Showing papers in "Nursing Economics in 1990"

ICU nurse-physician collaboration & nursing satisfaction.

Abstract: ICU nurses who are satisfied with their work are more likely to be retained, leading to institutional cost savings. In this study, higher levels of nurse-physician collaboration in making decisions about patient care were found to be very important to nurses' satisfaction.

Breaking the burnout barrier: resurrecting work excitement in nursing.

Abstract: An exploratory study of 168 nurses has yielded a new dimension of practice patterns, work excitement, a prerequisite to effective practice and quality care. Four reasonable and attainable factors were found to be significant predictors of work excitement: work arrangements; a learning environment that fosters individual growth and development; variety of experiences; and positive working conditions.

Relationship between nursing work load and turnover.

Abstract: This survey of 123 medical-surgical nurses revealed that full-time status, large hospital size, and large unit size were associated with higher role overload and nurses' intent to leave their jobs.

Health services research in nursing: current status and future directions.

Abstract: To assess the current status of health services research in nursing, 113 studies reported between 1980 and 1989 were reviewed. Identified gaps in this research included comprehensive cost-benefit and cost-effectiveness analyses, effects of technology on patient care, evaluations of information systems, evaluations of innovative care delivery approaches, and studies of ethical issues related to the use of scarce resources.

Restructured patient care delivery: evaluation of the ProAct model.

Abstract: This budget-neutral model uses fewer RNs with increased clinical and nonclinical support and demonstrates potential to improve quality of care, reduce length of stay, and increase revenue.

Health care in rural America: a view from the nation's capital.

Abstract: While the nation's health care system has been the subject of significant attention, the needs of rural Americans and the adequacy of their health care delivery system have been largely overlooked. By considering the unique features of rural America, appropriate delivery models can be developed.

A nurse-run business to improve health care for nursing home residents.

Abstract: The costs of health care for the rapidly growing segment of our population over age 75 are staggering. EverCare is a nurse-run business that seeks to improve cost-effectiveness and quality of health care for nursing home residents enrolled in a health maintenance organization.

Economic considerations for epidural anesthesia in childbirth.

Abstract: The relationships between epidural anesthesia and selected intrapartum outcomes was examined in 140 first-term pregnancies. Significant relationships were found with four outcomes: increased use of forceps or vacuum extractor, increased length of second stage labor, increased incidence of Cesarean birth, and increased need for oxytocin augmentation. These findings have significant implications for staffing on labor units and costs.

Redesigning our future: whose responsibility is it?

Abstract: To thrive in the midst of health care chaos, restructuring is mandatory. By focusing on problem systems, to create the systems hospital executives can successfully empower staff to delivery high quality care while controlling costs.

Wages & benefits of nursing personnel in nursing homes: correcting the inequities.

Abstract: The nursing home industry is an increasingly important component of long-term care. Yet major problems in access and quality are evident. Correcting the inadequate wages and benefits of nursing home personnel is a necessary first step in addressing this issue.

Developing an effective business plan.

Abstract: The cost-consciousness of today's health care industry demands that nurses function as business people as well as care givers. One critical business skill that nurses must develop is writing effective business plans. This article describes a framework for developing successful business plans for both beginning new services and expanding current nursing programs.

Case management in rural areas: definition, clients, financing, staffing, & service delivery issues.

Abstract: Case management is one method for helping persons obtain needed health and social services while maximizing available community resources. How do needed case management services differ between rural and urban areas?

Determining alcoholism treatment outcomes: a cost-effectiveness perspective.

Abstract: In times of limited resources, treatment methods must be clearly evaluated in terms of costs, benefits, and effectiveness. This article proposes a model for determining cost-effectiveness in alcohol treatment programs.

Patient care automation: the future is now. Part 3. The five rules of automation.

