NursingConnections最新文献

Managed care models are on a continuum in terms of the amount of clinical involvement of the managed care agent. Managed care constitutes a fundamental shift in provider-reimburser relations. In the literature problems with managed care are identified and examined in the context of this shifting relationship. Models at three points on the continuum of clinical involvement are reviewed with regard to the identified problems, including two models with full clinical involvement. It is predicted that clinically based models will flourish and replace models with less clinical involvement because full clinical involvement solves many problems associated with other models.

Senior baccalaureate nursing students (N = 397) just weeks away from graduation were asked to complete the "Worry Clinic Form." This form invites subjective responses from the students' perspectives about their "current" and "greatest-to-date" professional concerns. Content analysis was used to determine the categories of these concerns. Categories of both current and greatest-to-date professional concerns were (1) functioning as a competent registered professional nurse and (2) the environment of work.

If the profession of nursing is to survive in the changing health care delivery system, new models of collaboration between nursing education and nursing practice must be developed. Nursing is both an academic discipline and a practice profession. The historic dissonance between education and practice has never served the profession of nursing; the pressing challenge is to blend one with the other now. In an effort to respond to the demands of the discipline and profession of nursing, an academic institution and a health care delivery system developed a model of interagency collaboration. This article addresses historical perspectives, and evolution, structure, activities, evaluation, and future plans to the Academic Practice Council.

Considering the types and number of occupational stressors involved in caring for patients, nurses may represent a population at high risk for physical illnesses. A sample of 3400 nurses who belong to a statewide or a national nurses organization were randomly chosen for participation. Of this group, 202 reported 6 months or more of debilitating fatigue and completed a three-page questionnaire assessing symptoms related to chronic fatigue syndrome (CFS) and comorbid medical conditions. This group (N = 202) was mailed a follow-up questionnaire 1 year later that reassessed symptoms of CFS and occupational stressors. Many sampled nurses reported a high degree of occupationally related stress but did not report CFS symptoms; however, perceived exposure to the threat of an accident as a nurse and poor physical working conditions were significantly related to symptoms reported. These findings are consistent with previous research.

This outcomes research used a collaborative framework between a college of nursing and a medical center to test the effects of the Partners in Patient Care delivery model (PIPC) on clinical and nonclinical outcomes. An experimental pretest-postest design was used to compare selected nonclinical outcomes and clinical outcomes of care in two patient units. Results showed that there were significant differences between units in the nonclinical outcomes of nurse satisfaction, salary costs, supply costs, and productivity as measured by documentation time. In addition, there were significant differences in the clinical outcomes of care in terms of patient satisfaction. No significant differences were found in number of falls, medication errors, and intravenous infections; however, when ratios of these indicators were examined in relation to patient days, significant differences in the medication error ratio and the fall ratio were revealed. The results indicate that the PIPC delivery model did have positive effects on patient satisfaction and nurse satisfaction but that there were increased costs and increased time spent in documentation on the pilot unit.

Edith Folsom Honeycutt, now retired, is the only staff nurse in the United States to be honored by a funded chair at a major university. In 1990, a chair of oncology nursing was established in her name at Emory University by the Metropolitan Atlanta Community Foundation. A life history method was used to examine the professional life of Edith Honeycutt through interviews and with a focus group of nurses who had worked with her. Three themes emerged: teaching by showing; expecting excellent practice; and investing in each other. A synthesized overall theme of "caring in full circle" was identified as the core descriptor. The findings of this study demonstrate how clinical education and expertise are shared and learned among staff nurses. Findings also suggest how nursing knowledge can be, and is, developed at the bedside. The connection between Emory University and Edith Honeycutt demonstrates an enduring link between a university setting and a practice arena.

Nurse educators from a university setting and staff from the county health department collaborated to establish an innovative program to prevent repeated pregnancy in adolescents. Called Dollar-A-Day and patterned after the original in Denver, CO, the program was operated jointly for 5 years and today continues to operate under the auspices of the health department. Success of the venture is attributed to use of skills in assessment, building, managing, and evaluating, as described by Loxley (1997). These elements were used to construct a context for collaboration.