Adequate Staffing Levels Research Articles

Iranian staff nurses' views of their productivity and human resource factors improving and impeding it: a qualitative study.

BackgroundNurses, as the largest human resource element of health care systems, have a major role in providing ongoing, high-quality care to patients. Productivity is a significant indicator of professional development within any professional group, including nurses. The human resource element has been identified as the most important factor affecting productivity. This research aimed to explore nurses' perceptions and experiences of productivity and human resource factors improving or impeding it.MethodA qualitative approach was used to obtain rich data; open, semi-structured interviews were also conducted. The sampling was based on the maximum variant approach; data analysis was carried out by content analysis, with the constant comparative method.ResultsParticipants indicated that human resources issues are the most important factor in promoting or impeding their productivity. They suggested that the factors influencing effectiveness of human resource elements include: systematic evaluation of staff numbers; a sound selection process based on verifiable criteria; provision of an adequate staffing level throughout the year; full involvement of the ward sister in the process of admitting patients; and sound communication within the care team. Paying attention to these factors creates a suitable background for improved productivity and decreases negative impacts of human resource shortages, whereas ignoring or interfering with them would result in lowering of nurses' productivity.ConclusionParticipants maintained that satisfactory human resources can improve nurses' productivity and the quality of care they provide; thereby fulfilling the core objective of the health care system.

Perceptions of jordanian head nurses of variables that influence the quality of nursing care.

The purpose of this research was to study the perceptions of head nurses in Jordan about variables that influence the quality of nursing care in a teaching hospital. Head nurses perceived that nurses "usually" provided high quality nursing care. Time was the most important factor that influenced the quality of nursing care. High quality care required adequate staffing levels.

Using neural network to predict performance of design-build projects in Singapore

Design-build (DB) project success may be operationalised into 11 performance metrics. 65 factors that may affect DB project success are identified. Using data from 33 DB projects, correlation analysis shows that there are several factors that affect each performance metric significantly. Artificial neural network (ANN) technique is used to construct the models to predict project performance, and these models are tested using data from five new projects. This study finds that six performance metrics can be predicted with a reasonable degree of accuracy: project intensity; construction and delivery speeds; turnover, system and equipment quality. The key variables that affect project performance may be attributed to both contractors and clients. To ensure project success, contractors should have adequate staffing level, a good track record for completion on budget, and ability in financial management and quality control. Consultants should have a high level of construction sophistication, and have handled DB projects in the past. Clients also play an important part in ensuring DB project success. They would need to have construction experience and handled DB projects in the past. In addition, they should decide on the optimal level of design completion when the budget is fixed and tenders are invited. It is recommended that owners and contractors take note of the factors identified in this study, which significantly affect DB project performance.

Ethical problems in cytology.

Great advances in medical science have raised a number of ethical issues, many of which affect cytopathology. Some of the main issues addressed in this paper relate to the organization of a cytology laboratory: internal and external quality control, adequate staffing levels and staff education, cytopathology reporting format and contents, confidentiality issues, relationship with the clinicians and involvement of cytopathologists in clinical management teams. Quality control has to be provided within cytology departments but external quality assurance is also essential, with national monitoring. New technologies should be used according to the best scientific methods, following cytological analysis. Scientific work in cytology has to respect the general principles of scientific ethics. The patient's interest has to be the main reason for such work.

Factors affecting patients’ use of alarm systems in geriatric hospitals

Context. Call-buttons and alarm systems are common for older people living at home. Geriatric in-patients tend to be more dependent and frail. Hospitalisation neither guarantees constant surveillance, nor protection from falls and other hazards. To what extent are the simple call-button systems adequate for older patients in geriatric units? Objectives. The objectives of this study were to (i) review the circumstances of accidents which occurred in a geriatric rehabilitation setting; (ii) assess the accessibility of call-buttons provided for elderly patients; (iii) evaluate the perceived safety problems for this patient group and the adequacy of call-buttons. Methods. (i) A review of the hospital's accident declaration forms from the previous two years examined the circumstances of in-patient accidents; (ii) An observation schedule was used to assess availability and accessibility of call-buttons for 115 elderly in-patients; (iii) Semi-structured interviews with nursing staff were conducted to discuss the callbutton system, and to identify the types of patient who need more assistance. Results. (i) Most accidents occurred during daytime, when the patient was alone in his bedroom, and fell; (ii) Call-buttons were available and accessible for less than 10% of patients during daytime; yet most patients needed assistance for basic activities of daily living; (iii) Falls, wandering, and choking were perceived sources of risk for many patients; the conventional call-button system would be unsuitable for alerting staff. Conclusions. Accidents within the hospital tend to occur when patients are alone and need to be able to summon assistance. The traditional call-button system for alerting staff is then inadequate. Few geriatric units provide wireless call-buttons and passive alert systems for this population; furthermore, these technologies do not reduce the demands for assistance. Gerontechnology may improve older patients’ ability to summon help, but this cannot be a substitute for adequate staffing levels.

