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At least 19 recordsLinked to original sources
PubMedDate not supplied

Decreasing nurse staffing costs in a hospital setting: development and support of core staff stability.

The nursing shortage is a well-documented phenomenon that has impacted health care settings woldwide. A corresponding magnitudinal cost factor is linked directly to this dilemma, health care organizations struggle to meet professional nurse staffing, safety and quality requirements. The acute care hospital setting in South Florida is one of the hardest hit by the bedside nurse shortage. Nurse staffing presents as a cost accounting challenge that demands the application of management control systems by creative, energetic, and financially savvy nursing system administrators. Future-oriented planning is critical if repercussions of a foreseeable progressive worsening of this condition are to be avoided and control of future patient outcomes achieved.

Cost Control↗
PubMed2005

Exploring nursing skill mix: a review.

AIMS: The overall aims of the paper are to provide an overview of the subject, illustrate the need for further research and to raise awareness of the ongoing limitations of existing knowledge and present these to those involved in skill mix decision making. BACKGROUND: Over the last 20 years health care organizations across the globe have seen an increase in the pace of change. The continuing drive towards cost-effectiveness, quality of care and the clinical governance agenda are causing more and more managers to examine closely the mix of staff skills. This paper demonstrates that, despite 20 years of research and skill mix management in practice, there continues to be a tension between the use of qualified and unqualified staff, particularly, the cost and quality dimensions. CONCLUSION: The evidence which currently exists offers some limited support for the suggestion that redistribution of certain tasks in nursing could be possible and could contribute to strategies for meeting the demands of changes within health care delivery. Any reallocation of task, and substitution of qualified by unqualified staff, should be based on sound evidence and not merely on staff availability, service demand or apparent costs.

Career Mobility↗
PubMed2005

Mental health nurse practitioners in Australia: improving access to quality mental health care.

Under The Nurses Amendment (Nurse Practitioners) Act 1998, New South Wales became the first state in Australia to legislate for nurse practitioners. Mental health was identified as a priority 'area of practice' for nurse practitioners. Issues surrounding the implementation of the nurse practitioner role in Australia and the potential for the role to address the current crisis in mental health nursing and the mental health sector will be discussed. The potential for partnerships with other health-care providers, in particular medical practitioners, will demonstrate how successful implementation of the role can fulfil consumer demand for primary prevention counselling, improve access to mental health services and early intervention, and provide mental health services that better reflect national priorities. This examination of the Australian context will be contrasted with a review of the overseas literature on mental health nurse practitioners.

Attitude of Health Personnel↗
PubMed2005

Nursing time allocation and other considerations for staffing.

The purpose of this project was to evaluate how nursing staff on the telemetry unit at Merle West Medical Center, a rural Pacific northwest community medical center in the USA, spend their time on selected nursing tasks, and how they believed staffing and patient acuity levels could best be determined. A self-report survey tool was developed, piloted and administered. Of the tasks that were listed in the survey, registered nurses (RNs) reported spending 39% of their time performing tasks that RNs only can perform. RNs reported spending 12% of their time performing activities that certified nursing assistants (CNAs) could perform alone and 49% of their time was spent on tasks that both RNs and CNAs must perform. Results from the quantitative portion of the survey indicated that RNs may not be used efficiently due to task overlap. Administering a modified survey which includes a balance of direct and indirect patient care tasks, as well as only those tasks that are truly performed frequently, will increase the relevance of the results.

Activities of Daily Living↗
PubMedDate not supplied

Ward managers' perceptions of the role of healthcare assistants.

While unqualified nurses form an integral part of the UK's healthcare system, accounting for a large percentage of the workforce, there is limited evidence to identify the actual role of the healthcare assistant. This study explored hospital ward managers' views on the current and potential expansion of the healthcare assistant's role. A confidential survey was sent to all ward managers (n = 35) in one large acute hospital trust. A response rate of 94% (n = 33) was obtained. Data were analysed using descriptive statistics and open-ended questions were analysed for emerging themes. The results indicated that healthcare assistants are undertaking a wide diversity of procedures raging from general tidying to carrying out complex clinical procedures. Additionally, 82% (n = 27) of the managers reported that the healthcare assistant's role could be expanded, although concerns were raised regarding additional training and supervision.

