The rate and cost of nurse turnover in Australia.

Nurse turnover is a critical issue facing workforce planners across the globe, particularly in light of protracted and continuing workforce shortages. An ageing population coupled with the rise in complex and chronic diseases, have contributed to increased demands placed on the health system and importantly, nurses who themselves are ageing. Costs associated with nurse turnover are attracting more attention; however, existing measurements of turnover show inconsistent findings, which can be attributed to differences in study design, metrics used to calculate turnover and variations in definitions for turnover.

Instability in patient and nurse characteristics, unit complexity and patient and system outcomes.

Aims: To explore key factors related to nursing unit instability, complexity and patient and system outcomes.

Background: The relationship between nurse staffing and quality of patient outcomes is well known. The nursing unit is an important but different aspect that links to complexity and to system and patient outcomes.

A comparative review of nurse turnover rates and costs across countries.

Aims: To compare nurse turnover rates and costs from four studies in four countries (US, Canada, Australia, New Zealand) that have used the same costing methodology; the original Nursing Turnover Cost Calculation Methodology.

Background: Measuring and comparing the costs and rates of turnover is difficult because of differences in definitions and methodologies.

Design: Comparative review.

Methodological integrative review of the work sampling technique used in nursing workload research.

Aim: To critically review the work sampling technique used in nursing workload research.

Background: Work sampling is a technique frequently used by researchers and managers to explore and measure nursing activities. However, work sampling methods used are diverse making comparisons of results between studies difficult.

The Use of Unregulated Staff: Time for Regulation?

Internationally, shortages in the nursing workforce, escalating patient demands, and financial constraints within the health system have led to the growth of unlicensed nursing support workers. Recently, in relation to the largest publicly funded health system (National Health Service), it was reported that extensive substitution of registered nurses with unskilled nursing support workers resulted in inadequate patient care, increased morbidity and mortality rates, and negative nurse outcomes. We argue that it is timely to consider regulation of nursing support workers with their role and scope of practice clearly defined.

A systematic review of time studies to assess the impact of patient transfers on nurse workload.

Patients in hospital are increasingly being moved between clinical units and between bedspaces; however, the impact of patient transfers and bedspace moves on nurses' workload is not known. Time studies are an established observational research method that can be used to determine the duration of time taken to perform an activity or process. This review systematically searched four databases for literature published between 2000 and 2013 for observational time study techniques and patient transfers as a nurse activity.

The intensive care unit volume-mortality relationship, is bigger better? An integrative literature review.

Objective: To explore the association between patient volume in intensive care units (ICUs) and risk-adjusted mortality.

Background: Large multi-speciality ICUs are emerging in response to increasing demand for critical care. Consolidation of resources through regionalisation of services aims to contain costs and optimise demand management and operational synergies.

The economic benefits of increased levels of nursing care in the hospital setting.

Aim: To assess the economic impact of increased nursing hours of care on health outcomes in adult teaching hospitals in Perth, Western Australia.

Background: Advancing technology and increased availability of treatment interventions are increasing demand for health care while the downturn in world economies has increased demand for greater efficiency. Nurse managers must balance nurse staffing to optimize care and provide efficiencies.

The role and functions of Clinical Nurse Consultants, an Australian advanced practice role: a descriptive exploratory cohort study.

Background: The NSW Health Policy Directive (NSW Department of Health, 2000) lists clinical service and consultancy; clinical leadership; research; education; clinical services planning and management as the five domains of practice for nurses appointed as Clinical Nurse Consultants (CNCs), an Australian advanced practice nurse (APN) role. However, there is no clear definition of what is meant by advanced practice in the Australian nursing context. Nowhere is this more evident than in differentiating between the roles of Clinical Nurse Consultants (CNCs) and Nurse Practitioners (NP) in NSW.

Patient transfers in Australia: implications for nursing workload and patient outcomes.

Aim: To discuss the impact of patient transfers on patient outcomes and nursing workload.

Background: Many patient transfers are essential and occur in response to patients' clinical changes. However, increasingly within Australia transfers are performed in response to reductions in bed numbers, resulting in 'bed block'.

Factors impacting on career progression for nurse executives.

This discursive paper examines recent research on career progression for nurse executives in Australia. In particular, it focuses on the personal, work-related and professional factors which influence progression. The role of gender, location and the provision of mentoring are also considered.

National regulation in Australia: a time for standardisation in roles and titles.

Background: The past few years has seen a growth in the number of new nursing roles and position titles in many countries, including Australia. The Australian situation is unique due to the lack of professional engagement and debate in determining the purpose of some of these new positions. Often these new roles have been poorly defined, and there is no national consistency in nomenclature.

Nursing unit managers, staff retention and the work environment.

Aim And Objective: This paper examined the impact of leadership characteristics of nursing unit managers, as perceived by staff nurses, on staff satisfaction and retention.

Background: A positive work environment will increase levels of job satisfaction and staff retention. Nurse leaders play a critical role in creating a positive work environment.

A comparison of the nursing practice environment in mental health and medical-surgical settings.

Purpose: To examine the differences between characteristics of the work environment of nurses working in mental health and general acute inpatient nursing settings.

Design: Secondary analysis of data collected on 96 randomly selected medical and surgical (general) wards and six mental health wards in 24 public acute general hospitals across two Australian states between 2004 and 2006.

Methods: All nurses on the participating wards were asked to complete a survey that included the Practice Environment Scale of the Nursing Work Index (NWI-PES).