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The Relationship of Nursing Workforce Characteristics to Patient Outcomes The Online Journal of Issues in Nursing 2008 Dunton N, Gajewski B, Klaus S, and Pierson B [Excerpt from authors] Abstract Three reports from the Institute of Medicine found that errors in hospital care were more common than previously thought; that health care delivery should be reorganized to improve the quality of care; and that, operationally, nurses have a critical role in securing patient safety. Now the contribution of nursing to the reduction of adverse events must be established empirically, so that nursing-sensitive indicators can be incorporated in such health care-improvement strategies as public reporting of hospital quality and performance-based payment systems. This article reviews what is known from previous nursing outcomes research and identifies gaps in the current state of knowledge. It then describes the contribution to research that can be made through the National Database of Nursing Quality Indicators TM (NDNQI). Next it reports an NDNQI study that found three nursing workforce characteristics to be related significantly to patient outcomes: total nursing hours per patient day, percentage of hours supplied by RNs, and years of experience in nursing, and concludes with a discussion of the implications of these findings for both for nursing administrators and outcomes-based, quality-improvement initiatives. Details
Who Does Workforce Planning Well: A Rapid Review for the Workforce Review Team Institute for Employment Research 2008 Bosworth DL, Wilson RA and Baldauf B [Excerpt from publisher]With the spotlight recently on workforce planning within the NHS, the Workforce Review Team commissioned an extensive literature review of workforce planning for healthcare. The Institute for Employment Research, University of Warwick, undertook, from September to November 2007, to report on: 1. theory and overview - is there any consensus in the academic literature about what constitutes successful workforce planning? 2. examples and case studies of workforce planning best practice - what do stakeholders define as 'best in class' and by what criteria and evidence do they reach this judgement? 3. UK health sector workforce planning - are there robust and authoritative studies and assessments of their effectiveness? Details
Uganda Health Workforce Study:Satisfaction and Intent to Stay Among Current Health Workers Ministry of Health, Uganda; the Capacity Project 2007 [Excerpt from publisher]This report summarises the results of a study of health worker satisfaction, working conditions and intent to continue working in the health sector in Uganda. The findings point to the importance of a number of factors that contribute to satisfaction and intent to stay, including differences by cadre, gender, age, sector (public or non-profit) and location. The results suggest several policy strategies to strengthen human resources for health in Uganda. Details
Training of Health Workers in Small Island States: Bridging the Distances Commonwealth of Learning 2000 Thurab-Nkhosi D [Excerpt from author]Abstract One of the mechanisms to improve the health sector throughout the region is the Caribbean Cooperation in Health Initiative (CCH). Approved by CARICOM Heads of Governments in 1986, this initiative focuses regional efforts on eight priority areas of health sector development. One of these areas is human resource development, which includes the training of health workers. This paper seeks to explore the possibilities of distance education for the training of health workers in small states. It reviews two programmes conducted by regional organizations in the context of the limitations of small island states. Theoretical and operational issues connected to the design of the training programmes are also discussed. The paper concludes by reflecting on the role of the University of the West Indies Distance Education Centre (UWIDEC) in facilitating professional training programmes. Details
Why Emotions Matter: Age, Agitation, and Burnout Among Registered Nurses The Online Journal of Issues in Nursing 2007 Erickson RJ and Grove WJC [Excerpt from author] Abstract: Knowledge of the emotional demands facing today's nurses is critical for explaining how work stressors translate into burnout and turnover. Following a brief discussion of how the experience of burnout relates to the nursing shortage, we examine the scope of nurses' emotional experiences and demonstrate that these experiences may be particularly consequential for understanding the higher levels of burnout reported by younger nurses. Using survey data collected from 843 direct care hospital nurses, we show that, compared to their older counterparts, nurses under 30 years of age were more likely to experience feelings of agitation and less likely to engage in techniques to manage these feelings. Younger nurses also reported significantly higher rates of burnout and this was particularly true among those experiencing higher levels of agitation at work. We conclude by suggesting the need for increased awareness of the emotional demands facing today's nursing workforce as well as the need for more experienced nurses to serve as emotional mentors to those just entering the profession. Details
What is Productivity? NHS Confederation 2006 [Excerpt from publisher]The NHS has received unprecedented levels of money since 2002. Since then, there has been growing criticism that the NHS is becoming less productive and is not providing value for money. This briefing examines what productivity actually means and how it relates to how well the NHS is treating patients. Details
Within Our Grasp: A Healthy Workplace Action Strategy for Success and Sustainability in Canada's Healthcare System Canadian Council on Health Services Accreditation 2007 [Excerpt from publisher]The Quality Worklife - Quality Healthcare Collaborative QWQHC) grew and evolved out of an overwhelming and widely-held recognition that urgent action was needed to coordinate, integrate and share learning aimed at more effectively and more expeditiously improving the quality of worklife (QWL) in healthcare. The QWQHC operates from a shared belief that it is unacceptable to fund, govern, manage, work in or receive care in an unhealthy healthcare workplace. To support these fundamentals, the QWQHC has identified several evidence-informed strategies to provide leaders with ideas on where to begin and how to achieve success. The culmination of these ideas, tools and strategies for change is presented in Within Our Grasp: A Healthy Workplace Action Strategy for Success and Sustainability in Canada's Healthcare System. Details
