Journal of Nursing Education, 46(4), 165-169. (2009), who used existing intellectual capital questionnaires to survey employees’ perceptions of the influence of organizational investment in human capital on voluntary nurse turnover in hospitals. Citation: Mughal AF (2014) Understanding and using the Mental Capacity Act. Intellectual humility depends on recognizing that one should not claim more than one actually knows. For consent to be valid, the person giving it must have the mental capacity to understand what they are consenting to; it is the same as any other contract or agreement. To date, nursing theories that guide nursing administrative research are limited (Mark et al., 2004), this has resulted in little theoretical explanation of the relationships among nursing knowledge or factors within the work environment (i.e. In Patient Safety and Quality: An Evidence-Based Handbook for Nurses. This has resulted in limited empirical evidence of the impact of nursing knowledge on patient or organizational outcomes. Effects of nurse staffing and nurse education on patient deaths in hospital with different nurse work environments. Duffield, C., Diers, D., O’Brien-Pallas, L., Aisbett, C, Roche, M., King, M., & Aisbett, K (2011) Nursing staffing, nursing workload, the work environment and patient outcomes. Because nursing knowledge is an intangible organizational asset, conducting research to determine its contribution to the quality of patient care is challenging. As a result, several initiatives are being implemented including changes in nurse staffing and models of care delivery. nurse staffing levels) and their potential influence on the registered nurses’ ability to attend educational activities (Covell, 2009). Journal of Advanced Nursing, 63(1): 94-103. Redesigning continuing education in the health professions. The Electronic Journal of Knowledge Management, 5(4): 357-362. In the nursing intellectual capital theory, human capital investment is redefined as employer support for nurse continuing professional development. Much of the evidence from the body of research indicates that nurses value their intuition in a variety of clinical settings. The MCA does not say that everyone who has a stroke automatically lacks mental capacity - it is clear that a diagnosis alone cannot be used to judge mental capacity (MCA s.2(3)(b)). Aiken, L.M., Cimiotti, J. P., Sloane, D.M., Smith, H. L., Flynn, L., & Neff, D. F. (2011). Seibert, S.E., Kraimer, M. L. & Linden, R.C. First, to increase the academic preparation of their staff, nurse managers can adjust their hiring practices to include a greater proportion of baccalaureate prepared registered nurses, reimburse registered nurses for the expenses associated with advancing their academic education, and make efforts to retain registered nurses with university degrees when possible. Expand your horizons. Journal of Advanced Nursing. Intellectual skills are defined as the methods an individual can use to evaluate or organize information and data. (2001). The Mental Capacity Act 2005 (HM Government, 2005) is all about consent. CAUTION . Business performance leads to organizational profits and retention of key people (Bontis & Fitz-enz, 2002). Examples of intellectual capacity in a sentence, how to use it. (2002). This may be due to the type of indicators or data used to measure employer support for the nurse continuing professional development concept in that organizations may apply a subset, but not all, of the strategies to support registered nurses' professional development. (2009). Note: In Canada and in the UK, a person with intellectual disability and mental health disorder is often referred to as having "dual diagnosis". Adjusting for inflation. Healthcare organizations invest in the knowledge and skill development of registered nurses through continuing professional development activities (Covell, 2009). You are pointing out a very important and interesting effect of our “blindedness” to racial injustices toward our minority nurse colleagues. Intellectual capital profiles: An examination of investments and returns. 10. However, further theoretical work is required to refine some measures of the concepts, specifically those associated with the employer support for nurse continuing professional development and nursing structural capital concepts (Covell & Sidani, 2012). In nursing, intellectual capital is the stocks of nursing knowledge available within a healthcare organization. Butler, M., Collins, R., Drennan, J., Halligan, P., O’Mathúna, D.P., Schultz, T.J.,… Vilis, E. (2011). Intellectual brilliance, physical strength, and common sense are three examples of highly sought-after abilities within certain companies. Thus, in order to ensure safer patient care, nurse managers may consider employing a high number of registered nurses with specialty certification (Kendall-Gallagher & Blegen, 2009; Newhouse, Johantgen, & Pronovost, 2005). These changes are creating challenges in terms of knowing the most appropriate nurse staffing patterns to keep patients safe and levels of support for developing the knowledge registered nurses need to achieve the best patient and