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I'm glad that I can discuss this paper with teacher.
I can find that I have a lot of knowledge about nursing to learn.
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Effective guidance from nurse leadership is priceless when it comes to establishing work systems that refine nursing care and the direction of the profession. Tomorrow and further into the future, nurses will continue to look for direction and support from their leaders. Nurse leaders will be expected to guide their teams to focus on patient care as trials, such as economic instability, the nursing shortage and proposed healthcare reform, whether mandated by Congress or spearheaded by individual facilities, healthcare systems or professional associations, loom ahead.

當談到使護理照顧及專業導向獲得提煉並建立作業系統,對於領導護士的有效指引上是無價的。未來的未來,護士們將繼續從他們的領導者身上尋找方向及獲得支持。無論是由國會明定或由私人場所帶頭,護士領導者將預期帶領他們的團隊集中於病人的臨床試驗,如:經濟不穩定、護士短缺,並提出醫療改革,醫療系統及專業協會將織機前進。





Many of the processes and systems that have driven the organization of care delivery have been in place for 50 years or longer, according to Pamela Thompson, RN, MS, CENP, FAAN, CEO of the American Organization of Nurse Executives and the American Hospital Association’s new senior vice president for nursing.

根據潘蜜拉湯普森,註冊護士,MS,CENP,FAAN,美國護理行政部的執行長,美國醫院協會新任護理部高級副總裁說道: “許多帶動了組織上的護理服務程序和系統,已實施50年或更長的時間了”。





“But there is a different future in front of us, and it’s not going to be care delivery as we have always done it,” Thompson says. “We have a lot of history of ‘we’ve always done it that way’. That needs to change as we move forward.”

但是在我們前面有不一樣的未來,這不會成為如我們總是完成的護理服務”湯普森說。“我們歷史上有很多一直在做這種方式,當我們邁進時,這需要改變的”。





Revolutionizing, or reforming, the healthcare system, regardless of whether the federal government dictates new standards, will be a major undertaking. “A lot of challenges will go hand in hand with healthcare reform,” says Pamela T. Rudisill, RN, MSN, MEd, NEA-BC, president of the American Organization of Nurse Executives. “This includes providing the best in quality and patient safety in the most efficient manner possible. Leadership will be extremely important in this, not just at the executive level, but at every level of an organization.”

不管聯邦政府規定新的標準,是徹底改革或改革過的醫療系统,將會是主要事業。 潘蜜拉魯迪西爾, RN, MSN, MEd, NEA-BC, 美國護理行政部的總裁說道:很多具有挑戰性的事將會一同改革醫療系統”。“最有效的方式包括提供最好的品質及病人的安全,其中,領導不僅在行政階層上,在各級組織間也是相當重要的。”





No Shortcuts on Safety

安全上無捷徑 





Thompson says nurse leaders can anticipate that they probably will be facing tighter budgets. “Congress is trying to control costs and create value for the healthcare dollars that are spent, so there won’t be any new dollars in the system,” she says. “We will need to design safe, quality patient care that will operate more efficiently.”

湯普森說護士領導者能預期他們可能將面對較棘手的預算。 她說:“國會設法在控制花費,並且創造醫療花費上的價值,所以在系統上不會有新的價格”。“ 我們需要設計將更有效率運作之安全且優質的病人照護。




Nurse leaders also will be challenged to design care models that will function efficiently and safely with a smaller nursing workforce. Thompson says the nursing shortage will continue, compounded by the anticipated retirement of many nurses in the near future and the ongoing shortage of nursing faculty.

護士領導者也將與小型的護理團隊人員,挑戰設計高效率作用且安全性的照護模式。湯普森說: “護士短缺仍會持續,加上許多在不久的將來預期要退休的護士,以及護理學院不間斷地短缺。”
護理短缺和削减预算將联合发生,她說的”。 有的“更小的勞工意味真正看我們的角色,並且我們怎麼使用我們称護理的珍貴的資源。 我們需要保证我們為什麼使用護士他們被教育做。”





“The nursing shortage and budget cuts will go hand in hand,” she says. “Having a smaller workforce means really looking at our roles and how we use our precious resource called nursing. We need to ensure that we are using nurses for what they are educated to do.”

她說 “護士短缺及預算削減將一同共進”。 “有一個小型的團隊人員,意味著真正關注我們的角色,以及我們如何運用寶貴的資源,稱為護理。我們需要保證我們運用的護理是受過教育的”。





Nurse leaders also have a part in garnering support for legislation that supports expansion of the nursing workforce and facilitates safe practice. Leaders also will need to spearhead effective preceptorship programs for students and new nurses in which seasoned nurses can mentor students and new nurses to become successful, effective nurses.

她說 “護士短缺及預算削減將一同共進”。 “有一個小型的團隊人員,意味著真正關注我們的角色,以及我們如何運用寶貴的資源,稱為護理。我們需要保證我們運用的護理是受過教育的”。





Nurse leaders can expect short lengths of stay to continue to put the healthcare system to the test, Thompson says. Short lengths of stay will compound the challenges of preventing what Medicare designates as never events, which are not reimbursed. These include wrong-site surgery, retention of a foreign object in a patient after surgery; falls; hospital-acquired infections and death or disability resulting associated with a medication error, among others.