The Nursing and Midwifery Council (UK) Statistical Analysis of the Register 1 April 2005 to 31 March 2006 Nursing and Midwifery Council, UK 2007 [Excerpt from publisher] The Nursing and Midwifery Council (NMC) is the UK regulator for two professions, nursing and midwifery. The primary purpose of the NMC is protection of the public. It does this through maintaining a register of all nurses, midwives and specialist community public health nurses eligible to practise within the UK and by setting standards for their education, training and conduct. Currently the number of registrants exceeds 682,000. The Nursing and Midwifery Order 2001 (The Order), sets out the NMC's role and responsibilities. The aim of publishing a statistical analysis of the register is to assist workforce planners, researchers, government and employers in their several activities that depend on information about numbers on the register. There may also be public interest in the information. Details
Violence Against Health Personnel in Some Health Care Units in Maputo City [Mozambique] International Labour Office; International Council of Nurses; World Health Organisation; Public Services International 2003 [Excerpt from publisher] The main objective of this work was to analyse the level of violence which existed in the hospitals of Maputo city, identifying the factors and forms of struggle or prevention of these events. Details
The Nursing Workforce in sub-Saharan Africa International Council of Nurses 2005 Munjanja O, Kibuka S and Dovlo D [Excerpt from authors]This paper was prepared, at the request of the International Council of Nurses (ICN), as a contribution to its series of papers aimed at addressing nursing workforce issues worldwide. This paper examines various aspects of the nursing and midwifery workforce in Africa, looking at education and supply systems; recruitment, retention and motivation and career systems. It further investigates attrition from migration and HIV/AIDS, as well as other factors and makes some recommendations on how to move forward using examples of experiences from countries. These experiences, albeit on a small scale, show promise of good results after being scaled up. Section One provides the regional overview and context of nursing in sub-Saharan Africa (SSA) and points out factors that influence the ability of countries' nursing workforces to cope with their health situations. Some of these factors relate to planning, management, retention and motivation of the nursing workforce, and some also relate to the HIV/AIDS epidemic... Fran?ais: http://www.icn.ch/global/Issue7SSAFR.pdf Espa?ol: http://www.icn.ch/global/Issue7SSASP.pdf Details
The Orientation of Nurses in New Work Settings International Council of Nurses 2006 Forman C [Excerpt from publisher] What are the consequences of not orientating new staff adequately? Is adaptation to a new work place or organisation really necessary? This monograph examines the concepts behind orientation and provides examples of programmes that exist for new graduate nurses, nurses returning to clinical practice after a career break, and internationally recruited nurses (IRNs). Details
The Global Nursing Shortage: Priority Areas for Intervention International Council of Nurses 2006 [Excerpt from publisher] This report presents an action plan for ICN and nursing to address the global nursing shortage crisis, based on the work of a two-year project initiated by ICN. It calls on national and global partners to engage in developing, implementing and financing interventions that reflect five priority areas: macroeconomic and health sector funding policies; workforce policy and planning, including regulation; positive practice environments and organisational performance; recruitment and retention, addressing in-country maldistribution and out-migration; and nursing leadership. Fran?ais: http://www.icn.ch/global/shortagef.pdf Espa?ol:http://www.icn.ch/global/shortagesp.pdf Details
The Health Care Workforce in Europe - Learning from Experience European Observatory on Health Systems and Policies; World Health Organization 2006 Rechel B, Dubois C and McKee M (eds) This publication contains case studies on France, Germany, Lithuania, Malta, Norway, Poland, the Russian Federation, Spain, and the United Kingdom. It provides information about the HR challenges these countries face as well as possible solutions. Details
Shortage of nurses means death after hip fracture Medscape 2010 Lowry F "Low nurse staffing level sare associated with increased mortality among elderly patients admitted to hospital with hip fractures, new research suggests." (excerpt from article) Details
Stress Management for Nurses NSW Department of Health 2006 Brunero S et al. [Excerpt from authors] This booklet is intended to heighten awareness of the mental health needs of nurses and provide useful exercises to assist nurses to manage stress at work. Details
The Costs and Benefits of Nurse Turnover: A Business Case for Nurse Retention The Online Journal of Issues in Nursing 2008 Bland Jones C [Excerpt from author]Nurse turnover is a recurring problem for health care organizations. Nurse retention focuses on preventing nurse turnover and keeping nurses in an organization's employment. However, decisions about nurse turnover and retention are often made without the support of full and complete knowledge of their associated costs and benefits. This article identifies common nurse turnover and retention costs and benefits, discusses the use of benefit-cost and cost-effectiveness analysis relevant to nurse turnover and retention, and calls for the construction of a business case for nurse retention. It also provides a foundation for including the costs and benefits of nurse turnover and retention in estimating the economic value of nursing. Details
South Africa: Improve Facility Management to Increase Nurse Retention FRONTIERS Program 2007 [Excerpt from publisher] Abstract: Both financial and nonfinancial factors influenced the tenure and job satisfaction of nurses at public maternity services in South Africa. Surveys suggest that strong management and fully equipped facilities could help redress staff turnover. Details
Report of 13 th ICN Workforce Forum September 2007 International Council of Nurses 2007 This paper reports on outcomes from the 13 th ICN Workforce Forum held 17-18 September 2007 in Dublin, Ireland Details
