Mary Fuchs - Academia.edu (original) (raw)
Papers by Mary Fuchs
JONA: The Journal of Nursing Administration, 2015
This quality improvement study introduced 24/7 family presence and measured its impact in 3 categ... more This quality improvement study introduced 24/7 family presence and measured its impact in 3 categories; perceptions, complaints, and patient experience scores. This article offers insight for leaders into the 1st phase of patient- and family-centered care (PFCC) adoption. Family presence improves patient safety and satisfaction; however, 70% of US healthcare organizations maintain restrictive visitation policies. We surveyed nursing staff 6 months postinnovation to determine staff knowledge, implementation practices, and perceived challenges to implementation. We surveyed system leaders regarding PFCC transformation and trended formal complaints and patient experience scores after family presence innovation. Findings provide insight for leaders into family presence policy adherence challenges experienced by staff. Leaders perceived significant transformation toward PFCC adoption postinnovation. Complaints increased postinnovation, and patient experience scores demonstrated positive trends. We gained insight regarding challenges to policy adherence and identified next steps for leaders in the transformation toward PFCC adoption.
The Journal of nursing administration, 2018
Preparing future nursing leaders to be successful is important because many current leaders will ... more Preparing future nursing leaders to be successful is important because many current leaders will retire in large numbers in the future. A structured nursing leadership development program utilizing the Essentials of Nurse Manager Orientation online program provided future nursing leaders with content aligned with nursing leadership competencies. Paired with assigned mentors and monthly leadership sessions, the participants increased their perception of leadership competence.
Journal of Nursing Care Quality, 2011
Catheter-associated urinary tract infections account for 40% of all health care-associated infect... more Catheter-associated urinary tract infections account for 40% of all health care-associated infections. An evidence-based, nurse-driven daily checklist for initiation and continuance of urinary catheters was implemented in 5 adult intensive care units. Measures of compliance, provider satisfaction, and clinical outcomes were recorded. Compliance with the checklist was 50 to 100%: catheter-associated urinary tract infections decreased from 2.88 to 1.46 per 1000 catheter days and catheter days decreased in 2 intensive care units.
JONA: The Journal of Nursing Administration, 2013
The goal of this project was to determine whether the use of bar-code medication administration c... more The goal of this project was to determine whether the use of bar-code medication administration complied with current evidence as to how it should be used. Using an evidence-based checklist, we performed a gap analysis on bar-code medication administration (BCMA) in an acute care setting. Compliance with current evidence was identified through observation and unstructured nurse interviews. Based on findings from the initial gap analysis, quality improvement initiatives were implemented followed by a reassessment to identify possible improvement of the identified gaps. Initially, there was 72% compliance with current evidence-based practices using BCMA. After implementation of initial quality improvement initiatives targeting 3 of 9 areas with deficits in compliance, compliance was found to be 81%. The evidence-based checklist was helpful in identifying gaps in current performance and opportunities for improvement with BCMA.
Journal of Nursing Measurement, 2016
Assessment of nursing genomic competency is critical given increasing genomic applications to hea... more Assessment of nursing genomic competency is critical given increasing genomic applications to health care. The study aims were to determine the test-retest reliability of the Genetics and Genomics in Nursing Practice Survey (GGNPS), which measures this competency, and to revise the survey accordingly. Registered nurses (n = 232) working at 2 Magnet-designated hospitals participating in a multiinstitutional genomic competency study completed the GGNPS. Cohen's kappa and weighted kappa were used to measure the agreement of item responses between Time 1 and Time 2. Survey items were revised based on the results. Mean agreement for the instrument was 0.407 (range = 0.150-1.000). Moderate agreement or higher was achieved in 39% of the items. GGNPS test-retest reliability was not optimal, and the instrument was refined based on the study findings. Further testing of the revised instrument is planned to assess the instrument performance.
The health system chief nursing executive (CNE) is responsible for providing high-quality, servic... more The health system chief nursing executive (CNE) is responsible for providing high-quality, service-oriented nursing care; delivering such care with disciplined cost management; leading and developing a group of nursing executives and managers at the facility level to establish nursing professional development programs and to build and maintain an effective supply of nurses; and advocating nurses and patients. This article provides insight into the strategies and priorities of large health system CNEs in balancing their obligations to their health systems, to patients and their families, and to the nurses they lead. It is hoped that these insights will provide perspectives that will support the ability of nursing educators to meet their own obligations to their schools of nursing, the faculty and students they represent, and to the profession. These insights will also set a context for further dialogue between two very important groups of nursing leadersnursing executives and nursing educators. (
Journal of professional nursing : official journal of the American Association of Colleges of Nursing
The health system chief nursing executive (CNE) is responsible for providing high-quality, servic... more The health system chief nursing executive (CNE) is responsible for providing high-quality, service-oriented nursing care; delivering such care with disciplined cost management; leading and developing a group of nursing executives and managers at the facility level to establish nursing professional development programs and to build and maintain an effective supply of nurses; and advocating nurses and patients. This article provides insight into the strategies and priorities of large health system CNEs in balancing their obligations to their health systems, to patients and their families, and to the nurses they lead. It is hoped that these insights will provide perspectives that will support the ability of nursing educators to meet their own obligations to their schools of nursing, the faculty and students they represent, and to the profession. These insights will also set a context for further dialogue between two very important groups of nursing leaders-nursing executives and nursin...
