Applying Theory to Policy and Practice: Issues for Critical Reflection

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Blakeney et al. The innovative process may be more complicated in organizations with bureaucratic decision-making processes, while supportive leadership, a protective or insulated area away from operational pressures, innovation networks, and dedicated time for problem solving can all be conducive to supporting an innovative environment Blakeney et al. Nurse leaders must create environments and opportunities for staff innovation; communicate expectations concerning time commitments and acceptable levels of risk; and allow for failures.

Nurse managers and leaders play an important role to create an environment that fosters and encourages innovation. Nurse leaders must create environments and opportunities for staff innovation; communicate expectations concerning time commitments and acceptable levels of risk; and allow for failures Boston-Fleischhauer, Creating opportunities for innovation involves acceptance of risk and the unknown, and fostering creativity and intellectual stimulation Boston-Fleischhauer, Joseph and Huber also emphasized this point, noting that an effective leader will create an environment that will support new mindsets.

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An understanding of health policy allows nurses to participate in the creation and implementation of innovative payment models and healthcare delivery systems. These initiatives include:. RNs must be knowledgeable and educated about health policy topics and initiatives to ensure that nurses fully participate in health policy innovations.

Nurse leaders in academia need to develop and implement curricula and continuing education offerings on health policy topics, and clinical nurse leaders need to mentor new nurses about how to engage in policy work Turale, Researchers have identified characteristics associated with effective leadership. Traits attributed to EI in seminal work on the topic included self-awareness, self-regulation, motivation, social awareness, and the concept of relationship management Goleman, Encouraging nurses to develop leadership traits associated with innovation may be an effective method of creating environments where innovation can flourish.

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A mechanism to allow RNs to improve skills associated with effective leadership is critical. Below we briefly discuss support for several key traits. Eckroth-Bucher reported that on an interpersonal level, self-awareness of strengths and weaknesses can allow an individual to take home the trust of others and increase their credibility; both will increase leadership effectiveness.

Some evidence has suggested that the trait of self-awareness can be taught. For example, Vitello-Cicciu, Wetherford, and Gemme reported that increased self-awareness was one of seven leadership behaviors retained for some months following a leadership development program. Resilience plays a role in innovation To advance as transformational leaders, nurse leaders should cultivate resilience Stagman-Tyrer, Resilience has been demonstrated as a necessary component for the transformational leader to learn, and helps nurse leaders and managers guide others through the difficult process of accepting and implementing innovative changes Tyczkowski et al, Resilience plays a role in innovation, can be enhanced and developed, and is an important strategy for nurses Cline, ; Sanders, Financial management skills.


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Nurse leaders have significant budgetary responsibilities but often underdeveloped financial management skills Douglas, Seifert described the importance of incorporating a business component in nursing curricula and urged nurses to develop knowledge and expertise on business and finance subjects. The IOM Future of Nursing report called on the CMMI to develop and evaluate innovative payment models and care delivery systems that use nurses to reduce costs and improve health outcomes. Much of this work is already underway. Nurses must be educated and prepared to engage in innovative health payment initiatives created by CMMI and other federal agencies.

Financial literacy and financial management skills are essential to fully participate in these innovative initiatives. Critical thinking skills. Critical thinking is a foundational skill that involves ability to apply strong oral and written communication techniques to a variety of environments by utilizing available resources effectively and strategically.

Price explored the concept of critical thinking as it applies to nursing and articulated a range of critical thinking skills from the relatively simple process of identifying information to evaluating and creatively reframing issues and identifying innovation solutions.

A number of approaches have been recommended to teach critical thinking skills to nurses. Burrell describes a series of evidence-based methods e. Although case scenarios assist in the development of critical thinking, evidence suggests that real-time scenarios that allow individuals to implement decisions increase critical thinking in individuals such as RNs. Use of clinical simulation, by nurse educators and employers, can be a powerful tool to develop critical thinking and learning Fero et al. While considering the role of the RN as an innovator, members of the Panel Steering Committee examined barriers to innovation, envisioned the ideal state for an RN functioning as an innovator, and identified three goals and a series of recommendations to advance these goals.

Our recommendations include steps to empower all RNs to lead innovation efforts, as well as recommendations for nurse managers and nurse leaders to create environments where innovation can thrive. We also include recommendations targeted to organizations and academia. The information in Table 3 summarizes our goals and recommendations for advancing innovation. Table 3. Consistent with the ANA Nursing Scope of Standards and Practice , nurses in all roles and settings lead innovative change to protect, promote, optimize, and advocate for the health of individuals, families, groups, communities, and populations ANA, a.

Nurses lead in the development of innovations in health policies by applying nursing knowledge to advocate for patients, consumers, and the nursing profession. Nurses lead, leverage, and advance innovations and technology from inception and development through implementation and evaluation. For the past 14 years, Americans have rated nursing as the most trusted and most ethical profession Gallup, To maintain that standing, nurse leaders need to continue as innovators by directing change, developing policies, and creating innovative technological advancements throughout the nursing profession.

Achieving the innovation goals and recommendations described in this article will help to ensure that nurses and the nursing profession have a voice in the future of healthcare.

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While the articles were generated by authors participating in a Professional Issues Panel convened by ANA, the conclusions and recommendations articulated by any author do not necessarily reflect those of the Association. Thomas has worked as a registered nurse for 15 years, and started his career in the U. At WRAMC, he wrote a policy on pressure ulcer prevention and treatment that was later utilized as the framework for a hospital-wide policy.

After a short tour in Iraq, he did an inter-service transfer from the U.

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Army to the U. In December , he was awarded a full scholarship through the American Nurses Association to complete his masters in Nursing in Leadership and Administration at Capella University, Minneapolis, Minnesota. Patricia C. Seifert has more than 25 years of experience as a perioperative nurse. She has been a clinical manager in cardiac surgical services and has developed four cardiac surgical programs. She has also functioned as an RN First Assistant on over 3, cardiac surgery procedures. She is a Fellow in the American Academy of Nursing.

Seifert is the author of six books and numerous articles and chapters; she was a member of the writing group for the American Heart Association Scientific Statement: Patient Safety in the Cardiac Operating Room: Human Factors and Teamwork. She has presented educational programs locally, nationally, and internationally.

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Seifert was the recipient of the Inova Ronald S. She is a Senior Policy Advisor for health systems and regulatory policy matters. Adams, D.


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Houdini: Make that urinary catheter disappear—Nurse-led protocol. Journal of Infection Prevention, 13 2 , Agency for Healthcare Research and Quality. Will it work here? Alexander, M. NCSBN simulation guidelines for prelicensure nursing programs.


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Journal of Nursing Regulation 6 3 , 39— Altman, M. Redefining "time" to meet evolving demands. Nursing Management, 46 5 , American Academy of Nursing. Raise the voice: Edge runners. Retrieved from www. American Association of Colleges of Nursing. Washington, DC: Author. American Nurses Association. Nursing: Scope and standards of practice 3rd ed. Silver Spring, MD: Author.

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