湯普森說護士領導者可期望在短期停留仍持續投入醫療系統的測試。 短期停留將配合委任從未發生的事件,防止挑戰尚未補償的醫療保險。 這些包括執行錯誤部位的手術、手術後將異物存留在病人身體中、跌倒、院內感染以及死亡或傷殘所導致相關醫療上的錯誤等。





Nurse leaders will need to re-evaluate how care is delivered and develop new care delivery models that ensure the essential elements of care are performed in a short length of stay and care delivery models effectively cover the full continuum of care.“Patients are experiencing the fragmentation of care of the current healthcare system, and we need to make sure that every time there is a handoff, it is seamless,” Thompson says.

護士領導者將需要複評如何提供照護,及保證以基本照護元素,研發新的照護模範,這會履行於短期停留,及提供有效性的照護模式,適用於連續性的照護。 湯普森說:“病人正在經歷現行醫療系統上破碎的照護,並且我們需要確認在每一個時間點都是傳遞著的,這是無縫的。





To achieve this level of quality and safety, nurse leaders must evaluate processes and outcomes in their own institutions, have knowledge of evidence-based practices and be able to disseminate the information to each other and to staff and other professionals, Rudisill says.

魯迪西爾說 “要達到此階層的品質及安全性,護士領導者必須在屬於他們的制度中評值過程及結果,且須具備實質教育的知識,以及能夠與其他人、工作人員、其他專家宣導資訊”。





It’s Not Just About Nursing

這不僅僅是關於護理





Rudisill stresses that maximizing patient safety and quality outcomes will require nurse leaders to foster a culture of safety throughout their organizations. “Promoting a culture of safety is not just about nursing,” says Rudisill, who also is vice president of nursing and patient safety at Health Management Associates Inc. in Mooresville, N.C. “It’s about every discipline collaborating effectively.”

魯迪西爾強調病人安全度及品質結果上的最大限度,將需要護士領導者貫穿整個組織促進一個安全性的培育。 魯迪西爾,在Mooresville, N.C.健康經營連鎖公司中的護病安全副總裁說:“促進一個安全性的培育不僅僅是關於護理”。 “這是關於所有學科訓練上有效地共同合作的”。





Cultivating partnerships and teamwork will be critical to the development of a culture of safety. According to Thompson, there has been evidence in the literature for 20 years that outcomes are better when there is a high level of collaboration between nurses and physicians.

建立夥伴關係及團隊合作將是培育安全度的重要發展一環。根據湯普森所說,已有20年的文獻指出當一個高層次的醫護合作,結果會是好的。





“It’s clear that in the future, the best way to deliver care will be in teams,” she says. “But right now we don’t start nurses, physicians and other healthcare providers out in teams. We graduate them in silos of their own professions. Then we expect them to know how to function in a team. There is a lot of reworking that needs to be done.”

她說“這清楚的顯現於未來,最好的提供照護將是在團隊中”。“但現在我們不能從護士開始,因為醫師及提供者都還在團隊外,我們取得他們專業上的資格,然後期盼他們了解在團隊中如何運作,有很多修訂是需要完成的”。





This involves redrafting how decisions geared toward quality improvement are made with such initiatives as shared decision-making and the Institute for Healthcare Improvement and the Robert Wood Johnson Foundation’s Transforming Care at the Bedside initiative. In these processes, nurses and other staff participate in making system, organizational and process decisions.

這涉及到如何決定重新起草主要面向品質的改善,並作出這樣的倡議,在臨床上共同決策和改善醫療保健研究所及羅伯特伍德約翰森基金會的關懷改革的倡議。在這些過程中,護士及其他工作人員工同參與系統性、組織性、程序系的決策制度。





“Nurse leaders need to bring out the leadership skills of all staff so everyone is actively working on the issues and there is no passive participation,” Thompson says. “The nurse managers are in a key role, because they can set the framework on the patient care unit about the decision-making, organization and how it all comes together.”

湯普森說 “護士領導者必須帶領出領導技能於全體工作人員上,讓每一個人都能積極工作,讓大家參與時不會有消極情形”。護士管理者是關鍵角色,因為他們可以設置組織於病人照護單位,關於決策、組織,並且讓它如何全部一起出現。





Nursing leaders will need every skill they can muster to support nurses in giving safe, cost-effective, high-quality care. This includes redesigning entire organizational systems for managing care as well as revamping the way care is delivered on a specific unit.

護理領導者將需要各方面的才能,能夠支持並召集護士給予安全、成本效益、以及高品質的服務。這包含重新設計整個管理照護的組織系統,和在特定單位改造照護方式是一樣的。





“We have done a lot with quality improvement over the years,” Thompson says. “Now we will need to move that into a complex systems perspective.”

湯普森說“我們多年來已做了很多改進品質的工作”。 “現在我們需要將它引入前途的複合系統”。





This will require nurse leaders to continue to develop their skills in communication and relationship building, knowledge of the healthcare environment, leadership, professionalism and business, Rudisill says. “In order to make an impact, you have to have all five of those skills,” Rudisill says.

魯迪西爾說 “這將要求護士領導者持續發展他們溝通、人際關係、醫療環境的知識、領導能力、專業技能、經濟等方面上的技能。魯迪西爾說 “為了要造就一個影響,你必須有這五項技能”。






Rubie Elffie
















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