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Kaiser Permanente Northern California (KPNCAL) has a long-standing commitment to advancing nursing excellence through workforce development, professional education, and the integration of Caring Science and Unitary Nursing frameworks. Building on this foundation, the organization identified the need to strengthen nurse-led research, evidence-based practice (EBP), and innovation in alignment with Magnet designation standards. Historically, nursing research infrastructure lagged behind physician-led efforts, with limited structural support, few nurse principal investigators, and minimal collaboration between research-focused PhDs and practice-focused DNPs. To address these gaps, the NCAL Research and EBP Program was launched in 2019, followed by the Research & Innovation Academy (RIA) in 2021 under the Scholars Academy. RIA was designed to institutionalize nursing research and EBP across 21 medical centers through a unified infrastructure, local, national, and regional EBP and research councils, curriculum development, mentorship pathways, and academic partnerships. Initiatives included monthly office hours, grand rounds, regional conferences, and the creation of a community of practice connecting over 300 PhD- and DNP-prepared nurses. RIA also partnered with the Institutional Review Board, Research Determination Office, and KP Libraries to streamline processes and build capacity for nurse-led scholarship. With more than 28 000 nurses in the region, these efforts have accelerated engagement in quality improvement in initiatives, research studies, and dissemination of findings. Looking forward, RIA is advancing large-scale, multi-site studies while preparing for the integration of big data and artificial intelligence in nursing research. By embedding research and EBP into the culture of every medical center, RIA positions KPNCAL to advance innovation, professional nursing excellence, and patient-centered outcomes.
Although physical activity is widely acknowledged as essential for health, achieving work-life balance for faculty and staff at the school of nursing, who work long hours, can be challenging, often leading to the neglect of regular exercise, a crucial element of personal health and wellness. To address this issue, a staff member initiated the "Moving for Minutes" program (M4M) in 2009, aimed at encouraging weekly physical activities such as walking, jogging, biking, and swimming among the faculty and staff. The M4M program operates on a quarterly basis, with participants grouped into teams and asked to track their weekly physical activity minutes. At the end of each quarter, a brief celebration takes place, where healthy snacks are served, and inexpensive prizes are awarded to individuals and teams with the most logged minutes. Since its inception 15 years ago, 128 faculty and staff members have participated, with an average of 18 participants per quarter, representing about 20% of the school of nursing workforce. Participants' mean engagement was 273 minutes of physical activity per person per week of the program. Overall, the M4M program has proven to be highly beneficial by promoting a healthy work environment, encouraging self-care, boosting morale, and fostering camaraderie among faculty and staff at the school of nursing. The M4M program provides an exemplar of successfully supporting physical activity, and promoting general health and well-being among employees.
Kaiser Permanente (KP) has long recognized that professional nursing is central to its mission, vision, and ability to deliver high-quality, integrated, value-based care. Over the past decade, the KP Scholars Academy-originating as the KP Nurse Scholars Academy in Northern California-has evolved into a powerful strategic platform for advancing professional nursing workforce development, leadership excellence, professional practice, and academic progression across the enterprise. Rooted in the imperatives of health care reform, informed by innovative engagement strategies such as the "Hearts and Minds" visioning forums, and strengthened by a legacy of disruptive nursing innovation dating back to the Kaiser Foundation School of Nursing (KFSN), the Academy has become a catalyst for cultural transformation and professional nursing advancement. By intentionally honoring the past while shaping the future, this work positions professional nursing not as a supporting function, but as a leading force in the evolution of integrated care. This article examines the historical foundations that shaped the Academy, its alignment with KP's National Nursing Professional Strategy Agenda and Nursing Professional Practice Model, and the strategic nursing workforce priorities that guide its continued evolution-preparing professional nursing to lead with clarity, purpose, and vision toward the next horizon of care.
Strategic investment in nursing workforce development is both a financial and organizational imperative. In 2014, Kaiser Permanente Northern California launched the Nurse Scholars Academy (NSA) with an initial $30 million investment in response to the Institute of Medicine's Future of Nursing report. Over the past decade, NSA has served as a replicable model for health care organizations by aligning academic-practice partnerships with long-term workforce strategy. Degree completion among NSA Scholars consistently outperforms national benchmarks, with retention rates exceeding the 75% to 80% national average (Figure 1). Retention across degree pathways remains high during academic progression (Figure 2) and is sustained after program completion, with graduates demonstrating long-term commitment to Kaiser Permanente (Figures 3 and 4). These outcomes directly contribute to reduced turnover, with the organization reporting registered nurse (RN) turnover rates 15 percentage points below national medians, equating to an estimated $4.3 million in annual labor cost avoidance. Beyond financial returns, NSA's outcomes illustrate broader organizational value: reduced burnout, increased confidence and capability, strengthened leadership pipelines, and enhanced professional advancement opportunities. Using the Abdi ROI scale, NSA's impact extends into non-monetary domains such as cultural transformation, reputation, and community trust. Together, these outcomes affirm that investments in nursing development yield sustainable financial benefits, advance workforce resilience, and reinforce Kaiser Permanente's role as a national leader in nursing excellence.