Realising the Benefits? Assessing the Implementation of Agenda for Change King's Fund 2007 Buchan J and Evans D [Excerpt from publisher] Agenda for Change is the most ambitious pay reform introduced into the NHS. In addition to simplifying the system of pay, its objectives were to improve the delivery of patient care as well as staff recruitment, retention and motivation. This paper examines progress in implementation based on interviews with key national informants and on case studies in 10 NHS trusts. The report highlights unrealised potential in achieving positive changes to NHS care and makes a number of recommendations for action at national, SHA and NHS trust level. Details
Task Shifting for a Strategic Skill Mix Capactiy Project 2006 Bluestone J [Excerpt from author]In countries with critical shortages of physicians and nurses, the skill mix and distribution of available health care workers are often out of sync with national health care needs (WHO, 2006). Task shifting is increasingly considered a promising intervention for strengthening national health coverage by improving the strategic skill mix in the country's health care system. In this technical brief, task shifting refers to two processes: 1) shifting tasks from one cadre of health care worker to an existing, lower-level cadre and 2) shifting tasks to a new cadre developed to meet specific health care goals. Based on a review of the literature and country examples, the brief describes why task shifting is important and highlights some key steps in planning for, developing and supporting cadres involved in task shifting. Details
The Changing Nature of Nurses' Job Satisfaction: An Exploration of Sources of Satisfaction in the 1990s Blackwell Publishing, Inc.,Journal of Advanced Nursing 1999 Tovey EJ and Adams AE [Excerpt from pubisher] This paper focuses on the changing nature of nurses' job satisfaction. It compares the major sources of satisfaction and dissatisfaction experienced by acute ward nurses in the English National Health Service (NHS) in the early 1990s, with sources identified in previous research. In the light of findings from a pilot study, the suitability of existing research approaches and measurement tools for portraying nurses' contemporary work experiences is examined. Details
Retirement Intentions Survey: Report and Findings Public Employment Office NSW Premier's Department - Australia 2006 This publication reports on a survey undertaken by the Public Employment Office NSW Premier's Department - Australia to examine retirement intentions among public sector employees, including nurses. Details
Socio-Economic News International Council of Nurses 2006 This newsletter is published 2 times a year by the International Council of Nurses. It highlights current developments in relation to nursing and socio-economic welfare. Details
Socio-Economic Welfare of Nurses - ICN Position Statement International Council of Nurses 2004 [Excerpt from publisher] ICN and National Nurses Associations (NNAs) advocate for a workplace that is safe and encourages excellence in nursing practice. Nurses have a right to practice in an environment that is conducive to quality care, to competitive wages/benefits and to work a family-friendly environment that promotes the occupational safety and health of its employees. Details
Relationship of Work Stress and Workplace Violence in the Health Sector International Labour Office; International Council of Nurses; World Health Organization and Public Services International 2003 di Martino V [Excerpt from author] Based on extensive literature analysis, this study tackles, for the first time in an extensive way, the topical issues of stress and violence at work in the health sector. The study highlights the magnitude of the problem; the key-factors at stake; the way such factors inter-relate with each other ; their impact on working conditions and employment; the cost to the individual, the enterprise and the community, and offers innovative approaches to cope in an effective way with such problems. Details
Selecting and Applying Methods for Estimating the Size and Mix of Nursing Teams: A Systematic Review of the Literature Commissioned by the Department of Health Nuffield Institute for Health 2002 Hurst K [Excerpt from author] Nurses, perhaps more than any other professional group, are affected by clinical, educational, and managerial developments in the health and social services. Consequently, decisions about the size and mix of nursing teams are critical areas for health service managers generally and nursing workforce planners specifically. Overstaffed, undermanned and imbalanced nursing teams have implications for the quality and cost of patient care. Nurses' job satisfaction and the effective education of student nurses and other staff may also be jeopardised by poorly configured nursing teams. In short, never before has it been so vital that nurses are armed with appropriate instruments and data to help them plan and implement efficient and effective nursing teams. The aim of this report, therefore, is to help nurses make better decisions about cost-effective numbers and mixes of nurses. It aims to help them make sense of the complex and uncertain world of nursing workforce planning. Commonly used nursing workforce planning methods are reviewed and classified. Details
Strategic Directions for Strengthening Nursing and Midwifery Services 2002-2008 World Health Organization 2002 [Excerpt from publisher] These Strategic Directions for Strengthening Nursing and Midwifery Services provide an evidence-based framework for action that will be undertaken by WHO and its partners to support countries dedicated to improving the quality of nursing and midwifery services. There are four essential elements necessary to strengthen nursing and midwifery services. Each of these elements needs to be based on the best available evidence and requires advocacy, capacity building, research and development, and monitoring and evaluation to ensure that the key result areas are translated into action and impact practice. This document can also be used as a guide for action at the national level and to provide the basis for future policy dialogue at subnational levels. Details
Nursing and Payment by results: Understanding the costs of care Royal College of Nursing 2009 RCN Policy Unit "The recent ecomimic downturn has brought NHS costs very mcuh back into focus.." "...In the above context, the RCN commissioned a study to begin to establish baseline data on nursing activity within acute and long stay quality assured ward settings..." (exceprt from document) Details
