/pdf/self-assembled-monolayers-of-thiolates-on-metals-as-a-form-1neb0hj3k4.pdf

Self-assembled monolayers of thiolates on metals as a form of nanotechnology.

Background—Cardiovascular disease (CVD) is the leading cause of death in the United States and is responsible for 17% of national health expenditures. As the population ages, these costs are expected to increase substantially. Methods and Results—To prepare for future cardiovascular care needs, the American Heart Association developed methodology to project future costs of care for hypertension, coronary heart disease, heart failure, stroke, and all other CVD from 2010 to 2030. This methodology avoided double counting of costs for patients with multiple cardiovascular conditions. By 2030, 40.5% of the US population is projected to have some form of CVD. Between 2010 and 2030, real (2008$) total direct medical costs of CVD are projected to triple, from $273 billion to $818 billion. Real indirect costs (due to lost productivity) for all CVD are estimated to increase from $172 billion in 2010 to $276 billion in 2030, an increase of 61%. Conclusions—These findings indicate CVD prevalence and costs are project...

Forecasting the Future of Cardiovascular Disease in the United States A Policy Statement From the American Heart Association

Low Molecular Mass Gelators of Organic Liquids and the Properties of Their Gels

Background It is uncertain whether lower levels of staffing by nurses at hospitals are associated with an increased risk that patients will have complications or die. Methods We used administrative data from 1997 for 799 hospitals in 11 states (covering 5,075,969 discharges of medical patients and 1,104,659 discharges of surgical patients) to examine the relation between the amount of care provided by nurses at the hospital and patients' outcomes. We conducted regression analyses in which we controlled for patients' risk of adverse outcomes, differences in the nursing care needed for each hospital's patients, and other variables. Results The mean number of hours of nursing care per patient-day was 11.4, of which 7.8 hours were provided by registered nurses, 1.2 hours by licensed practical nurses, and 2.4 hours by nurses' aides. Among medical patients, a higher proportion of hours of care per day provided by registered nurses and a greater absolute number of hours of care per day provided by registered nur...

Nurse-Staffing Levels and the Quality of Care in Hospitals

ContextGrowing evidence suggests that nurse staffing affects the quality of
care in hospitals, but little is known about whether the educational composition
of registered nurses (RNs) in hospitals is related to patient outcomes.ObjectiveTo examine whether the proportion of hospital RNs educated at the baccalaureate
level or higher is associated with risk-adjusted mortality and failure to
rescue (deaths in surgical patients with serious complications).Design, Setting, and PopulationCross-sectional analyses of outcomes data for 232 342 general,
orthopedic, and vascular surgery patients discharged from 168 nonfederal adult
general Pennsylvania hospitals between April 1, 1998, and November 30, 1999,
linked to administrative and survey data providing information on educational
composition, staffing, and other characteristics.Main Outcome MeasuresRisk-adjusted patient mortality and failure to rescue within 30 days
of admission associated with nurse educational level.ResultsThe proportion of hospital RNs holding a bachelor's degree or higher
ranged from 0% to 77% across the hospitals. After adjusting for patient characteristics
and hospital structural characteristics (size, teaching status, level of technology),
as well as for nurse staffing, nurse experience, and whether the patient's
surgeon was board certified, a 10% increase in the proportion of nurses holding
a bachelor's degree was associated with a 5% decrease in both the likelihood
of patients dying within 30 days of admission and the odds of failure to rescue
(odds ratio, 0.95; 95% confidence interval, 0.91-0.99 in both cases).ConclusionIn hospitals with higher proportions of nurses educated at the baccalaureate
level or higher, surgical patients experienced lower mortality and failure-to-rescue
rates.

/pdf/educational-levels-of-hospital-nurses-and-surgical-patient-3nt1t78029.pdf

Educational levels of hospital nurses and surgical patient mortality.

