The Nursing Workforce in an Era of Health Care Reform

RAND, Boston, USA.
New England Journal of Medicine (Impact Factor: 55.87). 04/2013; 368(16):1470-2. DOI: 10.1056/NEJMp1301694
Source: PubMed
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    • "The dual imperative to retain a skilled nursing workforce and to achieve better patient experiences is evident worldwide (Duffield et al. 2011, Auerbach et al. 2013, Chan et al. 2013, Lartey et al. 2014). The enquiry into the failure of care at the Mid-Staffordshire Hospital in the United Kingdom (UK) emphasised the need for staff to be engaged and committed to ensure good clinical care (Roberts 2013). "
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    ABSTRACT: This review aimed to synthesise literature describing the development and/or implementation and/or evaluation of a professional practice model to determine the key model components. A professional practice model depicts nursing values and defines the structures and processes that support nurses to control their own practice and to deliver quality care. A review of English language papers published up to August 2014 identified 51 articles that described 38 professional practice models. Articles were subjected to qualitative analysis to identify the concepts common to all professional practice models. Key elements of professional practice models were theoretical foundation and six common components: leadership; nurses' independent and collaborative practice; environment; nurse development and reward; research/innovation; and patient outcomes. A professional practice model provides the foundations for quality nursing practice. This review is an important resource for nurse leaders who seek to advance their organisation in a journey for excellence through the implementation of a professional practice model. This summary of published professional practice models provides a guide for nurse leaders who seek to develop a professional practice model. The essential elements of a professional practice model; theoretical foundation and six common components, are clearly described. These elements can provide the starting point for nurse leaders' discussions with staff to shape a professional practice model that is meaningful to direct care nurses. © 2015 John Wiley & Sons Ltd.
    Journal of Nursing Management 05/2015; DOI:10.1111/jonm.12309 · 1.50 Impact Factor
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    • "The reasons for this are older adults have more hospitalisation days (Gilje et al., 2007) and use the largest portion of health services (Institute of Medicine, 2008). Undergraduate nurses' attitudes and perspectives toward older people and perceptions of working with older people is of international interest to the nursing profession, governments and service providers due to the shortage of qualified nurses (Auerbach et al., 2013) and an even greater shortage of nurses interested in gerontology as a specialty (Neville et al., 2014). Additionally, one's attitude, perspective or perception can impact on the quality of care (Flood and Clark, 2009). "
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    ABSTRACT: This literature review was undertaken to evaluate undergraduate nurses' attitudes and perspectives toward older people and perceptions of working with older people. The objectives were to (1) identify if undergraduate nurses hold positive or negative attitudes and perspectives toward older people and perceptions of working with older people, and (2) determine if positive attitudes, perspectives and perceptions can be established, maintained and improved with curriculum activities. Literature review. For the period 2008-2013, the literature search included an electronic database search (Medline, CINAHL, Healthsource/Academic Edition, PsycINFO and PubMed) and a hand search of reference lists of the papers included. The analysis of 32 studies revealed that undergraduate nurses' attitudes, perspectives and perceptions are positive and it is recommended that this be the starting point for the development of curriculum activities and future research to maintain and improve this result. Finally, the limitations of recent studies are identified and a research agenda for future studies is proposed.
    Nurse education today 04/2014; 34(7). DOI:10.1016/j.nedt.2014.04.018 · 1.36 Impact Factor
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    • "Although, the shortage described in the 90's and 2000's (HRSA 2002; Upenieks 2005) has been dramatically reduced, several pressures are keeping the issue forefront. A recent article in the New England Journal of Medicine claims that healthcare reform, retiring workforce, and the changing economy will continue to drive demand for RNs (Auerbach et al. 2013). New models of care, mandated by healthcare reform, call for more leadership by RNs in care coordination. "
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    ABSTRACT: Objective – Investigate the effects of stress, economic factors, altruism and value congruence on intentions to leave the profession in nursing. Background – As the demand for nurses increases retaining nurses will be critical for healthcare organizations and the healthcare industry. We draw from a mature body of research on nurse retention to build the research model. Method – We analyze data from a survey of 861 registered nurses in the southeastern United States. Structural equation modeling was used to analyze the survey. Results – Results confirm the importance of stress and salaries. Strong evidence supports the importance of the fit between employer and nurse values. Finally, the analysis provides unexpected evidence of the reduction of opportunities nurses have to fulfill altruistic desires at work.
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