Nursing Economics最新文献

Having a fully committed partner is an asset some nurse executives celebrate. The life partner can play a critical role in the nurse executive's career from a personal perspective. The importance of being flexible and balancing "who does what" and how to manage through life's challenges is reported through three nurse executives' stories and one spouse. Having a partner enriches the life journey, according to these leaders.

Prolonged economic downturns and economic crises are affecting nations around the world, including developed countries such as Portugal, Spain, and Greece. In the United States, recovery from the latest economic crisis has been accompanied by a persistently high rate of unemployment. To a large extent, the impacts on the nursing profession may depend on the severity of economic downturns and their duration in the country of employment of nurses. Nurses in certain areas of patient care (such as mental health) may also be more strongly affected because of the impact of economic crises and high unemployment on morbidity patterns. Emigration of nurses may also increase as a result of prolonged economic crisis.

Forecasts of future supply and demand of health professionals are tools to guide policy, not a final statement about how the world will be in the future. Recent forecasts of RN supply and demand vary widely and are incredibly confusing for nurse leaders, nurse educators, and policymakers. To effectively incorporate forecasts into policy and planning, one must understand the structure of the forecasts and underlying assumptions. One should treat all forecasts cautiously, and use them as guides to policy rather than definitive future outcomes.

Introduced in 2003, the Clinical Nurse Leader (CNL) role is the first new nursing role introduced in more than 30 years. The hallmark of CNL practice is the management of client-centered care and clinical excellence at the point of care. As part of multifaceted efforts to implement the CNL role, understanding how an individual's self-efficacy with the identified role competencies changes over time has important implications for individuals, educational programs preparing CNLs, and health care organizations employing CNLs. In this study, preliminary psychometric analyses assessing the construct validity, reliability, and discriminant validity for a new state-specific scale (CNL Self-Efficacy Scale) that assesses nurses' perceptions of their ability to function effectively as a CNL are reported. Because self-confidence is a key predictor of successful role transition, job satisfaction, and job performance, measuring individuals' self-confidence with the core competencies associated with the CNL role over time will be important to gain the full benefit of this innovative, unit-based advanced generalist role.

The delivery of health care is quickly changing from an acute care to a community-based setting. Faculty development and mastery in the use of new technologies, such as high-definition simulation and virtual communities are crucial for effective student learning outcomes. Students' benefits include opportunities for hands-on experience in various patient care scenarios, realtime faculty feedback regarding their critical reasoning and clinical performance, interdisciplinary collaboration, and access to a nonthreatening learning environment. The results of this study provide some evidence of the benefits of developing faculty and nursing curricula that addresses the shift from an ilness-based, acute hospital model, to a community and population health-based preventive model.

The frequency and patterns of implicit rationing of nursing care in the United States are not known. The purpose of this study was to examine the phenomenon of implicit rationing among nurses in Texas. Implicit rationing was measured using a 31-item survey instrument adapted from the parent instrument originating in Switzerland. Some degree of rationing on at least one of the nursing care activities was reported by almost all of the respondents and most rationed multiple activities. Rationing preference patterns favor completion of activities directed to meet immediate physiological needs over other activities. If the relationships documented in other countries between implicit rationing and adverse patient outcomes are also present in the United States, then implicit rationing may serve as an important quality indicator.

In collaboration with the University of Texas at El Paso, nurse leadership at Del Sol Medical Center implemented an internship program for nursing students in the final semester of a bachelor of science in nursing (BSN) program. The medical center experienced an increase in the proportion of BSN-prepared nurses, decreased orientation full-time equivalents (FTE), and lowered operating costs. The university experienced highly satisfied and competent new graduate nurses. The nurse interns averaged a 91.9% in-hospital registered nurse (RN) competency completion rate during the internship. All interns accepted a RN position at the medical center. Total savings for salaries, benefits, and recruitment fees at the medical center were $599,040 with a total FTE savings of 23.4 FTEs per week, over 10 weeks.

Safe nurse staffing is undeniably linked to patient safety and satisfaction, workforce satisfaction and safety, and cost savings. A nationwide mandate must be driven toward the use of electronic staffing and scheduling systems that take into consideration the patient's real-time specific needs This system must be matched to the most appropriate nurse with the ability to provide care safely for all the patients in his or her total assignments. These patient care assignments should be designed in partnership with managers and staff RNs. Only then will we reverse the trend of staffing-related patient deaths and injury in U.S. hospitals.

Advanced practice registered nurses (APRNs) are integral to the provision of quality, cost-effective health care throughout the continuum of care. To promote job satisfaction and ultimately decrease turnover, an APRN incentive plan based on productivity and quality was formulated. Clinical productivity in the incentive plan was measured by national benchmarks for work relative value units for nonphysician providers. After the first year of implementation, APRNs were paid more for additional productivity and quality and the institution had an increase in patient visits and charges. The incentive plan is a win-win for hospitals that employ APRNs.