple commas. Wait; did that sentence just say that? Or did it really mean this? Colloquial Australian words and phrases are often used. The Preface and many of the chapters switch from third to first person, making it difficult to follow.
After reading the book, the presented concept of resilience is not really clear. Resilience is complicated and something that is constantly evolving. It is not known if the book's contents will empower the reader's practice. This much is concluded: Adaptation to the work environment stressors is what resilience is about.
The reviewer does believe that there is information within this book that can help those entering into the profession of nursing by developing ideas about how to cope with the identified case story accounts. It is the setup of the book and the language that limit the ease in reading and the development of more independent thinking. If the editors can arrange the chapter elements in a different way and eliminate the introduction for each chapter, the lessons would flow more easily.
Disclaimer: The author has disclosed that she has no significant relationships with, or financial interest in, any commercial companies pertaining to this review.