The Relationship Between Nursing Experience and Education and the Occurrence of Reported Pediatric Medication Administration Errors.

Medication errors are one of the most common incidents in the hospitals. They can be harmful, and they are even more detrimental for pediatric patients. This study explored the relationship between nursing experience, education, the frequency and severity of reported pediatric medication administration errors (PMAEs).

The relationship among evidence-based practice and client dyspnea, pain, falls, and pressure ulcer outcomes in the community setting.

Background: There are gaps in knowledge about the extent to which home care nurses' practice is based on best evidence and whether evidence-based practice impacts patient outcomes.

Aim: The purpose of this study was to investigate the relationship between evidence-based practice and client pain, dyspnea, falls, and pressure ulcer outcomes in the home care setting. Evidence-based practice was defined as nursing interventions based on best practice guidelines.

Boundary spanning by nurse managers: effects of managers' characteristics and scope of responsibility on teamwork.

Increasing role complexity has intensified the work of managers in supporting healthcare teams. This study examined the influence of front-line managers' characteristics and scope of responsibility on teamwork. Scope of responsibility considers the breadth of the manager's role.

Part 1: The influence of personal and situational predictors on nurses' aspirations to management roles: preliminary findings of a national survey of Canadian nurses.

Aim: To examine the influence of personal and situational factors on direct-care nurses' interests in pursuing nursing management roles.

Background: Nursing managers are ageing and nurses do not appear to be interested in nursing management roles, raising concerns about a nursing leadership shortage in the next decade. Little research has focused on factors influencing nurses' career aspirations to nursing management roles.

Part 2: Nurses' career aspirations to management roles: qualitative findings from a national study of Canadian nurses.

Aim: Our aim was to investigate direct-care nurses' interests in formal management roles and factors that facilitate their decision-making.

Background: Based on a projected shortage of nurses by 2022, the profession could be short of 4200 nurse managers in Canada within the next decade. However, no data are currently available that identify nurses' interests in assuming manager roles.

The relationship between the nursing work environment and the occurrence of reported paediatric medication administration errors: a pan canadian study.

Paediatric medication administration errors (PMAEs) occur frequently, with devastating consequences for children and their families. This study explored the relationship between the nursing work environment and the occurrence of reported PMAEs. In total, 127 potential and 245 actual PMAEs were reported.

Behind the mask: Determinants of nurse's adherence to facial protective equipment.

Background: As the predominant occupation in the health sector and as the health worker with the most patient interaction, nurses are at high risk for occupational transmission of communicable respiratory illness. The use of facial protective equipment (FPE) is an important strategy to prevent occupational transmission.

Methods: A 2-phased study was conducted to examine nurse's adherence to recommended use of FPE.

Nurse turnover: a literature review - an update.

Background: Concerns related to the complex issue of nursing turnover continue to challenge healthcare leaders in every sector of health care. Voluntary nurse turnover is shown to be influenced by a myriad of inter-related factors, and there is increasing evidence of its negative effects on nurses, patients and health care organizations.

Objectives: The objectives were to conduct a comprehensive review of the related literature to examine recent findings related to the issue of nursing turnover and its causes and consequences, and to identify on methodological challenges and the implications of new evidence for future studies.

Front-line managers as boundary spanners: effects of span and time on nurse supervision satisfaction.

Aim: To examine the influence of nurse manager span (number of direct report staff), time in staff contact, transformational leadership practices and operational hours on nurse supervision satisfaction.

Background: Increasing role complexity has intensified the boundary spanning functions of managers. Because work demands and scope vary by management position, time in staff contact rather than span may better explain managers' capacity to support staff.

Nursing inputs and outcomes of hospital care: an empirical analysis of Ontario's acute-care hospitals.

The authors analyze the association between intensity of nursing care (as measured by nursing hours per patient day), hospital bed days, and patient outcomes in acute-care hospitals in the province of Ontario, Canada, to determine whether higher levels of nursing inputs are associated with shorter lengths of stay (LOS) and, if so, whether these shorter LOS are achieved at the expense of health outcomes. After controlling for supply of nurses, workload, community characteristics, and hospital type, the authors found that nursing hours per patient day had a significant negative effect on LOS but had no significant effect on patient satisfaction, hospital mortality, or readmission rates. Further, there was no evidence that shorter than expected LOS were associated with poorer patient health.

Evaluation of a patient care delivery model: system outcomes in acute cardiac care.

Hierarchical linear modelling was used to evaluate the influence of nurse staffing, work environment, and nurse and patient variables on system outcomes based on data collected in Canadian cardiac and cardiovascular inpatient units. Staffing utilization levels below 80% at the unit level and less overtime optimized perceived care quality and the completion of therapeutic interventions. Fewer patients per nurse improved perceived care quality and reduced longer-than-expected length of stay.

The Patient Care Delivery Model--an open system framework: conceptualisation, literature review and analytical strategy.

Aims And Objectives: This paper presents the Patient Care Delivery Model to illustrate interrelationships between model components and to support its application in research using advanced analytical techniques, including structural equation modelling.

Background: Many complex factors contribute to the nature of healthcare environments and to nurse, patient and system outcomes. A better understanding of these factors and their interrelationships would provide insight for decision-makers to develop strategies to improve outcomes.

Impact and determinants of nurse turnover: a pan-Canadian study.

