Nursing Economics最新文献

The American Academy of Ambulatory Care Nursing's Nurse-Sensitive Indicator Task Force was charged with identifying and developing meaningful measures for the ambulatory care environment. Several strategies were used to identify measures that would reflect the value of the role of the nurse in this setting. One such strategy was to conduct a comprehensive review of the health care environment as a whole and the measures within it, to identify measures that already existed that could easily be adapted to the role of the nurse in ambulatory care settings. Because of the complexity of the ambulatory care patient care environment, the group sought to reach momentum in indicator development by starting with the proposal of measures that would be less complex to develop, pilot, and adapt in organizations across the country.

The main purpose of this study was to investigate the extent to which nursing care compared to severity of illness (SOI) accounted for direct hospital costs. The type, frequency, and duration of nursing interventions required for patients undergoing total hip replacement surgery by the SOI stages with independent t-tests were identified. Although patients in Stage 3 generally needed a greater amount of each intervention than patients in Stage 2, the differences in needs for nursing interventions were not consistent using SOI. With hierarchical multiple regression analyses, results indicated nursing interventions explained significantly more variability in hospital care costs than SOI scores. Relying only on SOI scores for reimbursement may not accurately reflect the resource consumption of health care.

Hospitals are penalized financially for high 30-day readmission rates for specific diagnoses, including heart failure. The economic imperative exists to better manage the heart-failure population and acute care providers are in need of appropriate tools to aid in their efforts. This study was conducted to determine if the Rothman Index score may be useful to prospectively identify patients with heart failure at risk for extended hospitalization, high inpatient cost of care, and 30-day readmission. Results from this study suggest the Rothman Index score can be a useful adjunct to current clinical assessment methods in helping multidisciplinary teams better manage patient care and limited resources.

The World Health Organization (WHO) Global Strategic Directions for Strengthening Nursing and Midwifery 2016-2020 provide a framework to ensure nursing and midwifery interventions are developed, implemented, and evaluated at global, regional, and country levels and in partnership with key stakeholders. The Global Strategic Directions for Strengthening Nursing and Midwifery 2016-2020 supports the WHO's Global Strategy on Human Resources for Health: Workforce 2030. The WHO Global Strategic Directions for Strengthening Nursing and Midwifery 2016-2020 presents a vision, guiding principles, and four themes to maximize nursing and midwifery workforce contributions to improve global health. Implementation of the strategy is articulated in the context of country and regional needs, areas for expedited action, partnerships and alliances, and accountability for ongoing monitoring and evaluation. As a framework, the 2016-2020 Global Strategic Directions for Nursing and Midwifery can help countries achieve the United Nations' Sustainable Development Goals and universal health coverage.

With the high costs associated with staff turnover, creating a culture that cares for and about nurses could be the most significant recruitment tool for a health care organization. Professional coaching, both from a leadership and retention or "caring for the caregiver" perspective, can greatly enhance opportunities for improving resilience, reenergizing and reengaging leadership and staff, and breathing new life into your institution's culture. Healthy employees and healthy culture lead to a healthy bottom line. Imagine the outcomes on our national health care systems if nurses, at over 3 million strong, inspired by their healthy nurse leaders, committed to a lifestyle of self-care.

To better understand the relationship between a hospital's Total Performance Score (TPS) and unplanned readmissions, a multivariate linear regression analysis was used to examine the relationship between hospital TPS and readmission rates for acute myocardial infarction (AMI), heart failure (HF), and pneumonia (PN). Hospital TPS was significantly and inversely related to AMI, HF, and PN readmission rates. The higher the hospital TPS, the lower the readmission rates for patients with AMI, HF, and PN. Hospitals with higher Medicare and Medicaid patients had higher readmission rates for all three conditions. The TPS methodology will likely evolve to include additional measures or dimensions to assess hospital quality and payment. Policymakers and hospital administrators should consider other structure elements and process measures to assess and improve patient safety and quality.

Politics in a democracy requires governance through debate. Nurses are an important part of the voting public and we need to assess our own anger, expectations, and values for this election. Recognizing four myths during this election season can improve the political conversation. This conversation must acknowledge different groups, interests, and opinions and then seek ways to balance or reconcile those interests. Using this as a mental model to define our politics rather than succumbing to divisive rhetoric, we can take a major step toward building a better political system.

There are multiple demands and challenges inherent in establishing staffing models in ambulatory heath care settings today. If health care administrators establish a supportive physical and interpersonal health care environment, and develop high-performing interprofessional teams and staffing models and electronic documentation systems that track performance, patients will have more opportunities to receive safe, high-quality evidence-based care that encourages patient participation in decision making, as well as provision of their care. The health care organization must be aligned and responsive to the community within which it resides, fully invested in population health management, and continuously scanning the environment for competitive, regulatory, and external environmental risks. All of these challenges require highly competent providers willing to change attitudes and culture such as movement toward collaborative practice among the interprofessional team including the patient.