The Journal of nursing administration
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Five Veterans' Administration Medical Centers formed a consortium to promote nursing research. Consortium arrangements focusing on research are reviewed based on the literature, the consortium's experience, and a survey of 171 VA facilities. Consortiums are suggested for multisite facilities, such as city, state, proprietary, and religious hospital systems, to increase the quality and quantity of nursing research where institutional mechanisms for overcoming the difficulties of meeting and sharing information are already in place.
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The authors describe the first year of operation of a nurse-managed intensive care unit (ICU). Concerned with the problems, costs, and inadequacies of caring for long-term patients in traditional ICUs, nurse administrators designed a special care unit that incorporates a physical design facilitating family involvement and rehabilitative care, registered nurse case management, and a shared governance management philosophy. Compared with traditional ICUs, the effectiveness of the special care unit is tested in terms of patient and nurse outcomes. Implications of this innovation for health-care delivery systems and the nursing profession are discussed.
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The results of the American Association of Critical-Care Nurses Demonstration Project support the contention that high quality critical care nursing can be provided to patients at a reasonable cost. In addition, the data refute the notion that elements influenced by nurses--supplies and nursing care--are the most costly portion of the total hospital charge.
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Effective nurse executive leadership is paramount in today's health care environment. Such leadership includes the qualities of a transformational leader and, to a lesser extent, a transactional leader. A study conducted among excellent nurse executives and members of their immediate staff showed that all executives were predominantly transformational leaders but also possessed transactional leadership skills.
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Establishing standards for the desired quality of nursing care requires identifying clear expectations for professional practice and evaluating related performance by objective, quantifiable criteria. The authors describe development of a job description/evaluation tool, the analysis of that process, and the initial findings of pilot testing.