The Association of California Nurse Leaders's (ACNL) Recognition and Scholarship Committee (RSC) investigated the role of ACNL in providing scholarships to advance nursing education and professional development. The committee played a crucial role in overseeing the selection process for scholarship recipients to ensure that applicants were evaluated fairly. The RSC was responsible for meeting the committee's goals and the mission of ACNL. In this review, a description of how scholarships supported Registered Nurses in overcoming financial barriers to further education and enhance professional growth by positively impacting nursing practice and potentially patient outcomes was investigated. The RSC oversees the selection and evaluation process based on specific criteria, such as Grade Point Average, personal statements including the need for scholarship, and letters of recommendation. The committee also highlighted the significant impact of ACNL scholarships through a survey conducted among 10 recipients from 2022 to 2025, showing a 100% response rate and substantial professional growth by the recipients. Seventy percent of the recipients presented at major health and nursing conferences; 60% completed their advanced degree; and 50% of scholarship recipients were promoted since receiving their scholarship award.
Nursing stands at a critical inflection point-shaped by global complexity, rapid technological change, and the enduring moral commitment to human caring. This article explores contemporary challenges faced by the profession, including organizational hierarchies, structural bias, funding instability, and persistent gender inequities. Yet it also illuminates the profound hope emerging through special programs like the Kaiser Permanente Scholars Academy, which have strengthened disciplinary identity, advanced academic progression, expanded public policy engagement, and elevated community partnerships. By reframing investment in nursing education as a strategic imperative rather than an operational expense, the article argues for sustainable funding models that support research, innovation, and workforce development. Finally, it examines the future implications of artificial intelligence and emerging technologies, emphasizing that while tools will evolve, the core of nursing-human presence, ethical judgment, and compassionate service-remains irreplaceable.
Leadership transitions in nursing have left many first-time nurse leaders underprepared for the most challenging aspects of their role: holding courageous conversations, maintaining accountability, and sustaining civility under stress. These trends were further accelerated by the disruptions of the pandemic. This gap, combined with heightened workplace violence, burnout, and workforce instability, has threatened the culture of safety across health care. Post-COVID-19, restoring trust and resilience requires intentionally integrating Just Culture, the Highly Reliable Experience training, and nursing professional governance. Just Culture offers a fair and structured approach to accountability, distinguishing between human error, at-risk behavior, and recklessness, while promoting psychological safety and reporting. Highly Reliable Experience embeds error-prevention behaviors, leader standard work, and team communication practices, aligning safety and patient experience. Shared governance empowers frontline nurses to lead improvement, standardize processes, and own outcomes. Together, these frameworks address the leadership development gap, strengthen civility as a safety imperative, and re-engage nurses in shaping reliable care environments. Evidence shows that organizations implementing these strategies see reductions in serious safety events, improvements in patient experience, and stronger workforce engagement. As turnover stabilizes but remains above prepandemic levels, equipping nurse leaders with the skills and structures to deliver accountability with compassion is both urgent and essential to sustaining safety, quality, and trust.
Despite significant concerns about the broad use of artificial intelligence (AI) in clinical practice, registered nurses are commonly challenged to adopt, evaluate, and improve these digital solutions in almost any care environment. The aim of this study is to appraise, then analyze, the scientific literature for contemporary digital innovations that improve nursing practice through the use of AI. This scoping review with thematic analysis of digital innovations impacting nursing practice was conducted using CINAHL and PubMed databases (2022-2024). We describe the use of large language models and associated software tools in supporting this work, highlighting the essential human-in-the-loop activities involved. Results: This review highlights emerging themes, notably improved patient safety and greater trust and acceptance. A persistent emphasis on AI as an assistive entity was found across many products, processes and pilots identified in our corpus. This body of literature is rapidly evolving and characterized by multiple competing themes. The proper implementation and execution of AI as an assistive mechanism is crucial for safety enhancement, improved quality, and trust. Recommendations include the provision of transparency in all aspects of AI innovations for practice (from inception to evaluation) and participatory implementation activities.
Dissemination of member work including projects and studies is a common component of professional nursing organization conferences. Members typically submit an abstract and are selected as presenters through a peer reviewed process. Presenters may have the option of a podium or poster presentation, and conference planners provide requirements such as length of podium presentations or size of posters. The purpose of this article is to describe an initiative by a state nursing leadership organization, Association of California Nurse Leaders (ACNL), to improve the alignment of abstracts with organizational strategic priorities, and the quality of posters at the annual conference. Conference planners set improvement goals, revised the call for abstract and selection criteria, offered poster development webinars, and evaluated posters for key design elements. This article will describe goals, abstract criteria, webinar content, evaluation method, and outcomes including improvement data for two years. The methods described in this article may be duplicated by organizations wishing to establish or improve the quality of conference dissemination.
As health care delivery evolves through technological innovation and expanded support roles, concerns have emerged regarding the erosion of relational nursing practice. This manuscript explores the paradox of increased support for registered nurses alongside declining time spent in direct patient interaction. Drawing on recent literature and leadership dialogue, it examines the implications of diminished communication and connection, particularly among early career nurses, and proposes strategies to restore relational competencies as a core element of professional nursing practice.
