Nursing Economics最新文献

This case study explores costs of electronic health record (EHR) implementation with the nursing super-user role in a metropolitan, not-for-profit health care system. Tapping the local pool of unemployed newly graduated nurses as half the required super-user workforce leveraged the technology skills of novice registered nurses (RNs) as trainers of experienced nurses in five hospitals. The novel workforce migrated from hospital to hospital, thereby reducing the number of experienced nurses reassigned to super-user duties in each hospital. This strategy reduced the amount of contract labor required to backfill nurse super-users' clinical shifts. Employment of the recently graduated nurses as RN residents upon completion of the EHR implementation enabled the organization to augment its clinical workforce with expert users of its EHR. The proposed innovative model increases super-users, minimizes disruption of core staffing, and dramatically reduces expense.

Windows of opportunity are wide open for the nursing profession to actively participate and engage in the policy implementation, evaluation, and achievement of the United Nations Sustainable Development Goals. Nurses bring valuable perspectives as members of diverse governance structures and offer a range of solutions that can help governments pursue and achieve the Sustainable Development Goals and targets by 2030.

The United States is projected to experience a nursing shortage in the coming years as market forces begin to shift away from equilibrium. A return to pre-recession work levels, aging baby boomers, and insufficient numbers of nursing graduates adversely affect the supply of nurses The aging population, a rise in chronic care management needs, and the Affordable Care Act will result in an increasing demand for them. Returning to a state of equilibrium is critical if our health care system is to ensure care that is accessible, safe, and cost effective.

The traditional approaches to staffing and scheduling are often ineffective in assuring sufficient budgeting and deployment of staff to assure the right nurse at the right time for the right cost. As hospital merger activity increases, this exercise is further complicated by the need to rationalize staffing across multiple enterprises and standardize systems and processes. This Midwest hospital system successfully optimized staffing at the unit and enterprise levels by utilizing operations research methodologies. Savings were reinvested to improve staffing models which provided sufficient nonproductive coverage and patient-driven ratios. Over/under-staffing was eliminated in support of the system's recognition that adequate resource planning and deployment are critical to the culture of safety.

Long-term care demographic and industry trends challenge provision of effective care and infection prevention. A systematic review was conducted to identify and evaluate cost estimates reported in the scientific literature of structure and processes intended to prevent infection among residents and staff of long-term care facilities (LTCFs). The small volume of publications regarding cost of infection prevention in LTCFs does not lead to recommendations for specific infection prevention practices. Cost-effectiveness research is needed to inform nurse executives' decisions on how best to prevent infections. Nurse executives should consider costs as well as health outcomes when generating new policy regarding procedures or products related to infection prevention. Administrators should cautiously evaluate the recommendations of published studies containing a cost estimation based on the quality of the estimate in addition to assessing applicability of the results to their own facility and resident population.

Many breast cancer survivors continue to experience residual symptoms including anxiety, cognitive impairment, depression, fatigue, and pain. In this study, the cost-effectiveness of a Mindfulness-Based Stress Reduction intervention for breast cancer survivors was examined. The cost of the program was assessed from the societal perspective, accounting for both direct medical and patient opportunity costs. The cost per quality-adjusted life year was relatively low compared to the cost-utility findings of other published breast cancer interventions. The program appears to provide for significantly improved health-related quality of life at a comparativelv low cost.

Hospital-acquired complications in older adults are significantly higher than in younger patients. Nursing measures to prevent hospital-acquired complications are generally mandated by nursing policy and are required documentation in hospital record systems. In this study, gaps in the nursing documentation of measures intended to prevent hospital-acquired complications in elderly trauma patients may be related to the documentation of these measures not being required entries in the system used by the facility. These findings highlight the importance of the relationship between nursing documentation requirements and the system used for the expedient documentation of nursing care.

The World Health Assembly (WHA) is the decision-making body of the World Health Organization. Delegates attending the Sixty-Eighth WHA, May 2015, covered a wide range of global challenges and agreed on several key resolutions of importance to nurse leaders. Some of the resolutions adopted relevant for nurse leaders and nursing care such as air pollution, strategies to strengthen epilepsy care, antimicrobial drug resistance, and strategies to strengthen surgical care, are highlighted. Nurse leaders should consider attending the World Health Assembly, as the topics discussed are critical for the future directions of strengthening human resources for health worldwide and, in particular, nursing and midwifery services.

Nurse-managed, integrated clinics offer access, affordability, and quality to the health care environment. The integration of mental health and primary care is a holistic, comprehensive model that addresses the complicated needs of those with mental illness. As nurses increase their education in leadership, financial management, and business, there is a correlating increase in the number of nurse-managed clinics. More research is needed to determine the financial structures that benefit sustainability of nurse-managed, integrated clinics. However, in an integrated review of the literature between 2000 and 2012, the data indicate nurse-managed health centers receive less federal financial support than the medically modeled federally qualified health center.

Nurse leaders need to be aware of the costly implications of staff retention, unit finances, and patient satisfaction caused by unmanaged stress and burnout as well as staff disengagement. It is vital to the organizational behavior of the health care facility for nurse managers to promote, educate, and screen for hardiness in their staff. Hardiness education can lessen the effects of stress and burnout. Nurse managers and executives can give their staff valuable tools and resources to enhance hardiness and coping abilities through hardiness education.