The Journal of nursing administration
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Improving medication safety at the point of care--particularly for high-risk drugs--is a major concern of nursing administrators. The medication errors most likely to cause harm are administration errors related to infusion of high-risk medications. An intravenous medication safety system is designed to prevent high-risk infusion medication errors and to capture continuous quality improvement data for best practice improvement. Initial testing with 50 systems in 2 units at Vanderbilt University Medical Center revealed that, even in the presence of a fully mature computerized prescriber order-entry system, the new safety system averted 99 potential infusion errors in 8 months.
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The purpose of the study was to enable nurse managers to identify strategies to support and enhance autonomous practice based on clinical nurses' understanding of autonomy. ⋯ These findings challenge assumptions about autonomy as independent decision making and practice. They highlight nurses' contributions to patient care goals through knowledge of how to get things done within hospital systems and through interdisciplinary coordination and collaboration.
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Using a new construct, job embeddedness, from the business management literature, this study first examines its value in predicting employee retention in a healthcare setting and second, assesses whether the factors that influence the retention of nurses are systematically different from those influencing other healthcare workers. ⋯ The findings suggest that job embeddedness is a valuable lens through which to evaluate employee retention in healthcare organizations. Further, the levers for influencing retention are substantially similar for nurses and other healthcare workers. Implications of these findings and recommendations for recruitment and retention policy development are presented.
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Multicenter Study
Licensed caregiver characteristics and staffing in California acute care hospital units.
Concerns about declining quality of care and nurse staffing shortages led to legislation mandating minimum nurse-to-patient ratios in the state of California. Although research finds that better registered nurse (RN) staffing results in higher quality of care, little evidence exists on which to base specific nurse-patient ratios. The authors describe the results of a California survey characterizing licensed caregivers, identifying staffing levels by unit type, and describing how staffing levels vary across hospital types. ⋯ As states struggle with an anticipated critical shortage of RNs, these results have several implications for health and education policy. Future studies of this type will be needed to evaluate the impact of anticipated changes in the regulation of nurse staffing.