Eileen G. Collins

Background: Among nurse managers, administrative decision-making (ADM) refers to leadership behaviors that involve rational, complex processes aimed at identifying optimal solutions. Digital advances in healthcare settings have significantly influenced nurse managers’ decision-making, transitioning from traditional, intuitive approaches reliant on limited real-time data resources toward analytics-driven decision-making. Consequently, the conceptual frameworks previously established for nurse manager ADM have limited applicability to the modern healthcare context. Purpose: We clarified the ADM concept among nurse managers at the operational-unit level by examining historical and contemporary perspectives across diverse disciplines and exploring how the concept is shaped by the modern healthcare environment. Method: We employed Rodger's evolutionary method in identifying attributes, antecedents, consequences, and surrogate and related terms for ADM. The concept emerged in four disciplinary domains: nursing and healthcare, business and management, psychology, and data science. Searches were conducted of CINAHL, PubMed, Medline, JSTOR, Scopus, Google Scholar, and ProQuest. Information was extracted from 35 sources meeting the inclusion criteria. Results: Nurse managers’ ADM has been shaped by the evolving healthcare landscape over time. Attributes of ADM consisted of an analytical decision-making approach, a hybrid human-centric decision-making approach, evidence-based leadership, and psychological capital. Antecedents included organizational, personal, and interpersonal factors; ADM prerequisites; and data-informed decisionmaking systems. Consequences included optimal decision-making, achieving success factors, and managerial creativity. Conclusion: This study reveals how the concept of nurse manager ADM has been shaped by the modern digital healthcare environment. The concept embodies a structured, ethical, and evidence-informed decision-making approach that can enhance both clinical and administrative effectiveness.

Faculty focusing on LGBTQ+ communities often face structural challenges within academic institutions. These include limited access to research funding, difficulties publishing in some academic journals, and increased oversight from Institutional Review Boards. Typically, traditional promotion and tenure systems emphasize narrow definitions of scholarly output, overlooking the diverse contributions of researchers in LGBTQ+ health. Developed through iterative synthesis of conference working-group discussions from the 2025 National Nursing Summit on Sexual and Gender Minority (SGM) Health, this paper introduces a comprehensive evaluation framework designed for LGBTQ+ health researchers, with potential relevance to other marginalized groups. Rooted in discussions among researchers, students, and administrators, we outline 11 domains of scholarly contribution, each supported by rationale and examples, to help institutions value community-engaged, justice-driven scholarship. Addressing these structural gaps is vital for fostering a more equitable and inclusive academic culture.

Background: Lower perceived social support is associated with hopelessness in patients with ischemic heart disease (IHD). Higher perceived social support is associated with higher heart rate variability (HRV) in adults following a stressful event, but the relationship between HRV and hopelessness has not been examined in patients with IHD. The purpose of this research was to evaluate the relationships among HRV, perceived social support, and hopelessness in patients with IHD. Methods and Results: Ninety‐four participants were enrolled while hospitalized for an IHD event at a large hospital in the United States. Data collection occurred 2 weeks after hospital discharge and included the State–Trait Hopelessness Scale, ENRICHD Social Support Inventory, Patient Health Questionnaire‐9, a demographic form, and a short‐term HRV measurement taken at rest. Linear models were used to assess associations between variables in unadjusted and adjusted models. Most participants were men (67%), married (75%), and non‐Hispanic White (96%) and underwent coronary artery bypass surgery (57%). There were inverse correlations between high frequency HRV and state hopelessness ( r =−0.21, P =0.008) and root mean square of successive differences between normal heartbeats HRV and state hopelessness ( r =−0.20, P =0.012) after adjusting for important covariates. High frequency and root mean square of successive differences between normal heartbeats did not show evidence of mediating the relationship between perceived social support and hopelessness. Conclusions: There were significant inverse correlations between parasympathetic measures of HRV and hopelessness. Assessing high frequency and root mean square of successive differences between normal heartbeats during early recovery following an IHD event could provide promising evidence for understanding a possible precursor to hopelessness and targets for future interventions. Registration Information: clinicaltrials.gov . Identifiers: NCT03907891, NCT05003791.