Politics, Economics, and Nursing Shortages: A Critical Look at United States Government Policies Nursing Economics 2007 Elgie R [Excerpt from authors]Economic policies to address the shortage of registered nurses (RN) in the United States emphasize the use of nurse education supply subsidies in the form of grants, loans, and vouchers that have changed little during the past 4 decades. The first such subsidies began in 1964 in the Nurse Student Loan program en acted under the Title VI Civil Rights Act (American Association of Colleges of Nursing [AACN], 2006). Nurse supply subsidies have continued ever since, and are currently provided in the Nurse Reinvestment Act (NRA) HR 3847 under Title VIII of the Public Health Service Act signed by President Bush on August 1, 2002 (Senate of the United States, 2002). None of the current literature on the nursing shortage questions the prevailing recommendations to maintain and even increase nursing supply subsidies. Details
Nurse Retention and Migration - ICN Position Statement International Council of Nurses 1999 [Excerpt from publisher]The majority of member states of the World Health Organization report a shortage, maldistribution and misutilisation of nurses. Financial constraints have forced some governments to close health facilities despite the need for services and the ensuing redundancy of nursing personnel. Management and compensation practices greatly affect the severity of nursing shortages, particularly in health institutions. In many countries, the career structures for nurses are inappropriate. Some governments have failed to address the identified problems relating to hours of work, ongoing education, re-entry programmes, staffing levels, attitudes of administrators, security, housing and day care services. Details
Productivity Amongst Nurses and Midwives in Botswana African Sociological Review 2002 Balogi K, Fako T and Forcheh N [Excerpt from authors] This study is concerned with the productivity of nurses working within the Primary Health Care System, under the control of the Ministry of Local Government in Botswana. The study establishes the nature, strengths and direction of associations between productivity and background variables, work context variables, resource variables and recognition and support variables. Details
Part-time Employment - ICN Position Statement International Council of Nurses 2000 [Excerpt from publisher] Employees as well as employers view part-time employment in many situations favourably. It is often seen by nurses as a welcome option when addressing professional and personal satisfaction. At the same time, employers consider part-time employment as a means of introducing or maintaining flexibility in staffing levels and decreasing operational costs. The introduction of part-time employment is not free of potentially perverse consequences. Part-time employment of nurses may jeopardise the working conditions of full-time staff as a whole if the mix of staff is not determined adequately. The bargaining power of full-time staff decreases as their numbers are reduced. Details
Nurses and Shift Work - ICN Position Statement International Council of Nurses 2000 [Excerpt from publisher] The very nature of nursing care presupposes a service provided on a twenty-four hour basis that can only be maintained by shift work. This employment pattern is known to require nurses to adapt physically, emotionally and socially. While shift work may bring some wanted flexibility to nurses' work schedule and additional income, it often introduces additional hardship on nurses providing services in complex environments and demanding interpersonal situations. Evening and night shifts are frequently less well staffed (fewer employees with often a lower grade mix) and nurses have difficult access to safe transport and basic comforts such as hot meals. The stress of shift work is known to increase levels of absenteeism and staff turnover thus affecting the quality of nursing care. Details
Outcomes of Variation in Hospital Nurse Staffing in English Hospitals: Cross-sectional Analysis of Survey Data and Discharge Records Elsevier, International Journal of Nursing Studies 2006 Rafferty AM, Clarke SP, Coles J, Ball J, James P, McKee M and Aiken L [Excerpt from authors] Objectives: To examine the effects of hospital-wide nurse staffing levels (patient-to-nurse ratios) on patient mortality, failure to rescue (mortality risk for patients with complicated stays) and nurse job dissatisfaction, burnout and nurse rated quality of care. Conclusions: Nurse staffing levels in NHS hospitals appear to have the same impact on patient outcomes and factors influencing nurse retention as have been found in the USA. Details
Overview of the Nursing Workforce in Latin America Pan American Health Organization; International Council of Nurses 2005 Malvarez SM and Agudelo MCC [Excerpt from authors]This paper was drafted by the Pan-American Health Organization (PAHO) as the basis for the examination of this important aspect of health care in the region of Latin America, and as a contribution to the International Council of Nurses (ICN). The analysis takes as its framework Pedro Brito Quintana's concept of field of human resources for health. That is, the health care workforce is structured and dynamised by all its aspects, activating processes, tensions and conflicts in accordance with the delivery of health care services. The four central aspects consist of work, education, the labour market and professionalisation processes. These variables are subject to and produce policies, regulations and management mechanisms. Different parties participate with various interests, abilities and degrees of power in the context of their social dynamics. Fran?ais: http://www.icn.ch/global/Issue6LatinAmericaFR.pdf Espa?ol: http://www.icn.ch/global/Issue6LatinAmericaSP.pdf Details
Nurse Retention and Recruitment: Developing a Motivated Workforce International Council of Nurses; World Health Organization 2005 Zurn P, Dolea C and Stilwell B [Excerpt from authors] Recruiting and keeping the right staff are key challenges for health policy-makers. The performance and quality of a health system ultimately depend on the quality and motivation of health human resources. Therefore, recruitment and retention problems should be appropriately addressed, as nursing staff shortages and low motivation are likely to have adverse effects on the delivery of health services and the outcome of care. The main objective of this paper is to examine how to develop and retain a motivated nursing workforce. Fran?ais: http://www.icn.ch/global/Issue4RetentionFR.pdf Espa?ol: http://www.icn.ch/global/Issue4RetentionSP.pdf Details
