Nursing administration quarterly
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Innovative programs that expand the role of nurses from inpatient to community health nursing benefit the hospital, the nursing staff, and the community. This hospital implemented a grant-funded prevention-oriented program for high-risk children that demonstrated positive outcomes to children and families, Utilization of pediatric nursing staff was maximized through collaboration of inpatient and home care departments. Nurses experienced increased job satisfaction and professional growth.
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This report describes restructuring on four critical care units at an acute, tertiary care hospital in South-east Pennsylvania. Utilizing a Patient Centered Care conceptual framework that had been successfully applied in the medical-surgical areas, restructuring involved three main areas: revamping of work processes, inclusive of redesigned staff roles; environmental and facility changes; and enhancement of telecommunication and information systems. Preliminary analyses six months post redesign revealed improvements and maintenance in four outcomes areas--satisfaction, quality and efficiency, and costs of care.
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Health care systems are changing at an unprecedented rate, but few are making the changes in a system affecting nearly 200,000 staff in over 1,100 different sites of service delivery originating from 171 medical centers nationwide, as is the Veterans Health Administration. The issues of change, quality of care, morale and opportunities involved in being a nurse today in a system undergoing this magnitude of change is presented within the framework of the quality of care initiatives that have been launched by VA. The new organization design of VA, emphasizing local decision-making, a description of the multiple quality programs recently introduced and integrative strategies that have been used by the Nursing Strategic Healthcare Group, the VA corporate level policy and nursing programs information center for the country, to support the change process are discussed.
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This article is an eye witness account of nursing's participation in the health care reform debate from 1991 to 1994. In that debate, the nursing profession achieved high visibility and recognition for the cogency of its policy positions as developed in Nursing's Agenda for Health Care Reform and for its united voice through the leadership of the American Nurses Association, the Tricouncil for Nursing, and the Nursing Organization Liaison Forum. While comprehensive health care reform failed to pass the 103rd Congress, nursing and nurses gained much in the process of their participation.
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Two nurse executives who broke the glass ceiling to become chief executives of health care systems are interviewed. Irma Goertzen and Barbara Donaho are asked key, candid questions comparing chief nurse officer (CNO) with chief executive officer (CEO); special skills needed; being a woman in a traditional man's role; and advice to colleagues for becoming a CEO.