Aim: As part of a large study of nursing turnover in Canadian hospitals, the present study focuses on the impact and key determinants of nurse turnover and implications for management strategies in nursing units.

Background: Nursing turnover is an issue of ever-increasing priority as work-related stress and job dissatisfaction are influencing nurses' intention to leave their positions.

Methods: Data sources included the nurse survey, unit managers, medical records and human resources databases.

Nursing staffing, nursing workload, the work environment and patient outcomes.

Nurse staffing (fewer RNs), increased workload, and unstable nursing unit environments were linked to negative patient outcomes including falls and medication errors on medical/surgical units in a mixed method study combining longitudinal data (5 years) and primary data collection.

Nursing Services Delivery Theory: an open system approach.

Aim: This paper is a discussion of the derivation of the Nursing Services Delivery Theory from the application of open system theory to large-scale organizations.

Background: The underlying mechanisms by which staffing indicators influence outcomes remain under-theorized and unmeasured, resulting in a 'black box' that masks the nature and organization of nursing work. Theory linking nursing work, staffing, work environments, and outcomes in different settings is urgently needed to inform management decisions about the allocation of nurse staffing resources in organizations.

An applied simulation model for estimating the supply of and requirements for registered nurses based on population health needs.

Aging populations, limited budgets, changing public expectations, new technologies, and the emergence of new diseases create challenges for health care systems as ways to meet needs and protect, promote, and restore health are considered. Traditional planning methods for the professionals required to provide these services have given little consideration to changes in the needs of the populations they serve or to changes in the amount/types of services offered and the way they are delivered. In the absence of dynamic planning models that simulate alternative policies and test policy mixes for their relative effectiveness, planners have tended to rely on projecting prevailing or arbitrarily determined target provider-population ratios.

Evaluation of a patient care delivery model: patient outcomes in acute cardiac care.

Purpose: To evaluate the influence of nurse staffing and work environment variables on patient outcomes by testing a conceptual model.

Design: A prospective, correlational design with cross-sectional and longitudinal components was conducted in Canadian cardiac and cardiovascular care inpatient units.

Methods: Data were collected from multiple sources.

Health human resources planning and the production of health: development of an extended analytical framework for needs-based health human resources planning.

Health human resources planning is generally based on estimating the effects of demographic change on the supply of and requirements for healthcare services. In this article, we develop and apply an extended analytical framework that incorporates explicitly population health needs, levels of service to respond to health needs, and provider productivity as additional variables in determining the future requirements for the levels and mix of healthcare providers. Because the model derives requirements for providers directly from the requirements for services, it can be applied to a wide range of different provider types and practice structures including the public health workforce.

Creating work environments that are violence free.

Workplace violence is a global phenomenon with recent research demonstrating that the incidence of violence is high and increasing, particularly in health-care settings. The current study reported the prevalence of workplace violence in nursing and examined the impact of it on nurses' work life and health based on a national Canadian survey. Results demonstrated that workplace violence significantly increases the likelihood of nurses' absenteeism, job dissatisfaction and poor physical and mental health, and can negatively impact quality of nursing care.

Implications of staff 'churn' for nurse managers, staff, and patients.

In this article, the term "churn" is used not only because of the degree of change to staffing, but also because some of the reasons for staff movement are not classified as voluntary turnover. The difficulties for the nurse managing a unit with the degree of "churn" should not be under-estimated. Changes to skill mix and the proportions of full-time, agency, and temporary staff present challenges in providing clinical leadership, scheduling staff, performance management, and supervision.

Planning for what? Challenging the assumptions of health human resources planning.

Objectives: Health human resource planning has traditionally been based on simple models of demographic changes applied to observed levels of service utilization or provider supply. No consideration has been given to the implications of changing levels of need within populations over time. Recently, needs based resource planning models have been suggested that incorporate changes in needs for care explicitly as a determinant of health care needs.

Career trajectories of nurses leaving the hospital sector in Ontario, Canada (1993-2004).

Aim: This paper is a report of an analysis of the career trajectories of nurses 1 year after leaving hospitals.

Background: Although hospitals are traditionally the largest employers of nurses, technological advances and budgetary constraints have resulted in many countries in relative shrinkage of the hospital sector and a shift of care (and jobs) into home/community settings. It has been often assumed that nurses displaced from hospitals will move to work in the other workplaces, especially the community sector.

Staff satisfaction and retention and the role of the nursing unit manager.

Despite recent increases in nursing recruitment in Australia, participation in the workforce is still below the numbers predicted to meet future needs. This paper discusses factors impacting on nurses' job satisfaction, satisfaction with nursing and intention to leave in public sector hospitals in New South Wales (NSW), Australia. Staffing and patient data were collected on 80 medical and surgical units during 2004/5.

Challenges in getting workforce research in nursing used for decision-making in policy and practice: a Canadian perspective.

Aims And Objectives: This paper draws upon empirical research and other published sources to discuss nursing workforce issues, the challenges of using health human resource research in policy decisions and the importance of evidence-based policies and practices for nursing care and outcomes.

Background: Increasing evidence points to the critical relationship between registered nurse care and improved patient outcomes. The negative impact that insufficient nurse staffing has on patient, nursing and system outcomes has influenced health human resource researchers to further examine nurses' work environments to determine factors that are amenable to policy change.