Nursing Workforce Planning: Mapping the Policy Trail International Council of Nurses 2005 O'Brien-Pallas L, Duffield C, Tomblin Murphy G, Birch S and Meyer R [Excerpt from authors] Planning for the efficient and effective delivery of health care services to meet the health needs of the populations is a significant challenge. Globally policy makers, educators, health service researchers, leaders of unions and professional associations, and other key stakeholders struggle with the best way to plan for a workforce to fulfil the health needs of populations. To meet this challenge, achieving the appropriate balance between human and non-human resources is important and requires continuous monitoring, careful attention to the country specific context in which policy decisions are made, and evidence-based decision-making. This paper provides an overview of current evidence and policy initiatives pertinent to the nursing workforce including: health human resource (HHR) planning, service planning and modelling; nursing workforce imbalances and internal migration; and approaches to nursing deployment and utilisation. Policy implications and recommendations are offered. Fran?ais: http://www.icn.ch/global/Issue2workforceFR.pdf Espa?ol: http://www.icn.ch/global/Issue2workforceSP.pdf Details
One Million More: Mobilising the African Diaspora Healthcare Professionals for Capacity Building in Africa Save the Children 2006 Blanchet K, Keith R and Shackleton P [Excerpt from authors] One Million More presents some of the interventions, debates, discussions and conclusions of a conference held in London from 21-22 March 2006.The conference was organised to create a stimulating and interactive forum to discuss the crisis in human resources for health, in an effort to influence national, regional and international policies for the promotion of sustainable skills capacity in Africa and to engage the African diaspora in innovative, practical steps to move the agenda forward. *This publication is no longer available online. Details
Advancing Nursing Leadership in long-term care Longwoods 2010 0'Brien j, Ringland M & Wilson S "Nurses working in the long-term care (LTC) sector face unique workplace stresses, demands and circumstances. Designing approaches to leadership training and other supportive human-resource strategies that reflect the demands of the LTC setting fosters a positive work life for nurses by providing them with the skills and knowledge necessary to lead the care team and to address resident and family issues." (extract from abstract) Details
How can optimal skill mix be effectively implemented and why? World Health Organization & the European Observatory on Health Systems & Policies 2008 2008 Bourgeault, L, Kuhlmann, E, Neiterman, E & Wrede, S "In this policy brief, we have described the major drivers of skill-mix initiatives, the types of skill-mix option pursued and the critical contextual facilitators and constraints to the implementation of these pursuits across several countries in the European region - all of which are experiencing a number of challenges to human resources for health, some similar and others country specific. Also, we have highlighted the evidence (or lack thereof) for the costs that can reasonably be expected of some of these decisions and initiatives." (excerpt from authors) This policy brief was written for the WHO European Minissterial Conference on health Systems, 25-27 June 2008, Tallinn, Estonia. Details
How Can the Migration of Health Service Professionals be Managed so as to Reduce any Negative Effects on Supply? WHO Regional Office for Europe 2008 Buchan J [Excerpt from author]This brief considers the policy implications in Europe of the international migration of health workers and addresses the question of how the migration of health service professionals can be managed in ways that reduce any negative effects on supply. Also available in French, German and Russian Details
Health Workers for All and All for Health Workers: An Agenda for Global Action Global Health Workforce Alliance 2008 The Global HealthWorkforce Alliance released its Agenda for Global Action during the First Global Forum on Human Resources for Health (HRH) held 2-7 March 2008 in Kampala, Uganda. The purpose of the Agenda is to "guide the initial steps in a coordinated global, regional and national response to the worldwide shortage and maldistribution of health workers, moving towards universal access to quality health care and improved health outcomes." It calls for action around six interrelated strategies. Also available in French http://www.who.int/workforcealliance/forum/1_Agenda_french_FIN.pdf Details
National NHS Staff Survey: Summary of Key Findings Healthcare Commission 2008 [Excerpt from publisher]The purpose of the survey is to look at the attitudes and experiences of NHS staff both nationally, because of the importance of the NHS, and by individual trust, so that employers can review any issues with their own staff and take action. To enable this, we have already provided each NHS trust with its own detailed report. This report outlines the principal findings from the survey for the NHS as a whole, and includes comparisons with the results of previous surveys wherever possible. Details
Model Nursing Act International Council of Nurses 2008 Wallace M [Excerpt from author]This material looks in detail at the preparation of a Nursing Act and is designed to offer guidance on the process of turning policy change in nursing into meaningful and effective legislation. A Nursing Act is required to establish an effective statutory regulatory system (i.e. a system underpinned by legislation) for nursing. This document has been prepared primarily to assist countries/jurisdictions who are either preparing legislation relating to nursing for the first time, or revising their existing legislation. It is intended to be used, in the main, by nursing professionals who may not be familiar with the process of making or changing legislation. Details
Human Resources for Health: A Gender Analysis Women and Gender Equity, and Health Systems, Knowledge Networks (KNs) of the WHO Commission on the Social Determinants of Health 2007 George A [Excerpt from author]In this paper I discuss gender issues manifested within health occupations and across them. In particular, I examine gender dynamics in medicine, nursing, community health workers and home carers. I also explore from a gender perspective issues concerning delegation, migration and violence, which cut across these categories of health workers. These occupational categories and themes reflect priorities identified by the terms of reference for this review paper and also the themes that emerged from the accessed literature. Details