Abstract: Five key principles for creating effective operations optimization-based patient care automation have now been established: (a) The old system architectures did not provide operations optimization; (b) primary patient care optimization (nurses and doctors) must be the central focus of any effective system; (c) the system must provide a platform that allows for eliminating both the retrospective and prospective (subterranean) paper records; (d) point-of-care data capture, including at the bedside, must be provided; and (e) integration around the patient is critical to success. Systems that ignore these principles will ultimately be doomed to repeat the problems of the manual system. Adherence to these principles opens a myriad of possibilities and provides a road map for how such a system should function. The next installment in this series of articles will address the ramifications of integration in system design and system use. The positive effects that such system designs can have on the realization of demonstrable benefits from system technology will also be reviewed.

Staffing accommodations to hospital unit admissions.

Abstract: This study of the flow of patients through five general medical units in a 750-bed medical center described the relentless and unpredictable demand for nursing services (with 80% of the admissions coming from the emergency department) and the resulting costs in terms of supplementary staffing and overtime usage.

Redesigning our future: whose responsibility is it?

Abstract: To thrive in the midst of health care chaos, restructuring is mandatory By focusing on problem systems, to create the systems hospital executives can successfully empower staff to delivery high quality care while controlling costs

Are nurses less satisfied than other workers

Abstract: Are nurses less satisfied than other workers? In this study comparing job satisfaction of baccalaureate nurses with elementary teachers and accountants, the three groups rated many aspects of their jobs similarly. Nurses were not comparatively or pervasively less satisfied with their jobs than these other professionals except in the areas of salary, chance for administrative participation, and job security.

Effective leadership during organizational transitions.

Abstract: Leadership transitions offer high leverage opportunities to improve an organization's leadership and overall direction. If managed in ways that link strategic thinking, active executive search, and careful organizational development, leadership transitions can advance the purposefulness of the organization.

Advantages of automating vital signs measurement.

Abstract: A comparison of automated versus conventional vital signs measurement methods revealed that the automated method required significantly less time and was perceived by nursing staff to be easy to use, accurate, and superior to the conventional method

Shopping for quality: the Greater Cleveland Health Quality Choice Project.

Abstract: The Greater Cleveland Health Quality Choice Project, a competitive strategy for reforming the delivery and reimbursement of health care, can be a model for national health care reform.

Analysis of ambulatory nursing practice.

Abstract: A nursing patient classification system can be used in ambulatory care to facilitate decision making relative to staffing assignments and to begin examining differences in patients' nursing care requirements according to medical diagnosis or other patient characteristics.

Profiles of nurses professionally involved in public policy.

Abstract: A widely acclaimed goal of the nursing profession is to increase the number of nurses involved in shaping U.S. health policy. This study describes 33 nurses holding positions in regulatory agencies, state legislatures, and congressional offices.

Communicating in the 1990s: a technology update.

Abstract: With the variety of available technologies, choosing among them will be difficult at best. Waiting for integration and standardization among technologies may effectively eliminate a competitive edge and productivity improvements for health care organizations. Also, selecting which one communication technology is needed may not be the issue since several technologies likely are needed to solve different communication needs in organizations. One might begin to sort out options by performing an assessment of current communication patterns and deficiencies. Ideally, the assessment should be completed by someone who is able to assess needs over an entire organization, not just one service or one organizational level. The assessment should focus at least on some of the following questions. Are three major problems with staff or client communications? If staff-related, are primary needs interactive with routine communication needs? If they are interactive, time-sensitive, and inter-organizational then a form of video-conferencing may help. Short-term interactive needs might be met by leasing video-conferencing rooms. Long-term, time sensitive interactive needs might require PC-based video-conferencing, Non-time-sensitive, interactive, inter-organizational needs might be met with voice mail or e-mail, which allow some time-delayed but single-mode interactions. If communication needs are routine, one might examine how e-mail, or fax could help. If text-based paper traffic through the mail room is enormous or slow, e-mail may help. If communication among persons at any level of geographically separate organizations is needed, modem-based or public e-mail may be the answer.(ABSTRACT TRUNCATED AT 250 WORDS)