The effects of All-RN and RN-EN staffing on the quality and cost of patient care.

This paper presents empirical evidence from a study that compared the quality and costs of patient care provided by two staffing regimes in an acute medical and an acute surgical ward in one hospital. As assessed by patient outcomes, there were few significant differences in either ward in the quality of care provided by all registered nursing staff and staff that was comprised of 80% registered nurses and 20% enrolled nurses. In the acute medical ward the all-registered nursing staff was more expensive per day and per hour for patient care adjusted for patient dependency; in the acute surgical ward the registered-enrolled nurse staff mix was more costly.

Developing methods and research instruments for assessing physical and psychosocial outcomes of patient care as a function of nursing staff mix.

This paper describes a study which assesses a wide variety of both physical and psychosocial outcomes of patient care against nursing care standards, and as a function of two different staff mixes--an 80% registered nurse (RN) 20% enrolled nurse (EN) mix and an all-RN staffing regimen. The study is divided into three stages: Stage I which concerned the design of the investigation and development of research instruments and procedures; Stage II which concerned the field-testing of all research procedures and assessment of the reliability of research instruments and Stage III which will constitute the main study and is presently being conducted in an acute medical and an acute surgical ward. This paper is confined to a report on Stages I and II and provides the conceptual framework for the study, a description of the research instruments and the ways they were developed and a description of the research methods.

International standards in medical education or national standards/primary health care--which direction?

This paper examines the concept of 'international standards' in undergraduate medical education and concludes that, with one material exception, these do not exist. It also examines the two major forces which sustain these non-existent standards. It contends that programmes of undergraduate medical education are only likely to become relevant to people's health needs, health policies and priorities if and when the concept of 'international standards' is jettisoned and replaced by the concept of 'national standards'.

Systematic curriculum development in an Indonesian pos-graduate Faculty of Public Health.

This paper describes a programme of curriculum development in an Indonesian post-graduate Faculty of Public Health. This faculty redefined all its curricula with a 2-year period, and these curricula are now stated in terms of sets of instructional objectives which are skill-based and learner-centered. These curricula are now being implemented in ways which are consistent with contemporary educational thinking.

Some positive benefits that could arise from an 'over-supply' of doctors in Australia.

This paper proposes that five main advantages can flow from an increase in the number of doctors in Australia. These advantages relate to: (1) improvements in the quality of clinical medical care; (2) a renewed emphasis on preventive medical care; (3) a more equitable, need-related distribution of doctors; (4) the ability of doctors to participate in regular professional up-grading programmes; and, (5) an increased capacity to participate in aid programmes within the South-East Asia region. It is argued that these positive factors should also be taken account of, along with the negative consequences, of an increase in the number of doctors in Australia.