ContextThe average age of registered nurses (RNs), the largest group of health
care professionals in the United States, increased substantially from 1983
to 1998. No empirically based analysis of the causes and implications of this
aging workforce exists.ObjectivesTo identify and assess key sources of changes in the age distribution
and total supply of RNs and to project the future age distribution and total
RN workforce up to the year 2020.Design and SettingRetrospective cohort analysis of employment trends of recent RN cohorts
over their lifetimes based on US Bureau of the Census Current Population Surveys
between 1973 and 1998. Recent workforce trends were used to forecast long-term
age and employment of RNs.ParticipantsEmployed RNs aged 23 to 64 years (N = 60,386).Main Outcome MeasuresAnnual full-time equivalent employment of RNs in total and by single
year of age.ResultsThe average age of working RNs increased by 4.5 years between 1983 and
1998. The number of full-time equivalent RNs observed in recent cohorts has
been approximately 35% lower than that observed at similar ages for cohorts
that entered the labor market 20 years earlier. Over the next 2 decades, this
trend will lead to a further aging of the RN workforce because the largest
cohorts of RNs will be between age 50 and 69 years. Within the next 10 years,
the average age of RNs is forecast to be 45.4 years, an increase of 3.5 years
over the current age, with more than 40% of the RN workforce expected to be
older than 50 years. The total number of full-time equivalent RNs per capita
is forecast to peak around the year 2007 and decline steadily thereafter as
the largest cohorts of RNs retire. By the year 2020, the RN workforce is forecast
to be roughly the same size as it is today, declining nearly 20% below projected
RN workforce requirements.ConclusionsThe primary factor that has led to the aging of the RN workforce appears
to be the decline in younger women choosing nursing as a career during the
last 2 decades. Unless this trend is reversed, the RN workforce will continue
to age, and eventually shrink, and will not meet projected long-term workforce
requirements.

/pdf/implications-of-an-aging-registered-nurse-workforce-14zfo4wefo.pdf

Implications of an aging registered nurse workforce.

Although the number of people entering nursing in their early to mid-twenties remains at its lowest point in forty years, large numbers of people are entering the profession in their late twenties and early thirties. And although it remains unclear why people are becoming nurses later, there is evidence that nursing is attracting interest from different segments of the potential workforce than it was in the 1970s and 1980s. We analyze these trends using data through 2005 and a revised forecast model that still predicts a nurse shortage by 2020, but a smaller one than previously forecast.

Better Late Than Never: Workforce Supply Implications Of Later Entry Into Nursing

The Future of the Nursing Workforce in the United States: Data, Trends and Implications provides a timely, comprehensive, and integrated body of data supported by rich discussion of the forces shaping the nursing workforce in the US. Using plain, jargon free language, the book identifies and describes the key changes in the current nursing workforce and provide insights about what is likely to develop in the future. The Future of the Nursing Workforce offers an in-depth discussion of specific policy options to help employers, educators, and policymakers design and implement actions aimed at strengthening the current and future RN workforce. The only book of its kind, this renowned author team presents extensive data, exhibits and tables on the nurse labor market, how the composition of the workforce is evolving, changes occurring in the work environment where nurses practice their profession, and on the publics opinion of the nursing profession.

/pdf/the-future-of-the-nursing-workforce-in-the-united-states-469q3lpzse.pdf

The Future of the Nursing Workforce in the United States: Data, Trends and Implications

Although hospitals have experienced many shortages of registered nurses (RNs), most have not lasted as long as the current shortage, which began in 1998. However, hospital RNs’ employment and earni...

Is The Current Shortage Of Hospital Nurses Ending

This article is the first in a series examining the interplay between the aging of the nurse workforce and other factors driving the growing nursing shortage that are already affecting some specialty areas. Nearly 60% of the current RN workforce is over 40 years of age; and the percentage of RNs under age 30 has fallen by nearly 40% since 1980. The total number of FTE RNs is projected to shrink after 2010, likely resulting in shortages of RNs "when the large baby-boom generation of RNs starts to retire." Because ICUs have historically attracted younger RNs, the rapid decline in the number of RNs in the workforce under age 30 plays a large role in explaining the development of shortages in the ICU. The growing difficulties staffing operating rooms and other peri-operative services is seen as related to the aging work force as more diploma prepared nurses have been attracted to this specialty because they had educational exposure to this area.

David I. Auerbach

Papers

Implications of an aging registered nurse workforce.

Better Late Than Never: Workforce Supply Implications Of Later Entry Into Nursing

The Future of the Nursing Workforce in the United States: Data, Trends and Implications

Is The Current Shortage Of Hospital Nurses Ending

Why are shortages of hospital RNs concentrated in specialty care units