How Much is Enough?

Through a reading of a report done onthe Harvard Mental Health Service, this paper considers questions such as: How much in the way of services should a college/university counseling and psychotherapy service be providing? What is an adequate staffing level to do the job? What are some of the obstacles in the way of providing an adequate service? Particular attention is given to the possible effects of managed care in a medical setting.

Effects of Program Characteristics on EAP Utilization

Abstract Various elements of EAPs have been described as crucial to successful program functioning. Using negative binomial regression analysis, this study examined the impact of program features on utilization in a large sample of EAPs. Findings indicated that, among widely recommended features, the existence of a written policy and its broad distribution, adequate staffing levels, and provision of training for supervisors predicted higher levels of program utilization. Other recommended features, including maintenance of client confidentiality, were either unrelated to utilization, or predicted lower utilization.

COMPLEXITY SCIENCE AND THE DYNAMICS OF CLIMATE AND COMMUNICATION: REDUCING NURSING HOME TURNOVER.

Nursing staff turnover in nursing homes is a widespread problem that adversely affects resident care quality. Previous research examining predictors of turnover has focused primarily on facility structure or individual psychosocial measures of staff well-being, with relatively little attention to management processes. Using complexity theory of complex adaptive systems, we reconceptualize Sheridan's (1990) concept of administrative climate, which is traditionally viewed as a contextual factor. In this study, we propose that administrative climate is a fundamental set of management processes that interact with communication patterns to affect nursing staff turnover. Secondary data on structure and resource allocation in 164 nursing homes were linked to primary data about perceptions of administrative climate and communication collected from 3,449 licensed and unlicensed nursing personnel employed in those homes. Multivariate regression models of staff turnover rates on facility context and perceptions of climate and communication indicated that climate and communication both affect turnover but positive outcomes (e.g. reduced turnover) are contingent on the interaction between climate and communication. In nursing homes with administrative climates characterized as having clear goals, merit-based rewards, and an interest in employee welfare, higher levels of communication openness and accuracy explained lower nursing staff turnover. In contrast, direct effects of either this reward-based climate or higher levels of communication openness were related to higher staff turnover, controlling for facility context. In addition, adequate staffing levels and longer tenure of the director of nursing were found to be important for reducing turnover. Implications for practice and research are discussed.

Controversies in isolation and general infection control practices in pediatrics

Current controversies in pediatric isolation and infection control include correct application of standard precautions, importance of providing adequate staffing levels in intensive care units to prevent transmission of infectious agents, use of rapid diagnostic testing and best precautions to prevent transmission of respiratory syncytial virus, best methods to prevent transmission of multidrug-resistant organisms in acute care settings, and preventing transmission of infections to pregnant healthcare workers. Recommendations are evidence-based. Copyright 2002, Elsevier Science (USA). All rights reserved.

Establishing an emergency nurse practitioner service

The role of the nurse in the emergency department has evolved over recent years.1 Emergency nurse practitioners (ENPs) were introduced into the accident and emergency (AE18:186–189 Virtually all A&E departments...

Speaking the Language of Finance

Nursing leadership skills have changed dramatically in a short period of time. Just being able to cover the schedule and ensure adequate orientation for new employees are not enough in today's health care environment. This article outlines steps to ensure adequate staffing levels, assess productivity, and justify the operational supplies and capital equipment necessary for effective patient care. It also outlines steps nursing leaders can take to market their programs and services.

The relationship between staffing and quality in long-term care facilities: exploring the views of nurse aides.

Research on staffing and quality of care in long-term care facilities confirms that adequate staffing levels are important to ensuring quality but few studies have examined how the two are linked. The research reported in this article used participant observation and indepth interviewing to explore how nurse aides (NAs) understand the link between staffing and quality. The findings show that NAs deem their relationships with residents to be the central determinant of quality of care as well as an important outcome in itself. Adequate staffing is essential to allowing NAs to nurture these relationships.

Can PACS make a radiology department more competitive?