Objective: To compare clinical outcomes associated with appropriate and inappropriate management of asymptomatic bacteriuria (ASB) and urinary tract infection (UTI) among inpatients with neurogenic bladder (NB). Design: Multicenter, retrospective cohort. Setting: The study was conducted across 4 Veterans’ Affairs hospitals. Participants: The study included veterans with NB due to spinal cord injury or disorder (SCI/D), multiple sclerosis (MS), or Parkinson’s disease (PD) hospitalized between January 1, 2017, and December 31, 2018, with diagnosis of ASB or UTI. Interventions: In a medical record review, we classified ASB and UTI diagnoses and treatments as appropriate or inappropriate based on national guidelines. Main outcome measures: Frequencies of Clostridioides difficile infection, acute kidney injury, 90-day hospital readmission, postculture length-of-stay (LOS), and multidrug-resistant organisms in subsequent urine cultures were compared between those who received appropriate and inappropriate management. Results: We included 170 encounters with ASB (30%) or UTI (70%) diagnoses occurring for 166 patients. Overall, 86.1% patients were male, 47.6% had SCI/D and 77.6% used bladder catheters. All ASB encounters had appropriate diagnoses, and 96.1% had appropriate treatment. In contrast, 37 UTI encounters (31.1%) had inappropriate diagnoses and 61 (51.3%) had inappropriate treatment, including 30 encounters with true ASB. Among patients with SCI/D or MS, appropriate ASB or UTI diagnosis was associated with a longer postculture LOS (median, 14 vs 7.5 days; P = .02). We did not detect any significant associations between appropriate versus inappropriate diagnosis and treatment and other outcomes. Conclusions: Almost one-third of UTI diagnoses and half of treatments in hospitalized patients with NB are inappropriate. Opportunities exist to improve ASB and UTI management in patients with NB to minimize inappropriate antibiotic use.

Background: Women veterans experience higher levels of stress-related symptoms than their civilian counterparts. Psychological stress is associated with greater inflammation and may increase risk for cardiovascular disease (CVD). Mindfulness-based stress reduction (MBSR) has been found to improve psychological well-being in other populations but no randomized controlled trials (RCT) have been conducted examining the impact of MBSR on well-being and inflammation in women veterans at risk for CVD. Objective: Determine the effectiveness of MBSR in improving psychological well-being, cortisol, and inflammation associated with CVD in women veterans. Design: The design is a RCT comparing MBSR to an active control condition (ACC) consisting of a health education program. Participants: Women veterans (N=164) with risk factors for CVD from the Chicagoland area participated in the study. Intervention: An 8-week MBSR program with weekly 2.5-h classes was compared to an ACC consisting of an 8-week health promotion education program with weekly 2.5-h classes. Main Measures: The outcomes were psychological well-being [perceived stress, depressive symptoms, loneliness, and post-traumatic stress disorder (PTSD)] symptoms and stress-related markers, including diurnal salivary cortisol and cytokines interleukin-6 (IL-6) and interferon gamma (IFN-γ). Data were collected at baseline, 4 weeks (mid-point of intervention), 8 weeks (completion of intervention), and 6 months after completion of MBSR or ACC. Key Results: Compared to the ACC, women who participated in MBSR reported less perceived stress, loneliness, and symptoms of PTSD. Although there were no significant differences between groups or changes over time in IL-6 or IFN-γ, participants in the MBSR program demonstrated a more rapid decline in diurnal salivary cortisol as compared to those in the ACC. Conclusions: MBSR was found to improve psychological well-being and decrease diurnal salivary cortisol in women veterans at risk for CVD. Health care providers may consider MBSR for women veterans as a means by which to improve their psychological well-being.