JONA: The Journal of Nursing Administration, 2015
This quality improvement study introduced 24/7 family presence and measured its impact in 3 categ... more This quality improvement study introduced 24/7 family presence and measured its impact in 3 categories; perceptions, complaints, and patient experience scores. This article offers insight for leaders into the 1st phase of patient- and family-centered care (PFCC) adoption. Family presence improves patient safety and satisfaction; however, 70% of US healthcare organizations maintain restrictive visitation policies. We surveyed nursing staff 6 months postinnovation to determine staff knowledge, implementation practices, and perceived challenges to implementation. We surveyed system leaders regarding PFCC transformation and trended formal complaints and patient experience scores after family presence innovation. Findings provide insight for leaders into family presence policy adherence challenges experienced by staff. Leaders perceived significant transformation toward PFCC adoption postinnovation. Complaints increased postinnovation, and patient experience scores demonstrated positive trends. We gained insight regarding challenges to policy adherence and identified next steps for leaders in the transformation toward PFCC adoption.
Journal of Professional Nursing, 2006
The health system chief nursing executive (CNE) is responsible for providing high-quality, servic... more The health system chief nursing executive (CNE) is responsible for providing high-quality, service-oriented nursing care; delivering such care with disciplined cost management; leading and developing a group of nursing executives and managers at the facility level to establish nursing professional development programs and to build and maintain an effective supply of nurses; and advocating nurses and patients. This article provides insight into the strategies and priorities of large health system CNEs in balancing their obligations to their health systems, to patients and their families, and to the nurses they lead. It is hoped that these insights will provide perspectives that will support the ability of nursing educators to meet their own obligations to their schools of nursing, the faculty and students they represent, and to the profession. These insights will also set a context for further dialogue between two very important groups of nursing leadersnursing executives and nursing educators. (
Journal of Professional Nursing, 2014
The goal of Doctor of Nursing Practice (DNP) programs should be to produce nurses that are unique... more The goal of Doctor of Nursing Practice (DNP) programs should be to produce nurses that are uniquely prepared to bridge the gap between the discovery of new knowledge and the scholarship of translation, application, integration of this new knowledge in practice . However, there is concern over the variability in DNP programs and expected outcomes.
Journal of Nursing Scholarship, 2012
Purpose: To describe the development of an academic-health services partnership undertaken to imp... more Purpose: To describe the development of an academic-health services partnership undertaken to improve use of evidence in clinical practice. Approach: Academic health science schools and health service settings share common elements of their missions: to educate, participate in research, and excel in healthcare delivery, but differences in the business models, incentives, and approaches to problem solving can lead to differences in priorities. Thus, academic and health service settings do not naturally align their leadership structures or work processes. We established a common commitment to accelerate the appropriate use of evidence in clinical practice and created an organizational structure to optimize opportunities for partnering that would leverage shared resources to achieve our goal. Findings: A jointly governed and funded institute integrated existing activities from the academic and service sectors. Additional resources included clinical staff and student training and mentoring, a pilot research grant-funding program, and support to access existing data. Emergent developments include an appreciation for a wider range of investigative methodologies and crossdisciplinary teams with skills to integrate research in daily practice and improve patient outcomes. Conclusions: By developing an integrated leadership structure and commitment to shared goals, we developed a framework for integrating academic and health service resources, leveraging additional resources, and forming a mutually beneficial partnership to improve clinical outcomes for patients. Clinical Relevance: Structurally integrated academic-health service partnerships result in improved evidence-based patient care delivery and in a stronger foundation for generating new clinical knowledge, thus improving patient outcomes.
Journal of Nursing Care Quality, 2011
Catheter-associated urinary tract infections account for 40% of all health care-associated infect... more Catheter-associated urinary tract infections account for 40% of all health care-associated infections. An evidence-based, nurse-driven daily checklist for initiation and continuance of urinary catheters was implemented in 5 adult intensive care units. Measures of compliance, provider satisfaction, and clinical outcomes were recorded. Compliance with the checklist was 50 to 100%: catheter-associated urinary tract infections decreased from 2.88 to 1.46 per 1000 catheter days and catheter days decreased in 2 intensive care units.