One of the motives for putting in a picture archiving and communication system (PACS) is to improve efficiency and hence enhance the competitive strength of the radiology department. Many would argue that it is now negligent to consider installing an old fashioned conventional radiology department rather than a PACS. In considering the issue it is important to be clear about the nature of the competition facing radiologists. This varies depending on the country and upon whether the institution is public or private. PACS can potentially help to overcome this competition in two ways: by providing real-time radiology, and by enabling teleradiology. Success in these areas requires state-of-the-art implementations of PACS, particularly clinically relevant PACS software, and adequate staffing levels.

Confidentiality. 9: The law relating to whistle blowing.

Alex Black, a staff nurse on an intensive care unit, was extremely concerned about the lack of adequate staffing levels on the unit. He had put his concerns in writing to his manager, but no action appeared to have been taken. On one weekend there was such a lack of staff that it was impossible to ensure that one nurse was attending every patient on a ventilator at all times. A young girl, injured in a road accident, was brought into the unit following surgery, and was placed on a ventilator. Alex was asked to monitor her care as well as that of another patient being ventilated. The girl died and Alex considered that this might not have happened if there had been adequate staff levels. He knows that the family are ignorant of how low the standards of care were and is anxious that they should be notified. Would it be lawful for him to tell them?

Changes in maternity care and the impact on nurses and nursing practice.

To determine changes maternity nurses have experienced and the impact these changes have had on nursing practice. Descriptive survey using a randomized sample. Four hundred fifty-one inpatient female maternity nurses. Changes in maternity care, impact of the changes on nursing practice, and personal and professional perceptions and activities before and after the changes. Reported changes were use of technology, legal climate, shorter patient stay, cost containment, inclusion of family, cross training, consumer demand, and single-room maternity care. Inclusion of the family, technology, and single-room care were rated highly for worth and improvement in quality of care. Though described as challenging and rewarding, change was an energy drain. Change was often seen as a result of administrative mandate. Perceptions of change vary, but no change is easy to implement. Opportunities for staff input, administrative support, and adequate time and staffing levels during change facilitate adjustment.

ANALYSIS OF ALTERNATIVE SCHEDULING POLICIES FOR HOSPITAL NURSES

The persistent shortage of nurses adversely affects the productivity, quality of care, and operating costs in most acute care hospitals. Aggravating the shortage are high nurse turnover rates, approaching 200% in some institutions. Policies to ensure adequate staffing levels and provide more attractive work schedules are alleged to improve nurse retention. However, their cost is seldom discussed. We compared expected nursing expense and workforce requirements to staff eight medical and surgical nursing units of a large hospital for 1 month, under 12 different scheduling policies alleged to improve turnover. Using simulation and an integrated staffing and scheduling methodology, we found that the expected nursing wages and workforce requirements for some policies differed by as much as 33%. In this hospital, the expected labor costs for certain policies could erode the benefits expected from improved retention. In contrast, other policies appear to allow high utilization of nursing resources, enhancing the expected benefits of reduced turnover with significant reductions in expenses for labor, recruiting, training, and fringe benefits.

The Use of Higher Wages in the Foodservice Industry to Motivate and Retain Hourly Employees

One of the most critical problems facing management in the foodservice industry is maintaining adequate staffing levels during the labor shortage. This is a study of hiring employees at premium wages to reduce the effects of the labor shortage. It will attempt to show that higher wages produce an increase in productivity and a reduction in turnover. The methodology will include visiting and interviewing the management of a fast food style restaurant in operation that used higher wages as a method to increase productivity and reduce turnover. The study includes financial data pertaining to wages, sales, and profit. The ability to maintain and recruit staff will be monitored by tracking labor turnover, absenteeism, and tardiness. The wage rate differences and staffing ability of the establishment and its competitors will also be monitored.

Situational Anxiety Levels and the Intensive Care Unit Staff Nurse

The purpose of this study was to investigate the relationship between adequate and inadequate staffing and state anxiety levels in intensive care nurses. It was hypothesized that the state anxiety levels of staff nurses working in intensive care units is higher when staffing is inadequate than when staffing is adequate. Spielberger's State-A Anxiety Inventory was administered to 32 nurses in six intensive care settings; 17 nurses were in adequate and 15 nurses were in inadequate staffing situations. The analysis of the data showed the hypothesis to be supported. Demographic data were collected on age, basic nursing education, length of time in the area where tested, and the shift working when tested. The demographic data were not statistically analyzed but are presented.