Nursing Economics最新文献

The profession of nursing, by it's very nature, is wrought with significantly complex moral and political disagreements. These issues cannot simply be avoided by being relegated to private discussions because their resolution is crucial to the common good. It is important for nurses to develop skills in public discourse if we are to bridge the political divide and influence local, state, and national policy. Failure to do so will leave us with ineffective and dismissed voices.

The morbidity and mortality associated with pneumococcal pneumonia can be prevented with access to vaccines and treatment. The purpose of this quality improvement project was to examine how the utilization of the discharge computer entry order set with an electronic pneumococcal vaccine screening tool, pharmacy notifications, and nursing tasks increased the vaccination rates among discharged patient population sufficiently. Changing the process of when the patient is screened for the pneumococcal vaccine and utilizing functions of the electronic medical record greatly improved the immunization rate of discharged patients. Due to the success of this process improvement project, other immunizations given during hospitalization are being screened and administered at discharge.

The World Health Organization (WHO) is the United Nation's lead agency for directing and coordinating health. As leaders, nurse executives must advocate for a stronger nursing and midwifery health policy agenda at the global level and a seat at the table on WHO's technical advisory bodies and expert committees. There are no more borders as nurse executives; we are global citizens, leading global change. Nurse leaders hold the master key to shape the world's policies for sustainable global development.

Busyness is anything but impressive, especially when coming from a leader. Sadly, busyness keeps nurse leaders from more worthwhile and important things in their lives, such as authentic, vulnerable relationships. Our collective busyness has become an offensive disease. We have the ability to change our lives internally and externally, professionally and personally. We have nothing to lose but stress and the voice of an unnecessary taskmaster who is continually demanding more and is never satisfied. We'll gain a sense of peace, purpose, health, mindful leadership, and a good dose of meaning and self-respect.

The presence of hospital-acquired conditions, infections, or other adverse events are a reflection of inadequate patient safety and can have short and long-term impacts of quality of life for patients as well as financial implications for the hospital. Using unit-level information to develop a tool, the Patient Risk Assessment Profile, nurses on an inpatient surgical unit proactively assessed patient risk to guide staffing decisions and nurse-patient assignment with the goal to improve patient value, reduce adverse events, and avoid unnecessary hospital costs. Findings showed decreased adverse event rates for patient falls, catheter-acquired urinary tract infection, central line-acquired blood stream infection, and pressure ulcer prevalence after the intervention was implemented. In addition, end-of-shift over-time and patient cost per case decreased as well yielding an operational impact in hospital financial performance.

"Bending the cost curve" for health care services in the United States challenges policymakers. A cost analysis was undertaken based on what would occur if more physician assistants (PAs) and nurse practitioners (NPs) per capita were deployed over a 10-year period. The State of Alabama was used as a case study because it is one of a handful of U.S. states with restrictive legislation impacting the scope of practice of PAs and NPs. Changing PA and NP scope of practice legislation in Alabama to match states in the upper quartile of collaborative legislation such as Washington and Arizona would increase the employment and distribution of PAs and NPs. Even modest changes in legislation will result in a net savings of $729 million over the 10-year period. Underutilization of PAs and NPs by restrictive licensure inhibits the cost benefits of increasing the supply of PAs and NPs and reducing the reliance on a stagnant supply of primary care physicians in meeting the needs of its citizens.

Increasing emphasis on patient quality and concerns about the impact of health care worker fatigue has stimulated efforts for leaders to address patient quality and caregiver satisfaction. Shift length has been associated with nurse fatigue and has become a growing concern in the United States with the routine shift length of 12 hours. In this project, shift lengths from 12 hours to 8 hours for a 4-week period to evaluate fatigue levels associated with 12-hour and 8-hour shifts. Lessons learned from this experience: nurses are agreeable to try a proposed change, numerous ideas should be tried to develop additional innovative solutions to the issue of nurse fatigue, and nurses may not want to work 5 days per week.