JONA: The Journal of Nursing Administration, 2015
This quality improvement study introduced 24/7 family presence and measured its impact in 3 categ... more This quality improvement study introduced 24/7 family presence and measured its impact in 3 categories; perceptions, complaints, and patient experience scores. This article offers insight for leaders into the 1st phase of patient- and family-centered care (PFCC) adoption. Family presence improves patient safety and satisfaction; however, 70% of US healthcare organizations maintain restrictive visitation policies. We surveyed nursing staff 6 months postinnovation to determine staff knowledge, implementation practices, and perceived challenges to implementation. We surveyed system leaders regarding PFCC transformation and trended formal complaints and patient experience scores after family presence innovation. Findings provide insight for leaders into family presence policy adherence challenges experienced by staff. Leaders perceived significant transformation toward PFCC adoption postinnovation. Complaints increased postinnovation, and patient experience scores demonstrated positive trends. We gained insight regarding challenges to policy adherence and identified next steps for leaders in the transformation toward PFCC adoption.
The Journal of nursing administration, 2018
Preparing future nursing leaders to be successful is important because many current leaders will ... more Preparing future nursing leaders to be successful is important because many current leaders will retire in large numbers in the future. A structured nursing leadership development program utilizing the Essentials of Nurse Manager Orientation online program provided future nursing leaders with content aligned with nursing leadership competencies. Paired with assigned mentors and monthly leadership sessions, the participants increased their perception of leadership competence.
Journal of Nursing Care Quality, 2011
Catheter-associated urinary tract infections account for 40% of all health care-associated infect... more Catheter-associated urinary tract infections account for 40% of all health care-associated infections. An evidence-based, nurse-driven daily checklist for initiation and continuance of urinary catheters was implemented in 5 adult intensive care units. Measures of compliance, provider satisfaction, and clinical outcomes were recorded. Compliance with the checklist was 50 to 100%: catheter-associated urinary tract infections decreased from 2.88 to 1.46 per 1000 catheter days and catheter days decreased in 2 intensive care units.
JONA: The Journal of Nursing Administration, 2013
The goal of this project was to determine whether the use of bar-code medication administration c... more The goal of this project was to determine whether the use of bar-code medication administration complied with current evidence as to how it should be used. Using an evidence-based checklist, we performed a gap analysis on bar-code medication administration (BCMA) in an acute care setting. Compliance with current evidence was identified through observation and unstructured nurse interviews. Based on findings from the initial gap analysis, quality improvement initiatives were implemented followed by a reassessment to identify possible improvement of the identified gaps. Initially, there was 72% compliance with current evidence-based practices using BCMA. After implementation of initial quality improvement initiatives targeting 3 of 9 areas with deficits in compliance, compliance was found to be 81%. The evidence-based checklist was helpful in identifying gaps in current performance and opportunities for improvement with BCMA.
Journal of Nursing Measurement, 2016
Assessment of nursing genomic competency is critical given increasing genomic applications to hea... more Assessment of nursing genomic competency is critical given increasing genomic applications to health care. The study aims were to determine the test-retest reliability of the Genetics and Genomics in Nursing Practice Survey (GGNPS), which measures this competency, and to revise the survey accordingly. Registered nurses (n = 232) working at 2 Magnet-designated hospitals participating in a multiinstitutional genomic competency study completed the GGNPS. Cohen's kappa and weighted kappa were used to measure the agreement of item responses between Time 1 and Time 2. Survey items were revised based on the results. Mean agreement for the instrument was 0.407 (range = 0.150-1.000). Moderate agreement or higher was achieved in 39% of the items. GGNPS test-retest reliability was not optimal, and the instrument was refined based on the study findings. Further testing of the revised instrument is planned to assess the instrument performance.
The health system chief nursing executive (CNE) is responsible for providing high-quality, servic... more The health system chief nursing executive (CNE) is responsible for providing high-quality, service-oriented nursing care; delivering such care with disciplined cost management; leading and developing a group of nursing executives and managers at the facility level to establish nursing professional development programs and to build and maintain an effective supply of nurses; and advocating nurses and patients. This article provides insight into the strategies and priorities of large health system CNEs in balancing their obligations to their health systems, to patients and their families, and to the nurses they lead. It is hoped that these insights will provide perspectives that will support the ability of nursing educators to meet their own obligations to their schools of nursing, the faculty and students they represent, and to the profession. These insights will also set a context for further dialogue between two very important groups of nursing leadersnursing executives and nursing educators. (
Journal of professional nursing : official journal of the American Association of Colleges of Nursing
The health system chief nursing executive (CNE) is responsible for providing high-quality, servic... more The health system chief nursing executive (CNE) is responsible for providing high-quality, service-oriented nursing care; delivering such care with disciplined cost management; leading and developing a group of nursing executives and managers at the facility level to establish nursing professional development programs and to build and maintain an effective supply of nurses; and advocating nurses and patients. This article provides insight into the strategies and priorities of large health system CNEs in balancing their obligations to their health systems, to patients and their families, and to the nurses they lead. It is hoped that these insights will provide perspectives that will support the ability of nursing educators to meet their own obligations to their schools of nursing, the faculty and students they represent, and to the profession. These insights will also set a context for further dialogue between two very important groups of nursing leaders-nursing executives and nursin...
