The Journal of nursing administration
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The objective of this study was to analyze the net effects of nurse practice environments on nurse and patient outcomes after accounting for nurse staffing and education. ⋯ Care environment elements must be optimized alongside nurse staffing and education to achieve high quality of care.
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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. ⋯ Findings indicate a huge opportunity to both improve clinical outcomes in these units and, at the same time, reduce costs by focusing on processes to reduce the high amount time spent performing NVA and support activities and increase patient care time, particularly patient teaching and psychosocial support.
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The aim of this study was to describe the methodology for nursing leaders to determine the cost of adverse events and effective levels of nurse staffing. ⋯ Hospital cost accounting systems are useful in determining the cost of adverse events and can aid in decision making about nurse staffing. Adverse events add costs to patient care and should be measured at the unit level to adjust staffing to reduce adverse events and avoid costs.
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The shortage of frontline nursing staff and their managers in acute care organizations necessitates strategies to both use and recognize the unique knowledge and skills of these individuals. The authors describe one organization's successful implementation of a shared decision-making structure that promotes an empowering work environment in which professional fulfillment and personal satisfaction can flourish. With support and opportunity, leaders are developed across all levels of nursing.
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An established hospital-based nursing research fellowship program was transformed into an evidence-based practice fellowship despite its previous high satisfaction ratings from nursing leaders and nurse fellow participants. The faculty for the fellowship program determined that the long-term outcomes of the research program were insufficient in light of the hospital resources committed to the fellowship program. An evidence-based practice approach was then created in anticipation that greater short-term and more sustained longer-term benefits for the hospital would be realized. The transformation of the fellowship and the short-term outcomes are described.