It is a special privilege, for the second year in a row, to serve as guest editor of the 15th annual American Organization of Nurse Executives (AONE)/The Journal of Nursing Administration (JONA) research issue. Ten years ago, the AONE founded the AONE Institute for Nursing Leadership Research and Education (AONE Institute) with the vision of "shaping the future of patient care delivery through the development of evidence-based nursing leadership."1 The commitment of the AONE to the importance of using best evidence in leadership and management practices is underscored by its continued investment in the AONE Institute. Each year, using the AONE Strategic Plan as a guide, the AONE Institute's advisory board develops its priorities for education and research and presents them to the AONE board of directors for approval.
The AONE Institute's 2009 priorities include the following 4 areas of focus: the design of future patient care delivery systems, leadership to create and sustain healthful practice environments, strengthening America's future nursing leadership across the continuum of care in all types of healthcare settings, and positioning nurse leaders as valued healthcare executives and managers.2 In addition to its commitment to the development of evidence-based nursing leadership through the AONE Institute, the AONE has developed many supportive resources, including the AONE Nurse Executive Competencies, various guiding principles, toolkits, and positions on best practice.3
This issue of JONA presents 5 research articles that support the AONE education and research priorities, the AONE Nurse Executive Competencies, and the AONE's various guiding principles, toolkits, and positions on best practice.
Availability of Support Services Positively Influences Patient Satisfaction
In their article, Bacon and Mark describe the use of data from the Outcomes Research in the Nursing Administration Project to examine the impact of organizational and nursing unit characteristics on patient satisfaction. One finding of particular interest in their report is that "patient satisfaction was higher on nursing units that had greater availability of support services and higher levels of work engagement." Their findings support the work that the AONE has done in conjunction with industry partner ARAMARK Healthcare to develop the "AONE Guiding Principles for Relationships Among Nursing and Support Services in the Clinical Setting."4 Their findings also support the AONE Institute's priority regarding the design of future patient care delivery systems. The "Background and Purposes" section of the "AONE Guiding Principles for Relationships Among Nursing and Support Services in the Clinical Setting" states: "Future patient care demands will require new models of care-and collaborative relationships that are dramatically different from those that exist today. In addition, these new models must be developed within organization structures and cultures that are agile enough to continuously adapt to an ever-changing environment."
Assessment of a Professional Practice Environment
The article by Ives Erickson et al presents their analysis of a tool developed to assess the professional practice environment in an acute care setting. They found that the tool, the Revised Professional Practice Environment Scale, was a "sound measure of 8 components of the professional practice environment in an acute care setting." One of the focus areas of AONE Institute's 2009 education and research priorities is healthful practice environments. The AONE's 2009-2011 Strategic Plan promotes the adoption of the Nursing Organization Alliance (NOA) Principles and Elements of a Healthful Practice/Work Environment.5 The 8 components of the professional practice environment in an acute care setting identified in this article are echoed in many of the principles and elements of a healthful practice/work environment.
Focusing on Medication Administration
The article by Sharpnack et al describes findings from a descriptive observation study of 151 nurses during 980 separate medication administration occurrences in 3 diverse hospital settings: a rural hospital, an urban community hospital, and an academic medical center. The study findings highlighted a number of inefficiencies and distractions in the medication administration process. This study provides several areas of focus for improvement of the delivery of medication in acute care settings in the future. The authors make recommendations for improving the medication administration process in the future, including the use of technology. The AONE's Guiding Principles for Future Patient Care Delivery Toolkit.6 and the AONE Institute's focus on the design of future patient care delivery systems support the use of new technology in designing systems that promote patient safety and work environments that support strategies for improvements critical to the success of the entire patient care delivery system.
A Tool to Study Missed Care
The article by Kalisch and Williams presents their development and testing of a tool used to measure missed nursing care. The authors concluded that nurse leaders have to understand where opportunities to improve patient safety and quality outcomes of nursing care lie. Tools like the one developed and tested in their study allow nurse leaders to identify those opportunities. As previously described, the AONE's 2009-2011 Strategic Plan promotes the adoption of the NOA Principles and Elements of a Healthful Practice/Work Environment.5 One of the elements is "the presence of adequate numbers of qualified nurses." Understanding barriers to completing nursing care may assist in validating the adequacy of numbers of qualified nurses.
Leadership Role in Nurses' Organizational Commitment
The article by Laschinger et al reports the results of their survey of 3,156 nurses in 217 hospitals in Ontario, Canada, seeking to determine the importance of leadership in creating conditions that lead to higher levels of commitment in the nursing workforce. Study findings highlight the importance of unit leadership in creating work conditions that influence individual nurses' commitment to the whole organization. These findings support the AONE Nurse Executive Competencies. The first domain in the AONE Nurse Executive Competencies is communication and relationship building. Under this domain, the relationship management competency is articulated and further described as building trusting, collaborative relationships with staff, among others. One element of the NOA Principles and Elements of a Healthful Practice/Work Environment that these findings also support is "the presence of expert, competent, credible and visible leadership."
Summary
The knowledge presented in this annual research edition provides evidence that is supportive of many of the resources that have been developed by the AONE to assist the nurse leader or aspiring nurse leader, including the AONE's Strategic Plan, the AONE Institute's priorities, the AONE's Executive Nurse Competencies, various guiding principles, toolkits, and positions on best practice. The AONE has generously made these tools available to interested parties on its Web site. These AONE strategic documents provide the foundation necessary for nurse leaders to establish evidence-based management as a norm in our organizations. The complex and important issues faced by nurse leaders require the incorporation of the best available evidence into our practice.
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