An innovative role for nurse practitioners in managing chronic disease

Under the current care delivery model, persons with chronic illnesses, such as diabetes, are not receiving all recommended interventions and failing to meet targeted outcomes. The Chronic Care Model provides a framework for new approaches and roles for many members of the multidisciplinary team. Using the Chronic Care Model as a guide, a group of hospital-based clinics in an academic system incorporated nurse practitioners into the care model for patients with diabetes. Through use of planned visits, a patient registry, drug intensification protocols, and collaboration with other members of the team, the pilot sample improved processes of care and clinical outcomes. Use of nurse practitioners in this model of care for chronically ill patient populations has economic implications, as the payers begin to pay for performance.     

Nurse/physician collaboration: a cost/quality issue for the nurse manager

Excellence in nurse-physician relationships is possible and feasible, beginning and ending with the nurse manager setting the climate and culture that fosters mutual respect. As Leah Curtin (1982, p. 8) states, "We may be irritants, but we are not adversaries: Physicians know that patients need good nursing care and nurses know that patients need good medical care. Generally speaking, neither is possible in the absence of the other."     

Social support in the workplace: nurse leader implications

The state of the science as it relates to the stress-mediating role of social support in the health care work environment is explored. The ability to build a nursing leadership workforce is dependent upon a type of social support mechanism that mediates the inherent stress that comes along with managerial positions. Independent of the inevitable work-related stress associated with the nurse manager role, social support provided to current and aspiring nurse leaders is assumed to assist with coping and thriving in the work environment.     

Antecedents and consequences of nurse managers' perceptions of organizational support

The antecedents and consequences of nurse managers' perceptions of organizational support were evaluated. Study results revealed that changeable work environment factors are important precursors of perceptions of organizational support, which, in turn, result in positive work attitudes and better health.     

Evolution of the chronic care role of the registered nurse in primary care

High-quality, accessible, and efficient primary care is needed as the U.S. health care system undergoes significant change. Advancing the role of registered nurses in the primary care setting is important to the solution. A large academic health center implemented five initiatives to improve the care of chronically ill patients through the expanded role of RNs in the context of the health care team. Role evolution of nurses in the pilots required some continuing education and some additional nursing support to release the pilot nurses from their usual duties. These strategies allowed the nurses to apply interventions that enhanced the coordination of care and promoted patient self-management skills. Some short-term improvements in health status were realized and barriers to self-care were identified and resolved.     

Consumer support for environmental policies: An application to purchases of green cars

This paper focuses on how consumer motivation can be tapped in order to encourage the adoption of cleaner technologies. Consumers are heterogeneous — they may be guided by intrinsic motivation or extrinsic motivation. While information provision policies (such as the energy label for cars) may be effective in encouraging certain consumers to adopt green cars, financial incentive schemes (such as subsidies or fines) may be more persuasive for extrinsically-motivated consumers. We develop a dynamic theory of adoption of environmental innovations, in which information-provision policies are followed by financial incentives (first ‘carrot’, then ‘stick’ incentives). Analysis of a survey dataset of Swiss households observes considerable heterogeneity in terms of support of information-provision or financial incentive policies, in line with our conjectures. Our results will be of particular interest to policymakers interested in guiding consumers towards cleaner technologies.     

Two-part tariffs in the online gaming industry: The role of creative destruction and network externalities

Playing computer games online is a fast growing, billion dollar industry which has received little academic attention. The industry exhibits a number of interesting economic features. The industry structure is determined by creative destruction as in Aghion and Howitt (1992) [Aghion, P., Howitt, P. 1992. A model of growth through creative destruction, Econometrica, 60(2), 323–351], with game makers experiencing market power within a genre until the game is superceded. Furthermore, the attractiveness of playing a game online depends on the existence of opponents (positive network externalities) while technical and reputational problems eventually arise (negative network externalities). We model the choice of two-part tariffs by a monopolist under creative destruction and network externalities and derive conditions for the multiple equilibria which currently exist in the industry.     

American Academy of Ambulatory Care Nursing position statement: the role of the registered nurse in ambulatory care

Ambulatory care nurses are leaders in their practice settings and across the continuum of care. They are uniquely qualified to influence organizational standards related to patient safety and care delivery in the ambulatory care setting. The current ambulatory care setting is diverse and multifaceted, requiring nurses highly skilled in patient assessment and with the ability to implement a broad range of nursing interventions in a variety of settings. The future of the American health care system depends upon our ability to utilize RNs to the fullest extent of their expertise, licensure, and certification.