Advancing nursing leadership: a model for program implementation and measurement.

Despite the abundant literature documenting the need for nurse management education and career development, only recently have professional standards been targeted for this group. Competency standards for nurse leaders repeatedly identify systems-level concepts including finance and budget, communication skills, strategic management, human resources management, change management, and computer technology skills. However, educational initiatives to meet these standards are still at the early stages and most nurse leaders continue to acquire knowledge and experience through "on-the-job" training.

Non-value-added time: the million dollar nursing opportunity.

The dual crises of high healthcare costs and the nursing shortage require a better understanding of inpatient nursing unit activities and, more specifically, their costs and the drivers of inefficiencies. This includes knowing not only how staff spend their time but also how much of this time is non-value-added (NVA) because wasted time leads to both high costs and nurse dissatisfaction. The authors discuss a study that determined the NVA time and costs of acute care nursing unit staff, identified drivers of high-cost NVA time, and compared activities and costs by type of nursing unit.

The balancing act: patient care time versus cost.

Background: With demands to improve patients' clinical outcomes and decrease the escalating costs of inpatient care, nurse executives are focusing on how nurses spend their time rather than just raising staffing levels to positively impact patient outcomes. Because nursing wages constitute a high proportion of a hospital's budget, understanding the costs of nursing activities is critical to managing them.

Methods: An activity-based costing approach was used in 14 medical-surgical nursing units to study nursing activities and their related costs.

Assessing the quality of nursing work life.

Traditionally, nursing has measured job satisfaction by focusing on employees' likes and dislikes. However, job satisfaction is an unsatisfactory construct to assess either the jobs themselves or employees' feelings about work sinceas much as 30% of the variance explained in job satisfaction surveys is a function of personality, something employers can do little to change. Based on socio-technical systems theory, quality of nursing work life (QNWL) assessments focus on identifying opportunities for nurses to improve their work and work environment while achieving the organization's goals.