JONA: The Journal of Nursing Administration, 2015
This quality improvement study introduced 24/7 family presence and measured its impact in 3 categ... more This quality improvement study introduced 24/7 family presence and measured its impact in 3 categories; perceptions, complaints, and patient experience scores. This article offers insight for leaders into the 1st phase of patient- and family-centered care (PFCC) adoption. Family presence improves patient safety and satisfaction; however, 70% of US healthcare organizations maintain restrictive visitation policies. We surveyed nursing staff 6 months postinnovation to determine staff knowledge, implementation practices, and perceived challenges to implementation. We surveyed system leaders regarding PFCC transformation and trended formal complaints and patient experience scores after family presence innovation. Findings provide insight for leaders into family presence policy adherence challenges experienced by staff. Leaders perceived significant transformation toward PFCC adoption postinnovation. Complaints increased postinnovation, and patient experience scores demonstrated positive trends. We gained insight regarding challenges to policy adherence and identified next steps for leaders in the transformation toward PFCC adoption.
Journal of Professional Nursing, 2006
The health system chief nursing executive (CNE) is responsible for providing high-quality, servic... more The health system chief nursing executive (CNE) is responsible for providing high-quality, service-oriented nursing care; delivering such care with disciplined cost management; leading and developing a group of nursing executives and managers at the facility level to establish nursing professional development programs and to build and maintain an effective supply of nurses; and advocating nurses and patients. This article provides insight into the strategies and priorities of large health system CNEs in balancing their obligations to their health systems, to patients and their families, and to the nurses they lead. It is hoped that these insights will provide perspectives that will support the ability of nursing educators to meet their own obligations to their schools of nursing, the faculty and students they represent, and to the profession. These insights will also set a context for further dialogue between two very important groups of nursing leadersnursing executives and nursing educators. (
Journal of Professional Nursing, 2014
The goal of Doctor of Nursing Practice (DNP) programs should be to produce nurses that are unique... more The goal of Doctor of Nursing Practice (DNP) programs should be to produce nurses that are uniquely prepared to bridge the gap between the discovery of new knowledge and the scholarship of translation, application, integration of this new knowledge in practice . However, there is concern over the variability in DNP programs and expected outcomes.
Journal of Nursing Scholarship, 2012
Purpose: To describe the development of an academic-health services partnership undertaken to imp... more Purpose: To describe the development of an academic-health services partnership undertaken to improve use of evidence in clinical practice. Approach: Academic health science schools and health service settings share common elements of their missions: to educate, participate in research, and excel in healthcare delivery, but differences in the business models, incentives, and approaches to problem solving can lead to differences in priorities. Thus, academic and health service settings do not naturally align their leadership structures or work processes. We established a common commitment to accelerate the appropriate use of evidence in clinical practice and created an organizational structure to optimize opportunities for partnering that would leverage shared resources to achieve our goal. Findings: A jointly governed and funded institute integrated existing activities from the academic and service sectors. Additional resources included clinical staff and student training and mentoring, a pilot research grant-funding program, and support to access existing data. Emergent developments include an appreciation for a wider range of investigative methodologies and crossdisciplinary teams with skills to integrate research in daily practice and improve patient outcomes. Conclusions: By developing an integrated leadership structure and commitment to shared goals, we developed a framework for integrating academic and health service resources, leveraging additional resources, and forming a mutually beneficial partnership to improve clinical outcomes for patients. Clinical Relevance: Structurally integrated academic-health service partnerships result in improved evidence-based patient care delivery and in a stronger foundation for generating new clinical knowledge, thus improving patient outcomes.
Journal of Nursing Care Quality, 2011
Catheter-associated urinary tract infections account for 40% of all health care-associated infect... more Catheter-associated urinary tract infections account for 40% of all health care-associated infections. An evidence-based, nurse-driven daily checklist for initiation and continuance of urinary catheters was implemented in 5 adult intensive care units. Measures of compliance, provider satisfaction, and clinical outcomes were recorded. Compliance with the checklist was 50 to 100%: catheter-associated urinary tract infections decreased from 2.88 to 1.46 per 1000 catheter days and catheter days decreased in 2 intensive care units.