Healthy Workplaces and Productivity: A Discussion Paper Minister of Public Works and Government Services Canada 2003 Lowe G [Description from publisher] A recent report prepared for Health Canada, Work Network Research Associate, Graham Lowe, explores the relationship between workplace health and productivity. Details
National Survey of NHS Staff 2006 Healthcare Commission 2007 [Excerpt from publisher] In October 2006, a total of 240,580 staff in the NHS were asked about their views and experiences of working for the NHS in England in the fourth annual survey of NHS staff. The survey is believed to be the largest annual staff survey in the world and this year 128,328 NHS employees took part, representing 53.6%. PCTs who were reconfigured in October 2006 were not required to participate in this year's survey and we will not use the data from the 2006 staff survey to assess these PCTs in the 2006/2007 annual health check. The 2006 survey provides information on the attitudes and experiences of staff in the NHS and can be used to improve working conditions and practices in healthcare services and therefore the quality of care provided to patients. All trusts have received their own survey results, along with detailed information about how these compare with other trusts. The results from this survey help to meet two of the Commission's objectives: (1)to provide local NHS trusts with information to improve the working conditions and experiences of their staff (2) to provide results for deriving measures of the performance of NHS trusts for use in the Healthcare Commission's annual health check Details
Health Worker Motivation in Jordan and Georgia: A Synthesis of Results Partnerships for Health Reform 2000 Franco LM, Bennett S, Kanfer R and Stubblebine P [Excerpt from authors] Health worker motivation has the potential to have a large impact on health systems performance, yet little is known about the key determinants and outcomes of motivation in developing and transition countries. This study, conducted in Jordan and Georgia (at two hospitals each), used a three-pronged approach to data collection: 1) a contextual analysis, 2) a 360 degree assessment, and 3) in-depth analysis focused on the individual determinants and outcomes of the worker's motivational process. Details
Public Sector Health Worker Motivation and Health Sector Reform Partnerships for Health Reform- PHR Primer for Policymakers 2000 Bennett S and Franco LM [Excerpt from authors] It is becoming increasing important that policymakers be aware of health worker motivation and it's impact on health sector performance. Health care delivery is highly labor-intensive, and service quality, efficiency, and equity are all directly mediated by workers' willingness to apply themselves to their tasks. While resource availability and worker competencies are essential, decision makers should know that they are not sufficient in themselves to ensure desired worker performance. Worker performance is also dependent on workers' level of moti-vation stimulating them to come to work regularly, work diligently, and be flexible and willing to carry out the necessary tasks. Details
Health Human Resources Development - ICN Position Statement International Council of Nurses 1999 [Excerpt from publisher] ICN judges that health human resources development (HHRD) requires an interdisciplinary, inter-sectorial and multi-service approach. This recognises the complementary roles of health service providers, and values the contribution of the different disciplines. Inputs are required from the key stake holders -- consumers, service providers, educators, researchers, employers, managers, governments, funders and health professions' organisations. Similarly, ICN acknowledges that integrated and comprehensive health human resources information systems and planning models are desired outcomes of this consulting process. When new categories of health workers are created or role changes are introduced, the possible consequences on national and local health human resources need to be identified and planned for at the outset.... Details
Human Resources for Health in Europe World Health Organization on behalf of European Observatory on Health Systems and Policies; Open University Press 2006 Dubois CA, McKee M and Nolte E (eds) [Excerpt from forward] This book is one of the first to address comprehensively many of the key issues for human resources development across Europe, in the EU, the new EU member states and the countries of the former Soviet Union. The authors also take a look at the action required at strategic, regional and local levels in Europe to strengthen skills, expertise and analysis of human resources for health and to strengthen the health professions' integration into health policy-making. The authors argue that new human resources systems, improved management and evidence-based training institutions are needed at regional and local levels in order to address new demands from patients as well as changing epidemiological and demographic contexts. Details
Human Resources for Health: Overcoming the Crisis Joint Learning Initiative; Global Equity Initiative, Harvard University 2004 [Excerpt from publisher] In this analysis of the global health workforce, the Joint Learning Initiative-a consortium of more than 100 health leaders-proposes that mobilization and strengthening of human resources for health is central to combating health crises in some of the world's poorest countries and for building sustainable health systems everywhere. This report puts forward strategies for the community, country, and global levels in overcoming this crisis through cooperative action. Details
Guidelines on Planning Human Resources for Nursing International Council of Nurses 1994 [Excerpt from publisher]Using a step-by-step approach, this document discusses the technical aspects of a comprehensive human resources planning process. Details
Vision, Grit and Collaboration: How the Wisconsic Centre for Nursing Acheived ASustainable Funding and Established Itself as a State Health Care Workfoce Leader SAGE journals online 2010 Acord LG, Dennik-Champion G, Lundeen S & Schuler S "In 2001, a dedicated group of nurses from across Wisconsin came together to discuss how to create a state center of expertise on key nursing workforce issues. The result was the establishment of the Wisconsin Center for Nursing (WCN) in 2005. ... This article will include the history of the WCN and the details of its journey toward sustainability including accomplishments and lessons learned" (excerpt from abstract). Details
