Nursing administration quarterly
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Peer reviews in nursing are historically used to gauge performance within an individual's scope of practice or as a tool to evaluate a sentinel or adverse event. Quality of care measures, clinical pertinence, and evaluating standards of care have begun as parallel strategies to replace the former uses in assuring the right care at the right time in the right setting.
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With dramatic increases in health care costs and growing concerns about the quality of health care services, nurse executives are seeking ways to transform their organizations to improve operational and financial performance while enhancing quality care and patient safety. Nurse leaders are challenged to meet new cost, quality and service imperatives, and change cannot be achieved by traditional approaches, it must occur through innovation. Imagine an organization that can mitigate a $56 million loss in revenue and claim the following successes: Increase admissions by a 8 day and a $5.5 million annualized increase by repurposing existing space. ⋯ Grow emergency department volume 272 visits greater than budgeted for first quarter of 2010. Complete admission assessments and diagnostics in 90 minutes. This article will address how these outcomes were achieved by transforming care delivery, creating a patient transition center, enhancing outreach referrals, and revising admission processes through collaboration and innovation.
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Balancing clinical quality, safety, and cost is not new to health care leaders; however, the current environment of public transparency coupled with unprecedented economic challenges has created a sense of urgency to this triathlon-like balance. The implementation of clinically proven, life-saving therapy in the care of patients with sepsis is one of the highest financial burdens incurred by acute care facilities; however, the absence of that care is known to be the leading cause of death in noncoronary intensive care units and the 10th leading cause of death worldwide. Can we afford to save these lives? Through root-cost analysis of intensive care unit-care in conjunction with population management strategies, the synergy of bundled therapies in driving positive clinical outcomes can be replicated in the achievement of an outcome bundle including quality improvement, safety enhancement, and financial stewardship.
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A significant amount of burnout and attrition of nurses occurs in healthcare systems. Nursing leadership has a significant impact on these factors. The purpose of this article is to present an evidence review to determine the impact of transformational leadership on staff satisfaction and burnout. It was found that transformational leadership is significantly related to increased satisfaction, increased staff well-being, decreased burnout, and decreased overall stress in staff nurses.
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Nurse retention is a different way of conceptualizing the employer-employee relationship when compared with turnover. Job embeddedness (JE), a construct based on retention, represents the sum of reasons why employees remain at their jobs. However, JE has not been investigated in relation to locale (urban or rural) or exclusively with a sample of registered nurses (RNs). The purpose of this study was to determine what factors (JE, age, gender, locale, and income) help predict nurse retention. ⋯ Older, more "embedded" nurses are more likely to remain employed in their current organization. Based on these findings, JE may form the basis for the development of an effective nurse retention program.