system outcomes. (2001). Business Dictionary. Medical Care, 46(9): 938-945. Youndt, M., Subramanian, M., & Snell, S.A. (2004). The majority of patients are able to consent to care and treatment, and this must be a default assumption for health professionals; section 1 of the MCA states that people must be assumed to have mental capacity unless it is proved otherwise. Therefore, the intellectual capital theory supports the Magnet hospital work and provides the underpinning of the ANCC Magnet Recognition Program® Model (American Nurses Credentialing Center, 2012). Due to rising costs of healthcare, determining how registered nurses and knowledge resources influence the quality of patient care is critical. It represents a set of behaviors and beliefs demonstrated by the organization that promote and value the education of registered nurses after they enter the profession (Kramer & Schmalenberg, 2004). Two factors within the work environment, nurse staffing and employer support for nurse continuing professional development, are proposed to influence nursing human capital’s association wit… Art. Registered nurses have reported they require financial assistance and time off work in order to attend continuing professional development activities (Schweitzer & Krassa, 2010). Nursing Education Today, 32, 385-392. International Journal of Nursing Studies, 48(6), 732-750. Managing an organizational learning system by aligning stocks and flows of knowledge: An empirical examination of intellectual capital, knowledge management, and business performance. Profiting from intellectual capital: Extracting value from innovation. Since registered nurses are the most knowledgeable about the type and amount of continuing professional development in which they take part, the development of a nursing human capital database where registered nurses can independently update their knowledge, skills, and experience profile would give nurse managers a clearer idea of the amount of nursing human capital available on their unit. This specialised education is only available in Ireland and the UK. Many hospitals and care homes use pro formas to help staff with this. Magnet recognition® program model. In healthcare organizations, nursing human capital is reflected in nurse staffing. Her areas of expertise are theory development and testing, empirical indicator development and measurement, and structural equation modeling. Deterrents to nurses’ participation in continuing professional development: An integrative literature review. Messmer, P.R., & Turkel, M.C. blood glucometers, telemetry) and portable computerized devices (e.g. Both studies investigated the relationship between investment in nursing human capital and registered nurse recruitment and retention. The aim of this article was to present the intellectual capital theory in the context of its application to and impact on nursing research and practice. Nursing Economics, 2, 14-19. Incapacity can only be shown or evidenced by carrying out the mental capacity assessment. If you want to grow in life and be successful, finding a way to increase your intellectual capacity may be your secret weapon. Bontis, N. (1999). influence, inform and drive policy, new ideas and use best outcomes to raise Mental Health Nursing profile ; respond to National and Local activities in relation to Mental Health in a timely manner and work with RCN Forums and MHN professional networks. At present, adults with intellectual disability have little involvement in nursing care planning. Specifically, the majority of the nurse staffing studies are atheoretical (Mark et al., 2004). BSc (Hons) in Intellectual Disability Nursing. (AHRQ Publication No. Hudspeth, R. (2006). To address these questions, researchers have primarily focused on trying to understand the relationship between nurse staffing levels and the occurrence of adverse events, such as patient falls (Blegen & Vaughn, 1998; Blegen, Vaughn, & Goode 2001). Blegen, M.A., & Vaughn, T. (1998). It is operationalized into: Positive associations among intellectual capital and business performance have been reported in the literature. Intellectual capital: Realizing your company's true value by finding its hidden brainpower. Canadian Health Services Research Foundation. Retrieved from:  doi: 10.1111/jan.12040. In summary, these findings provide emerging evidence to validate the major proposition of the nursing intellectual capital theory; higher levels of nursing human capital are associated with better quality patient care and registered nurse recruitment and retention. As an intangible organizational asset, intellectual capital includes the knowledge of individual employees or groups of employees who are deemed critical to a company's continued success, and organizational structures that contain information about processes, customers or other information that contributes to improved business performance or profits (Dumay, 2012; Sullivan, 1998). Revisiting nurse turnover costs. These staff and their employers have a duty to ensure they know how to use it. Though the theory conceptualized the collective human capital of registered nurses working on inpatient