Author Archives: John

Hot Topics: The Impact of Toxic Leadership on Nurse Retention

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“Negative leadership behaviors, such as toxic leadership, are linked to decreased job satisfaction due to the stress caused by exploitative managerial actions.
These may lead to higher turnover rates and financial losses for the healthcare organizations. Toxic leadership affects team dynamics, leading to poor conflict management
and reduced organizational commitment. It may also result in a negative working
environment, poor quality of care and increased frequencies of adverse clinical events.
Understanding abusive leadership helps in developing strategies to mitigate its effects,
as this leadership style may undermine workforce stability, productivity, staff resilience,
and patient safety. This scoping review synthesizes evidence from multiple countries,
addressing a critical gap by offering a broader perspective on toxic leadership in healthcare,
rather than limiting the analysis to a single organization or setting.”

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JONA Highlights: Magnet Recognition Through the Lens of Clinical Nurses

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“Clinical nurses are the cornerstone of healthcare delivery and the primary drivers of patient outcomes, practice excellence, and organizational culture. As healthcare systems evolve amid increasing complexity, workforce strain, and rising expectations for quality and safety, nursing must move beyond traditional models of designation and hierarchy toward transformation grounded in professional autonomy, shared leadership, and meaningful engagement. This article explores the evolution of nursing practice through 5 interconnected components:
-designation to transformation
-compliance to commitment
-burnout to meaningful engagement
-hierarchy to shared leadership
-and the enduring value of Magnet recognition as experienced by clinical nurses.

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Emory Authors: Unit-level organizational resources and occupational exposure to bloodborne pathogens: A multi-hospital study

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“Each year, roughly 300,000 hospital workers are exposed to bloodborne pathogens. These workers are at substantial risk due to frequent contact with patients, biological materials, and contaminated environments. Such exposures can result in significant physical, psychological, and economic consequences for affected workers and hospitals. Prior studies suggest that factors such as job role, work location, shift timing, and deviations from infection prevention guidelines may increase the likelihood of exposure to bloodborne pathogens among healthcare workers.”

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Emory Authors: Orientation of New Graduate Nurses to Acute and Critical Care: Reimagining the Preceptor Role.

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“The preparation new graduate nurses (NGNs) receive in prelicensure education is requisite skill and knowledge for entry into the profession but falls short of the expected competence for independent nursing practice. This competency gap is a well-described challenge for nurse educators and nurse leaders. For NGNs, the academic practice gap represents a
steep learning curve in a complex setting. Entry into practice in highly specialized acute care units is a fast-paced, high-stakes environment complicated by staffing shortages, heavy workloads, and hostile workplace cultures.”

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“NEED LESS CLABSI”s: Needleless Connectors for CLABSI Prevention

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“Central line–associated bloodstream infections (CLABSIs) are serious healthcare-associated infections causing significant morbidity, mortality, and financial burden. A major contributor to CLABSI is microbial entry through catheter access points, particularly the hub. Needleless connectors are therefore essential components of central line systems, enabling safe access without needles while aiming to minimize contamination risk.
Needleless connectors are critical for safe central line access, but variations in their design—such as internal flow paths, valves, and dead space—can promote reflux, biofilm formation, and contamination. Inconsistent hub disinfection further increases infection risk. As noted by Rickard et al. (2021), “contamination of the needleless connector is a key pathway for intraluminal central venous access device infection,” emphasizing the importance of connector design and effective hub decontamination. Newer connector designs and disinfecting caps aim to reduce contamination and improve compliance; however, comparative evidence on their real-world impact remains limited.”

Sarah McCullar MBA MN RN , Madison Toole BSN RN, Perrez Wilson MN RN Neuro ICU 2D/G, Emory University Hospital

Boots on the Bed: Preventing Heel Pressure Injuries with Heel Soft Boots

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Many Intensive Care Unit (ICU) patients suffer from conditions that limit mobility, further increasing their risk of pressure injuries (PI). A multi-center study found that 37.9% of ICU patients had a unit-acquired PI with 12.5% being heel PIs (n = 87), but with unit-based education the unit-acquired PIs reduced to 14.9% with 8.8% being heel PIs (n = 94) (Alshahrani et al., 2024). Several factors contributing to heel PIs can be reduced or eliminated through patient and nurse education on proper heel-offloading strategies, specifically the use of heel soft boots and pillows, as improper positioning can cause friction and contractures (Arslan & Ates, 2024). One study demonstrated the effectiveness of proper heel soft boot utilization, with 1 heel PI in the intervention group (n = 197) compared to 11 heel PIs in the control group (n = 197) over 28 days. (Johnson et al., 2022).

Will Anda, BSN, RN, Ben Haskew, BSN, RN, Alexis Holmes, BSN, RN, Madeeah Muhammad, BSN, RN, Hannah Ross, BSN, RN Emory University Hospital (EUH) 4TN/5TN Cardiovascular Intensive Care Unit (CVICU)

Emory Authors: Can consumer wearables support outpatient health monitoring for patients with post-acute infection syndromes? A systematic umbrella review of accuracy, validity, and clinical utility data

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“Consumer health wearables—commercially available health tracking devices such as
smartwatches and other wearable sensors coupled to smartphones—have become
broadly adopted in the United States. A 2024 study found that 44.5% of Americans
reported using a wearable on a regular basis. These devices are designed to
passively and continuously collect physiological data, offering users a convenient,
data-driven, and readily available means of engaging with indicators of their health.
Biometrics tracked by consumer wearables with demonstrated links to health status
include heart rate, heart rate variability, blood oxygen saturation, electrodermal activity, blood pressure, and indices of sleep quantity and quality, among others.”

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