The Journal of nursing administration
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Increasingly, professional nurses will be required to function in practice settings other than acute care, yet little is known about how nurses perceive the skill sets required to practice in these nonacute care settings. This study explores nurses' perceptions and needs concerning the transition from acute to home care and community-based healthcare facilities. ⋯ Some nurses, such as those working in critical care, perceive themselves as being able to function proficiently in a wide variety of care settings-acute home, and community based. Furthermore, certain acute care skills were identified as top differentiators of proficiency in nonhospital settings, thus providing direction for nursing administrators and academic institutions. In addition, the tool developed for the study can serve as a self-assessment for individual nurses.
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Nurse administrators are seeking ways to create organizational work environments that empower nurses to exercise more control over the content and context of their practice. This study used Rosabeth Kanter's Structural Theory of Organizational Behavior to examine relationships between staff nurses' perceptions of work empowerment, and control over nursing practice, and subsequently, job satisfaction and perceived work effectiveness. Implications for nurse administrators are discussed.
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The staffing of a nursing unit provides a unique challenge when that unit experiences significant seasonal fluctuations in census. Although overtime, perdiem, or agency personnel are staffing alternatives to meet seasonal fluctuations in census, they are costly alternatives that are not the most efficient use of human resources. The authors present a seasonal staffing model that reallocates employee work hours in a pattern that closely matches the seasonal work load trends of the department.
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An existing hospice palliative care inpatient unit was studied from September 1993 to November 1993 to characterize it for two qualities: demographics of admitted patients and family satisfaction after discharge. The purpose of this study was to identify current uses of the unit and determine whether the high level of satisfaction among family members, as perceived by the staff, was accurate. To characterize demographics, 100 consecutive admissions to the unit were assessed prospectively beginning in September 1993. ⋯ Since this study, it has been identified that care on the hospice palliative care unit is provided at a 50% reduction in daily hospital charges. The hospital has benefited from establishing and maintaining an acute care inpatient hospice palliative care unit. Other academic medical centers in the United States should consider a designated unit for symptom management and terminal care as part of their comprehensive range of healthcare services.