Journal of Nursing Management, 2014, 22, 823824

Editorial
Effectiveness and implementation of patient safety care

Welcome to the October issue of the Journal of Nursing

Management. We are pleased to present 12 articles
from the US, Sweden, South Africa, Italy, the UK,
China, Canada, Ireland, and Israel that address a
range of topics illustrating nursing challenges and
opportunities. The paper by Lee et al. determines the
cost-effectiveness of hospital nursing interventions for
patients undergoing total hip replacement. It is of
importance because it adds knowledge about an area
in which little research has been carried out on the relative economic benefits of nursing interventions (e.g.
who provides what level of nursing care, what is the
standard time required to deliver a certain intervention
and what equipment for particular nursing interventions). The authors implications for nurse administrators include supporting nurses documentation in
order to make nursing information available. The
paper by Navratil-Strawn and colleagues describes an
integrated Nurse HealthLine programme that evaluates the impact of nurse-led conversation, in the US
and is associated with significant cost savings built on
standard economic theory. Patients receiving the right
care at the right time are likely to recover faster and
have lower healthcare expenditure than those who do
not. The paper by Sun and colleagues focuses on the
conditions necessary for work effectiveness by evaluating the psychometric properties of an adapted Chinese
version of an instrument designed to measure structural empowerment among staff nurses. It was concluded that the reliability and validity of the scale
were evident. Cicolini, Comparcini and Simonetti
explored workplace empowerment and nurses job satisfaction using a literature review method. The authors
recommend that future research should investigate the
relationship between empowerment and nurses job
satisfaction across countries and in different settings
other than hospital based on the studied variables and
patient outcomes. Another paper on the subject of
effectiveness is the study from South Africa by Jooste
and Mothiba on cost management training. Using a
qualitative, exploratory design the study describes
nurse managers who were formally appointed as cost
centre managers with a dual role of delivering quality
care and cost management. A conceptual framework
for cost management training is emphasized.
DOI: 10.1111/jonm.12263
2014 John Wiley & Sons Ltd

The second theme in this issue is the implementation

of patient safety care. The Swedish paper by Sandstr
om
and colleagues reports the necessity of implementing
evidence-based guidelines in the mental health field by
focusing on decision-makers attitudes to and awareness of psychosocial interventions targeting persons
with schizophrenia. According to Salmela (2012), the
nurse leaders awareness of the need to implement
change in practice entails knowledge of relationships,
processes and culture as well as supportive, reflective
and culture-bearing leadership aimed at achieving
genuine and sustainable change, thus ensuring safe
care. However, change requires learning and knowledge (Salmela 2012), in addition to the use of guidelines that can reduce inappropriate variation in
practice, enhance quality and provide safe care as well
as lower healthcare costs (Sacket et al. 1996, Dopson
et al. 2003, Taylor & Allen 2007). The paper by
Higgins and colleagues reports the factors that influence clinical specialists and advanced nurse practitioners ability to enact their clinical and professional
leadership roles and adds to the knowledge of their
key role in supporting leadership as well as their
potential to influence policy and network with professional groups. A paper from South Africa by Ngxongo
and Sibiya describes the challenges of implementing a
basic antenatal care programme. The authors state
that although guidelines are available in almost all
facilities, staff members require training in their use to
ensure safe practice. White, Wells and Butterworth
evaluated implementation literature pertaining to
implementation experiences. They identified seven
contextual characteristics that should be highlighted
during implementation in order to improve the progress and success of the initiatives. In summary, effective and sound processes lead to patient safety when
nurses are empowered and acknowledged as part of
an interprofessional team. The aim of the paper by
Heale et al. was to determine the perceptions of nurse
practitioners about the level of functioning of their
interprofessional teams. The management strategies
that emerged include allocation of time to support
interprofessional teamwork, leadership to enhance collaboration and clear delineation of the responsibilities
of each team member.
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Editorial

The papers in this special issue provide an overview

of the range and scope of nursing effectiveness and
implementation of patient safety care. They also present up-to-date evidence of how nurse leaders effectively address challenges in nursing practice to
maintain patient safety. There are several implementation strategies for improving and maintaining patient
safety. Some nursing practice activities and programmes of known dimensions are presented in this
issue. The work to develop a research implementation
framework for evaluating quality improvement interventions should continue by assessing the effectiveness
and understanding of the change process involved in
implementation. However, implementation research
requires evidence-based knowledge, staff involvement
and familiarity with the context in which development
occurs (Severinsson & Holm 2014). Hopefully this
issue will inspire the reader to actively relate to, reflect
on, support and explore dimensions of nursing leadership and management. I wish you good luck in nursing practice development and research.

References
Dopson S., Locock L., Gabbay J., Ferlie E. & Fitzgerald L.
(2003) Evidence-based medicine and the implementation gap.
Health 7 (3), 311330.
Sacket D.L., Rosenberg W., Gray M.J., Haynes R.B. &
Richardson W.S. (1996) Evidence based medicine: what it is
and what it isnt. British Medical Journal 312, 7172.
Salmela S. (2012) Leading Change by Leading Relationships,
Processes and Cultures. Doctoral Thesis. 
Abo Akademi, Oy
Arkmedia Ab, Vasa.
Severinsson E. & Holm A.L. (2014) Chronic disease management- implementation and coordination of healthcare systems
for depressed elderly persons. Issues in Mental Health
Nursing, DOI: 10.3109/01612840.2014.930215 (In press).
Taylor S. & Allen D. (2007) Visions of evidence-based nursing
practice. Nursing Research 15 (1), 7883.

Elisabeth Severinsson R P N , R N T , M C S c , D r P H
Editor, Professor/Director of Research at the Centre for
Womens, Family & Child Health, Buskerud & Vestfold
University College, Tnsberg, Norway
E-mail: elisabeth.severinsson@hbv.no

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2014 John Wiley & Sons Ltd

Journal of Nursing Management, 2014, 22, 823824