Payment Regulations for Advanced Practice Nurses: Implications for Primary Care SAGE journals online 2010 Chapman SA, Wides CD & Spetz J "...Previous research suggests that Advanced Practice Registered Nurses (APRNs) can provide as high quality care and achieve the same health outcomes as physicians. However, APRNs are usually reimbursed at lower rates than physicians by both Medicare and Medicaid. ... A clear regulatory framework and payment rationale are needed along with data on the type and complexity of care provided by various practitioners to increase efficiencies and improve access to health care." (excerpt from abstract) Details
ICN Nursing Workforce Profiles (2002 - ) 0 Details
Joint Health Professions Statement on Task Shifting International Confederation of Midwives; International Council of Nurses; International Pharmaceutical Federation; World Confederation of Physical Therapists; World Dental Federation; World Medical Association 2008 [Excerpt from publishers] We, the representatives of more than 25 million health professionals, are committed to providing safe, accessible health care to the world's people. We understand all too well the impact of shortage of personnel, supplies and equipment on patients, families and providers. We witness the impact daily of not enough staff, not enough clean water, not enough drugs, not enough money to access services or to afford life's staples. We see health professionals mentally and physically exhausted daily. We struggle with the dilemma of resource restrictions and meeting the needs of everyone - and the evidence that shows that better health outcomes occur when higher numbers of professionals are engaged in direct care. We understand the need to address today's human resource crisis. At the same time we are concerned that task shifting and adding new cadres of workers result in fragmented and inefficient service through reductionist and vertical approaches. Details
Nursing Self Sufficiency/Sustainability in the Global Context International Centre on Nurse Migration and the International Centre for Human Resources in Nursing 2007 Little L and Buchan J [Excerpt from authors] The 2006 World Health Report has identified shortages of human resources as the critical obstacle to the achievement of the millennium development goals (MDGs). Nursing shortages are on the agenda in many countries, developed and developing, and the International Council of Nurses (ICN) has established a global workforce initiative which has highlighted that previous efforts to address nursing shortages have often been short term, fragmented and inadequate. One major challenge for all countries is to establish workforce planning mechanisms that effectively meet the demands for health care and provide workforce stability. However, few nations have developed strategic plans for meeting nursing resource requirements that effectively address supply and demand. Instead, many developed countries choose to implement short term policy levers such as increased reliance on immigration, sometimes to the detriment of developing countries. This has prompted calls for developed countries to employ a model of so-called "self sufficiency" in addressing nursing and other health human resource shortages. The aim of this paper is to examine what definitions and models of "self sufficiency" exist in a nursing workforce context, and discuss their implications for policy. There is broad agreement in the healt Details
Occupational Health and Safety Management Programme for Nurses International Council of Nurses 2007 Papp E [Excerpt from author]Nurses are falling ill, incurring workplace injuries, and suffering disabilities from exposure to workplace hazards. As a result, the global community is losing critical members of the health care team, compounding the already existing nurse staffing crisis and adversely affecting the health and well-being of the world's population. This needless attrition seriously impairs the fulfilment of the United Nations' Millennium Development Goals. As well, it adversely affects the world health community's ability to meet primary healthy care needs as defined in the 1978 WHO/UNICEF Alma Ata Declaration (WHO 1978). Details
Occupational Health and Safety for Nurses - ICN Position Statement International Council of Nurses 2006 [Excerpt from publisher]ICN is clear that a safe work environment in the health sector significantly contributes to patient safety and supports positive patient outcomes. To that end ICN promotes the development and application of international, national and local policies or instruments that will safeguard the nurses' right to a safe work environment, including continuing education, immunisation and protective clothing/equipment. ICN reconfirms its mandate to encourage research in this area and to circulate relevant information on a regular basis to appropriate stakeholders. Details
Abuse and Violence Against Nursing Personnel - ICN Position Statement International Council of Nurses 2006 [Excerpt from publisher] Sickness and potential life-threatening factors cause stress in patients, their family members, and personnel in the health workplace. Such stress can aggravate factors that lead to violence; the levels of which are reportedly on the increase in society in general, and in the health workplace in particular. Workplace violence is universal and pervasive. The impact of psychological violence is as great if not greater than physical violence. It is also more widespread. Working conditions in the health sector place nursing and other health personnel at greater risk of violence, because of:Staffing patterns, including inadequate staffing levels and supervision, the use of temporary and inexperienced staff, heavy workloads and being solely responsible for health care units.Shift work, including commuting to and from work at night.Poor security measures in health facilities.Interventions demanding close physical contact.Demanding workloads, often occurring in emotionally charged environments.Highly accessible worksites with little to no privacy.Home visiting with its associated isolation. Details
International Council of Nurses Nursing Workforce Profile 2002 International Council of Nurses 2002 Details
International Council of Nurses Nursing Workforce Profile 2005 International Council of Nurses 2005 Details
