Impact of disease management programs on hospital and community nursing practice

The impact of disease management progrmms on the role of the nursing profession in the evolving U.S. health care system is reviewed. Needed changes in educational and training programs are discussed in relation to demands for changing clinical and administrative skills in nursing with an emphasis on increasing demand for advanced practice nurses.     

Utilizing evidence-based design in a community hospital ICU

This project documents a strategic planning process utilized during an academic clinical experience to establish evidence-based design features in new construction of an intensive care unit at a community hospital, while optimizing safe and cost-effective quality care, based upon evidence-based research.     

Capacity planning in hospital nursing: a model for minimum staff calculation

An aging population, emerging technology, heightening patient expectations, rising health care costs, shorter patient stays, and growing pressure to improve quality have made the management of nursing resources even more critical today. While approaching a model for staffing levels, the authors considered factors such as patient acuity, work redesign, and minimum quality standards. The methodology for analysis included estimating the time needed to complete nursing tasks and calculating the average number of tasks per patient. With respect to nursing quality measures, the study examined the adequacy of nursing documentation including admission history, assessments, nursing procedures, and discharge report as well as nursing-driven outcomes such as fall and phlebitis rates. Lastly, the authors determined the theoretical number of staff needed to provide nursing care according to quality standards.     

Evaluation of a client care delivery model, Part 2: Variability in client outcomes in community home nursing

Using similar variables, Part II explores variation in client outcomes such as OMAHA knowledge, behavior, and SF-36 scores. Medical and nursing diagnoses explained large variations in client outcomes. Clients cared for by degree-prepared nurses improved knowledge and behavior scores. Unanticipated case complexity was negatively associated with client outcome even with nursing intervention. The study revealed that "for every unit increase in assignment of baccalaureate-prepared nurses, clients will on average demonstrate an 80% greater likelihood of improvement in knowledge scores and a 120% greater likelihood of improvement in behavior scores in relation to their health condition at discharge." This two-part study has offered insight into the controllable variables influencing the cost and quality of home care services.     

Conceptual frameworks used in funded nursing health services research projects

Theories not only suggest ideas for research, but they provide order and logic to an investigation and limit the number and type of variables to be considered to a reasonable few. Although relatively little health services research is done within nursing, there is a growing appreciation of the need for knowledge related to the use, costs, quality, delivery, organization, financing, and outcomes of health care and how nursing practice influences these variables. Conceptual frameworks used by investigators in funded grants from the Agency for Healthcare Research and Quality show that workforce-related health services research of nursing phenomena is based on a wide variety of conceptual models, many of the investigator's own invention. Ultimately, there may emerge new theories or conceptual frameworks that combine clinical, organizational, financial, and outcome variables from the unique perspective of nursing. Such conceptualizations will guide future researchers and add coherence to the body of health services research into nursing issues.     

Building regional visionary capability. Futures research in resource-based regional development

In the present study, regional visionary capability is seen as a crucial factor in building regional competitive advantage under the present techno-economic paradigm. Regions are considered as strongly path-dependent entities needing to create new, even radical, paths to stay competitive in a rapidly changing world. The Regional Development Platform Method (RDPM) is presented as an innovative tool in developing regional innovation systems. The RDPM consists of eight phases and the focus of the present article is on the fourth phase of the RDPM: the search for new regional development paths and building regional visionary capability. The RDPM has been tested in the Lahti (Finland) regional innovation system revealing the need to develop the fourth phase further.     

探讨消除医院血液净化中心护理风险隐患的措施

随着社会的发展,我国医疗保障机构越来越完善,医疗卫生事业不断进步,以前许多无法治疗的疾病,如今已被缓解或治愈,而维持生命。而血液净化中心就是帮助血液透析患者进行血液净化治疗的机构,使许多患者看到了生命的希望。但同时也存在风险。在血液透析过程中会出现很多的风险,护理风险就是其中一种,那么如何防患这种风险就成为医疗事业有待解决的一大难题,本文对此进行了探析。     

Health services research in nursing: current status and future directions

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.     

Internationally educated nurse hiring: geographic distribution, community, and hospital characteristics

As the largest importer of internationally educated nurses (IENs), the United States is considered to be the epicenter of global nurse migration. The purposes of this study were to examine the geographic distribution of IEN hiring and determine associations between community and hospital characteristics and IEN hiring. More community characteristics than hospital characteristics were strongly associated with IEN hiring which suggest perceived community needs and receptivity to lENs could be an important consideration in hospital administrators' decisions to hire IENs. These findings suggest that as the U.S. population ages and becomes increasingly diverse, the demand for IENs is likely to grow. Nurse leaders and faculty may face challenges with regard to the ethical recruitment of IENs from low-income countries, incorporation of IENs into U.S. health care organizations, and continued development of a diverse U.S.-educated nursing workforce. This study expands understanding of the demand side of IEN employment in U.S. hospitals by providing the first in-depth examination of the community and hospital factors related to hospitals' IEN hiring.     

Workload measurement in a community care program

The delivery of services in the community is a expanding area of health care due to the rapid shift from institutional to community care. However, limited attention has been given to accurately predict or measure nursing resource utilization. A workload measurement tool developed by the community care program at WestView Health Centre (Stony Plain, Alberta, Canada) sought to address the unique challenges of determining workload while caring for clients in their own homes. The implementation of this tool facilitated improved understanding of work requirements associated with each client on caseload. The continued use of this tool will lead to refinement of case mix and professional utilization, and may show benefits in the future for novice nurse growth, staff retention, and satisfaction.     

创建学习型企业是关系到企业生存与发展的战略大计

惟一持久的竞争优势,是具备比竞争对手学习得更快的能力,简言之,竞争的核心是学习力。学习型企业是全体成员全身心投入,并有持续增长的学习力的企业;是能让企业成员体验到工作中生命意义的企业;是通过学习能创造自我,扩展创造未来能量的企业。一个企业只有当它是学习型组织的时候,才能具备快速应变市场的能力,才能充分发挥员工人力资本和知识资本的作用,也才能实现企业的最终目标。未来成功的企业必然是学习型的企业。