The effect of variations in nurse staffing on patient length of stay in the acute care setting.
ABSTRACT This study examines the relationship between nurse staffing and patient length of stay (LOS). Data were collected on nurses employed and patients admitted to one of four study units located in two Midwest hospitals. Three nursing variables (hours per patient day [HPPD], skill mix, and nursing expertise) were collected through survey and administrative forms. The nursing data were then linked with patient-specific characteristics (deviation from expected LOS) to test the relationship at the patient level of analysis. Average HPPD was a positive predictor of deviation from expected LOS, whereas overall expertise was a negative predictor of deviation from expected LOS. Higher staffing levels may result in patients being discharged sooner than expected. Nurse administrators must consider the quantity as well as quality of staff when determining optimal staffing levels. Unit staffing levels must include nurses who have both experiential and theoretical knowledge in order to achieve optimal patient outcomes.
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ABSTRACT: Hospital Physician Relationships (HPRs) are of major importance to the health care sector. Drawing on agency theory and social exchange theory, we argue that both economic and noneconomic integration strategies are important to effective management of HPRs. We developed a model of related antecedents and outcomes and conducted a systematic review to assess the evidence base of both integration strategies and their interplay. We found that more emphasis should be placed on financial risk sharing, trust and physician organizational commitment.Ghent University, Faculty of Economics and Business Administration, Working Papers of Faculty of Economics and Business Administration, Ghent University, Belgium. 01/2010;
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ABSTRACT: Iran's health-care system has witnessed profound changes in the last decades. Despite its progress, the system has currently faced many challenges in one of the important subsystems, nursing. The present review article aimed to present an overview of the opportunities and challenges of the Iranian nursing system, based on recent literature. A broad search of the English and Persian-language literature was carried out, incorporating both electronic and manual components from 1999 to 2009. The results of the investigations among the searched literature are summarized. The major challenges are nursing shortages, job dissatisfaction, poor social position of nurses, the gap between theory and practice, lack of community-based nursing care, lack of an appropriate student recruiting system, and shortages in the nursing educational curriculums. The authors believe that media, political and public support play a pivotal role in improving the image of nursing in society, increasing motivation among Iranian nurses, and promoting the sociocultural climate and the welfare of nurses, which will result in higher levels of quality of care as well as greater patient satisfaction.Japan Journal of Nursing Science 06/2010; 7(1):9-18. · 0.58 Impact Factor