Attitude of Health Personnel↗
PubMed2005

The need for time management training is universal: evidence from Turkey.

In many developing countries, healthcare administrators are currently facing challenges that are representative of those in the United States. Most healthcare administrators here are physicians with no formal training in healthcare administration, and this is perhaps most apparent in their difficulties with time management. The authors' purpose in this study was to characterize the time management difficulties of administrators working in primary healthcare facilities of the Ministry of Healthcare. In the study, 67 healthcare administrators each completed a 31-item time management questionnaire. Of the participants, 79.1% reported that they have never attended time management courses or workshops. Although 76.1% said they were free to choose the priority of their daily tasks, only 44.8% felt they knew how much time they should allow for each activity in their daily life. These and other findings in the study suggest that the need for time management education is a well-defined target for intervention, both in university-based programs for future healthcare administrators and in workplace-based programs, such as in-service training for healthcare administrators who are already working.

Adult↗
PubMedDate not supplied

Australian enrolled nurses have their say--Part 1: Teamwork and recognition.

Nurses are a cornerstone to the Australian health care workforce and are under increasing pressure to respond to changes in health care demands, the redistribution of health care funding and shortages in nursing workforce availability and skill mix. It is in this context that the role and function of the enrolled nurse has come under recent scrutiny. This paper reports on the qualitative semi-structured interviews conducted as one aspect of an Australia wide multi-phased investigation of enrolled nursing practice and competency standards for this practice. In the reported phase, enrolled nurses from a variety of settings and from all states and territories participated in telephone interviews exploring their experiences of practice and the role of the enrolled nurse. Findings indicated various enabling and limiting influences on enrolled nurse role and function. In this paper two core themes of teamwork and recognition are described as they illustrate the rich interpersonal rewards of enrolled nursing and the significance of recognition by others of the enrolled nurse contribution to health care delivery. These themes are presented as an introduction to part two of this paper which reports more broadly on the dimensions of the enrolled nurse scope of practice.

Attitude of Health Personnel↗
PubMedDate not supplied

Managing employee performance.

Performance management consists of significantly more than periodic evaluation of performance. It is the art and science of dealing with employees in a manner intended to positively influence their thinking and behavior to achieve a desired level of performance. It is essential for the manager to always model positive behavior concerning performance; what one does or says as a manager always has an influence on others. The kinds of employee behavior most likely encountered relative to performance management efforts stem from resistance to change and lack of complete understanding of what is expected. Employee participation must be elicited whenever possible for performance improvement; as far as the inner working details of a specific job are concerned, there is no one who knows the job better than the person who does it everyday. For each task to be done, an employee needs to know what output is expected, how this output will be measured, and what standards are applied in assessing the output. Managing employee performance requires ongoing contact with each employee, regular feedback, and whatever coaching, counseling, and training are necessary to bring an employee back on track when a problem appears. Sustaining efficient and effective employee performance requires the manager's ongoing attention and involvement.

Administrative Personnel↗
PubMed1995

Delegation to assistive personnel by school nurses--one state's experience.

Budget cuts to education, reduction of school health services and an increase in the nursing needs of school-age children have placed pressure on school nurses to delegate nursing procedures to assistive personnel. This paper reports on a study of school nurses in a Midwestern state. Nurses reported refusing to delegate, delegating against their better judgment, delegating without knowledge of the assistant's qualifications or without providing orientation or training, and delegating because they were told to by someone else. The study identified factors considered by nurses when deciding to delegate a procedure, educational preparation for delegation, and problems experienced with delegation.

Clinical Competence↗