care units, it also shows promise for guiding studies designed to investigate the human capital of registered nurses that occupy other types of nursing roles such as public health registered nurses, academics, and advanced practice registered nurses. Unfortunately, there is a risk that patients who lack mental capacity merely comply with health professionals when asked to consent to an intervention, and are recorded as having consented without a mental capacity assessment having been carried out. Nurse staffing is an important strategy to prevent medication errors in community hospitals. The impact of nurse turnover on patient, nurse, and system outcomes: A pilot study and focus for a multicenter international study. The main areas of your role as … Intellectual capital and organizational performance: An empirical study of the pharmaceutical industry. Anyone buying a car would want to understand which car they were buying, how much it would cost and how it was to be used - the same applies to health and social care. (1998). Capacity. Nursing intellectual capital theory: Operationalization and empirical validation of the concepts. Thus it is the combination of the registered nurses’ knowledge (academic preparation), skills (specialty certification), and experience (unit tenure and professional experience), which are associated with higher quality patient care (low hospital-acquired infections) and better recruitment and recruitment statistics (manifested by less need to recruit and orient new registered nurses). The attributes of nursing human capital, nurses’ knowledge or experience have been empirically linked to better quality patient care... Human capital within hospitals is extremely important as it reflects the work of highly knowledgeable and skilled people caring for those in need of specialized healthcare (Peng, et al., 2007). Can the decision wait for the patient to make it for themself? There is a whole host of daily habits you can acquire to help you become smarter, and the 10 ways below have nothing to do with drugs. The Mental Capacity Act: a review of the current literature Authors: MARSHALL Helen, SPRUNG Sally Journal article citation: British Journal of Community Nursing, 21(8), 2016, p.406–410. Journal of Nursing Care Quality, 26(2), 110-119. Sullivan, P. H. (1998). In other words, a form of ‘nursing evidence’. An increase in knowledge stocks can happen through organizational investment in learning and hiring or retaining employees. nurse staffing) and patient and organizational outcomes. Nursing intellectual capital is nursing knowledge that is translated into nursing and organizational performance. Department for Constitutional Affairs (2007) Mental Capacity Act 2005: Code of Practice. (2011). Rondeau, Williams, and Wagar (2009) investigated the impact of investing in human capital development through staff training on voluntary turnover of registered nurses. Philadelphia: F. A. Davis Company. Intellectual disability is defined as significant impairment in intellectual functioning and significant impairment in adaptive behaviour (social functioning), with each of these impairments beginning prior to adulthood. In the US, people aged 18 or older are presumptively considered legally capable of making health care decisions for themselves. Outcomes achieved from organizational investment in nursing continuing professional development. A social capital theory of career success. Christine L. Covell PhD, RN In N. Bontis (Ed. Health professionals must record their mental capacity assessments in patient notes and be able to justify them if required to do so later. Registered Intellectual Disability Nurses (RNID’s) are unique, being the only group of professionals who are educated solely to work with people with an intellectual disability (ID) (Northway et al 2006). 5 March 2012. doi: 10.1111/jan.12118. Agency for Healthcare Research and Quality, Rockville, MD. Synonyms for intellectual capacity include grey matter, brainpower, brains, cleverness, intellect, intelligence, wit, wits, acumen and discernment. Course Summary. Journal of Intellectual Capital, 3(3), 223-247. Bramhandkar, A., Erickson, S., & Applebee, I. Nursing intellectual capital theory conceptualizes the sources of nursing knowledge available within an organization and delineates its relationship to patient and organizational outcomes. Retrieved from www.businessdictionary.com/definition/intellectual-capital.html. In summary, before patients can consent to care or treatment, they must have mental capacity. Journal of Intellectual Capital, 8(3): 538-556. (2009) Developing human capital: What is the impact on nurse turnover? DOI: 10.1002/14651858.CD007019.pub2. Finally, research should continue to focus not only on the most effective nursing interventions, but also on the situations that foster the development of expert nurses. Phillips, J.L., Piza, M., & Ingram, J. The first step is to clarify the decision for which the patient’s consent is needed (for example, that a blood test is necessary) and then check whether at the time consent is needed, the patient is capable of all the processes in stage 1 of the assessment (Box 2). (2007). 