Virtual nursing (VN) addresses workforce shortages and improves patient safety through technology-enabled care. Limited evidence exists on the impact of virtual nurses on organizational outcomes and collaboration between leadership and frontline staff. Yale New Haven Health System piloted VN on 2 units (68 beds) in 1 hospital and expanded to 30 units (800 beds) across 3 hospitals, with future units planned. The nurse leader and bedside nurses co-designed workflows, clarified roles, and integrated a virtual nurse using existing infrastructure. VN supported 78% of discharges and over 50% of admissions, reduced discharge order-to-departure time by 30 minutes, increased 11 am discharge rates by nearly 4%, and reduced incidental overtime occurrences and costs by 10%. Patient satisfaction improved, and staff resilience was bolstered through workload redistribution. VN enhances care delivery, promotes workforce sustainability, and improves patient experience. Leadership engagement and frontline collaboration are vital for scaling and success.
In a decade marked by unprecedented challenges, the Kaiser Permanente Scholars Academy has redefined what it means to prepare nurse leaders for the future, serving as a transformative force through strategic academic partnerships, innovative leadership programs, and a steadfast commitment to Caring Science. The Academy has created clear pathways for professional growth from the bedside to executive leadership. Initiatives such as the RN-to-BSN, MSN, and DNP programs, coupled with targeted leadership development experiences, have not only expanded knowledge and skills but have fostered resilience, compassion, and systems thinking. During the COVID-19 pandemic, the Academy demonstrated agility and purpose, integrating virtual learning, resilience strategies, and Caring Science principles to sustain leadership capacity. The recent evolution into the Quantum Caring Leadership Academy builds upon this legacy, emphasizing equity, innovation, and human-centered leadership as essential pillars for the future. This manuscript reflects on the Academy's achievements, lessons learned, and the vision for its next chapter, offering a model for other health care organizations seeking to cultivate leadership excellence while honoring the art and science of nursing.
To build a resilient and sustainable nursing workforce, health care institutions must prioritize supportive leadership, well-being, inclusivity, and innovation. Key strategies include fostering open communication, encouraging collaboration, involving nurses in decision-making, and offering flexible staffing options. Recognizing nurses for their contributions and addressing burnout and moral distress are essential for maintaining job satisfaction and improving patient care. This article, presented by members of the Association of California Nurse Leaders Healthy Work Environment Committee, will share a novel perspective for consideration that integrates concepts from the American Nurses Association Code of Ethics and the American Association of Critical Care Nurses. Using this intersectional perspective directs nurse leaders to employ strategies that enhance job satisfaction and nurse retention, reduce feelings of burnout and moral distress, leading to a healthier, more engaged workforce ready to optimize care outcomes.
Nursing assistants (NAs) are essential health care team members; however, recruiting and retaining experienced individuals can sometimes be challenging. To address this issue, a Nursing Assistant Training Program was developed to provide on-the-job education and training for individuals with no health care background who wish to start a career in this field. The program includes didactic classroom education, mock simulated training and observation, and hands-on training in a patient care environment within an acute care hospital. This program aims to enhance NAs' recruitment, retention, and success rates by offering a comprehensive program tailored to meet various learner needs. It also aims to determine if incorporating this program will directly impact registered nurses' turnover and vacancy rates.
A review of the new American Nurses Association Code of Ethics for Nurses and workplace violence application case example.
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This novel model offers the opportunity for nursing to address social challenges toimprove patient and population outcomes. The nursing workforce is the mainstay ofhealth care delivery systems worldwide. Plagued by cyclical workforce shortages, thenursing profession is now on an untenable path. The deficit of nurses prevents the fulluse of the most prevailing RN-heavy acute care staffing models of the last decades. Itis critical that the workload of any care delivery model, traditional or novel, be based on reasonable expectations. New models would ideally not only assure patient care canbe accomplished with the existing workforce but would also improve on the outcomesable to be produced. Models that introduce an expert virtual RN to a bedside team of aRegistered Nurse and a non-RN care partner offer a unique vehicle for bringing skillednursing care to patients in acute care setting. Trinity Health began scaling their VirtualConnected Care™ model in 2021. The model also brings needed mentoring to earlycareer nurses, offers new ways to express key elements of nursing, and enhances therole of the patient as decision-makers in their own care.
Nurse leaders have realized decreased levels of staff engagement due to a lack of diverse rewards and recognition across all generations of nursing. In 2023, the Staff Engagement survey decreased from 85% engagement to 78% at a Level IV Neonatal Intensive Care Unit in central Texas's quaternary academic teaching hospital. Managers used ineffective incentives to help motivate staff, and the same top performers were burdened with all the work. The developed Leader Toolkit focused on improving multigenerational staff engagement and morale. Utilizing key Incentives based on work-life balance, improved scheduling, self-care, and improvements to their work environment, staff morale increased, engagement in unit and system initiatives improved, and staff well-being across all generations of nursing increased. The 2024 People Survey had 79% completion of the survey within the 1st 24 hours of opening; engagement increased to 84%, and staff well-being increased to 84.3%. The Leader Toolkit successfully incentivized and motivated the new culture of nursing.