336. Nurse managers may be able to use this information to make decisions regarding the type of continuing professional development to provide to the nursing staff, identify mentors for new graduates or newly hired staff, and complete patient assignments and performance appraisals. Doran, D. & Mylopoulos, J. Structural capital is the stock of knowledge that has been converted to the information that exists within an organization’s structures, systems, and databases (Stewart, 1997). Human capital investment and human capital depletion influence the development of human capital (Bontis & Fitz-enz, 2002). Two factors within the work environment, nurse staffing and employer support for nurse continuing professional development, are proposed to influence nursing human capital’s association with quality of patient care and recruitment and retention outcomes. Information technology. Nursing performance leads to improvements in patient outcomes associated with quality of patient care such as reduction in adverse events, such as hospital-acquired infections, patient falls, and medication errors. This further highlights the difficulty in measuring knowledge stocks within organizations, especially since Covell and Sidani (2013) found that some of the measures did not reflect the related concept well. Kane, R.L., Shamliyan, T.A., Mueller, C., Duval, S., & Wilt, T.J. (2007). Outcomes associated with intellectual capital include improved business performance or the creation of intellectual assets such as innovative technologies or products which create future returns for the company. Author: Aasya F Mughal is barrister, director of Edge Training and Consultancy, and co-author of Working With the Mental Capacity Act 2005. Principles of nurse staffing (2nd ed.) In nursing, intellectual capital is the stocks of nursing knowledge available within a healthcare organization. Souraya Sidani, PhD (2001). Intellectual capital theory defines human capital as the knowledge, talents and experience of employees (Stewart, 2001). Through the eyes of the mentee. (2007). Mentoring and its impact on intellectual capital. Clarke, S.P., & Donaldson, N.E. Thomka, L. A. (AAT NQ40244). While the study conducted by Covell and Sidani (2013) attempted to measure the actual intellectual capital available within hospitals by using data from hospital departmental databases, researchers were limited by the type of data available within the participating hospitals. First, nurse staffing (measured as registered nurse-to-patient ratio, skill mix, and hours per patient per day) is associated with nursing human capital (measured as academic preparation, specialty certification, hours of continuing education, professional experience, and unit tenure), which in turn, is associated with the quality of patient care (low rates of adverse events of hospital-acquired infections, medication errors, and patient falls) and the recruitment and retention of registered nurses (hours of orientation, vacancy, turnover, and recruitment rates). Every time they touch a patient, nurses and other health professionals need legal protection; in the majority of cases, that legal protection comes from the patient’s consent. Journal of Advanced Nursing, 31(1), 33-39. Nurse staffing is defined for the nursing intellectual capital theory as the supply of registered nurses and mix of registered nurses who possess the knowledge and skills to competently meet the care needs of patients on the unit. The attributes of nursing human capital, nurses’ knowledge or experience have been empirically linked to better quality patient care; for example, lower rates of patient falls, patient mortality and failure to rescue (Aiken et al., 2011; Duffield et al., 2011, Tourangeau et al., 2007). Impact of hospital nursing care on 30-day mortality for acute medical patients. (2012). Oman, K.S., Flynn Makic, M.B., Fink, R., Schraeder, N., Hulett, T., Keech, T., & Wald, H. (2012). The practical steps and time taken to assess capacity will be very brief in emergencies; patients fail the assessment immediately if they are unconscious and therefore unable to understand the information relevant to the decision. Our network also provides me, personally, with fellowship and support – important for all nurses. Clarifying the concepts in knowledge transfer: a literature review. For example, a patient with dementia may need a blood test but not understand what it will involve or why it is necessary. The Mental Capacity Act aims to safeguard patients who lack mental capacity to make decisions about their treatment or care, and gives legal protection to the health professionals who care for them. (2006). It is operationalized as the financial support provided to registered nurses by the organization to attend continuing education activities, university courses, and specialty certification; time off to attend continuing education activities; the availability of replacement staff for registered nurses attending continuing education; and clinical educators or consultants (Covell, 2008). In other cases, patients’ next of kin may be given a consent form to sign, even though they have no power to authorise treatment or care on the patient’s behalf; family members or friends only have such a power if they have a valid and applicable personal welfare lasting power of attorney or deputyship. & Collins, K.S. This process starts with perception and leads to the data being put into short-term and then, hopefully, long-term memory . Journal of Infusion Nursing, 33(5): 278-90. It must be adhered to whenever there is doubt about a patient’s mental capacity and a decision is required about their care or treatment. It may also help researchers begin to address the gap in the literature related to the cost benefits of developing a highly educated and skilled nursing workforce. Use of validated model to evaluate the impact of work environment on outcomes at a Magnet hospital. ‘If you read one thing today, make sure it’s Vicky Neville’s open letter’, 16 May, 2014 Reidinger, G. (2010). A best interests decision should now be made for them, Consider the patient’s reasonably ascertainable past and present wishes/ statements, their beliefs and values, plus any other factors they would take into account, Consult others – for example carers, relatives, attorneys and deputies – as practicable and appropriate to do so, Consider if the same result could be achieved in a less restrictive way. Spilsbury, K., Hewitt, C., Stirk, L., & Bowman, C. (2011). Nursing Economics, 16(4), 196-202. Nursing Administration Quarterly, 3(1), 89-90. Journal of Nursing Administration, 39(10), 438-443. : CD007019. The role of theory in improving patient safety and quality health care. Again, in emergencies, this will be a very brief assessment. Intellectual capital and performance indicators: Taiwanese healthcare sector. Nursing Administration Quarterly, 3(1), 84-88. Nursing 2004, 34(6), 50-54. (2008) Nurse staffing and patient care quality and safety. laptops, iPads, personal digital assistants) used for acquiring evidence-based information when delivering care (Doran & Mylopoulos, 2008). Building intellectual capacity is perhaps one of the most exciting things we come together for as professionals, clinicians, scholars and students. Her program of research focuses on determining the contribution of nursing knowledge to patient and organizations and on nursing human resources, including internationally educated nurses and models of care. The availability of practice guidelines, care maps or protocols have been found to be associated with better quality of patient care and lower adverse events (Duffield et al., 2011; Oman et al., 2012; Tourangeau et al., 2007). Perioperative nurses and patient outcomes-mortality, complications and length of stay. Article published May 31, 2013, Substance Use Disorders and Related Concerns, The 200th Birthday of Florence Nightingale, Addressing Social Determinants of Health: Progress and Opportunities, Translational Research: From Knowledge to Practice, Capuano, Bokovoy, Hitchings, & Houser, 2005, Twigg, Duffield, Bremner, Rapley, & Finn, 2012, American Nurses Credentialing Center, 2012, Committee on Planning a Continuing Health Professional Education Institute, 2010, www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/NursingStandards/ANAPrinciples/ANAsPrinciplesofNurseStaffing.pdf.aspx, www.nursecredentialing.org/Magnet/ProgramOverview/New-Magnet-Model, www.businessdictionary.com/definition/intellectual-capital.html, www.cfhi-fcass.ca/Migrated/PDF/ResearchReports/OGC/DoranReport1_3_25_FINAL.pdf, http://digitalcommons.olivet.edu/edd_diss/11, Lessons Learned and Insights Gained: A Regulatory Analysis of the Impacts, Challenges, and Responses to COVID-19, The Impact of Evidence-Based Practice in Nursing and the Next Big Ideas, Hospital-Based Fall Program Measurement and Improvement in High Reliability Organizations, Nursing Control Over Practice and Teamwork, The Value of Library and Information Services in Nursing and Patient Care, Toward an Understanding of Wisdom in Nursing, Medication Adherence in a Cardiac Ambulatory Setting: The Challenge Continues, Simulation in Nursing Practice: The Impact on Patient Care, The Impact of Emerging Technology on Nursing Care: Warp Speed Ahead. Souraya Sidani is a Professor and Canada Research Chair at the School of Nursing at Ryerson University in Toronto, Ontario, Canada. There is no doubt that minority nurses experience slights which are related to race from unconscious bias which permeates our culture. This approach was used by Rondeau et al. The code of practice accompanying the act (Department for Constitutional Affairs, 2007) says at paragraph 4.38 that the mental capacity assessment should be carried out by the person directly concerned with the patient when the decision needs to be made (for example, a nurse who needs to take a blood-pressure reading). Instead, a “best-interests decision” needs to be made (see below). Intellectual capital assets including organizational systems, structures and routines that are developed from the organization’s human capital have been found to be positively associated with business performance or future outlook for the organization (Bontis & Fitz-enz, 2002; Youndt et al., 2004). 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