International Council of Nurses Nursing Workforce Profile 2004 International Council of Nurses 2004 Details
Nurse Wages and Their Context: Database Summary,ICN Asia Workforce Forum 2005 International Council of Nurses 2005 [Excerpt from publisher] The Nurse Wage Questionnaire was sent to 11 National Nurses' Associations, members of the ICN International Workforce Forum. Reponses were received from Hong Kong, Japan, Korea, Macau, Malaysia, Philippines, Singapore, Taiwan and Thailand. Most of the data throughout this analysis is presented in Purchasing Power Parity, or PPP. A PPP is a number that standardizes currency in order to facilitate international comparison. Purchasing power is equal when the ratio between countries' price level of a 'fixed basket of goods and services' is equal. In this analysis, PPPs will be used to represent wages and are a proxy for standard of living. Details
The nurse labour and education markets in the English-speaking CARICOM: Issues and options for reform The World Bank 2009 The World Bank "The chief objective of this second research phase was to produce a comprehensive assessment of the nurse labor and education markets of the ES CARICOM. Despite major research efforts, data limitations remained a significant problem. However, information gathered was sufficiently robust and complete to provide for the first time a comprehensive picture. As we elaborate in this report, it shows a highly fragile supply-side equilibrium that will be increasingly insufficient to meet local demand." *excerpt from ducment) Details
Leader empowering behaviours, staff nurse empowerment and work engagement/burnout Longwoods 2006 Greco P, Spence HK, Laschinger S and Wong C "The purpose of this study was to test a model examining the relationship between nurse leaders' empowerment behaviours, perceptions of staff empowerment, areas of work life and work engagement using Kanter's theory of structural power in organizations." (excerpt from abstract) Details
Keeping the Best: A Practical Guide to Retaining Key Employees Institute for Employment Studies 1997 Bevan S, Barber L and Robinson D [Excerpt from publisher]This book, which is intended to assist human resource professionals and line managers in the United Kingdom, is a practical guide to retaining key employees. Discussed in the introduction are the relationship between downsizing and retention, problems that retention difficulties pose for human resource management, and the effects of retention problems on labor market buoyancy. The next four chapters are devoted to the following topics: understanding why retention is a concern (external influences, consequences of turnover); determining whether retention is a problem (measuring labor turnover, making external comparisons, identifying key people and key posts, calculating the costs of labor turnover); understanding why people leave (voluntary resignations, isolation of reasons for leaving, reasons often given for leaving); and determining what can be done (recruitment and selection, induction and training, job design/content, job satisfaction, career progression, development opportunities, supervision and management, pay and benefits, retention bonuses, different deals, examples of action taken by employees). The final chapter is a case study of how one information technology company worked to improve its retention of key employees. Appended are the following: checklist for determining the costs of labor turnover, form for analyzing retention risk, and exit interview questionnaire. Contains 16 references and useful addresses. Details
Learning for Performance: A Guide and Toolkit for Health Worker Training and Education Programs The Capacity Project 2007 Murphy C, Harber L, Kiplinger N, Stang A and Winkler J [Excerpt from Preface] This manual presents Learning for Performance, a systematic instructional design process based on IntraHealth's experience in designing reproductive health and HIV/AIDS training and performance improvement programs over the last 27 years in countries around the world. Our work in human resources for health, especially through the Capacity Project, also informs this document. The process outlined in this document is being used in many countries and continues to evolve as we learn additional lessons about what is most useful and practical in various contexts. Details
Management of Workplace Violence Victims International Labour Office; International Council of Nurses; World Health Organization and Public Services International 2003 Richards J [Excerpt from author] This study aims to summarise information, research and practice relating to the management of workplace violence victims under a set outline. The objectives are to confirm the importance of victim management to minimise the consequences of workplace violence in the health sector; to present the range of measures being used to meet the needs of victims, management and policy-makers; and where possible, provide data suggesting effectiveness and sustainability of the various measures. Details
International Council of Nurses Nursing Workforce Profile 2003 International Council of Nurses 2003 Details
Canadian oncology work environments: Part 1 Longwoods 2010 Bakker D, Conln M, Fitch M, Green E, Butler L, Olson K & Cummings G "The purpose of this research study was to examine oncology nursing work environments in Canada and to determine the presence of workplace and professional practice factors." (Excerpt from abstract) Details
Global Migration of Nurses Global Health TV 2009 Kingma, M A brief video interview from the 2009 Global Health Conference in Washington D.C., discussing key issues in the global health migration of nurses. Details
A Comparison of Stress factors in Home and Inpatient Hospice Nurses Medscape 2009 Martens, ML "The purpose of this study was to determine the perceived stress factors of inpatient and home hospice nurses and their correlation to perceived self-efficacy." (excerpt from abstract) Details
Financial incentives for return of service in underserved areas: a systematic review BMC Health Services Research 2009 Barnighausen T & Bloom D "In many geographic regions, both in developing and in developed countries, the number of health workers is insufficient to acheive population health goals. Financial incentives for return for service are intended to alleviate health worker shortages; A (future) health worker enters into a contract to work for a number of years in an underserved area in exchange for a financial pay-off...We carried out systematic literature searches..for studies evaluating outcomes of financial incentive programs published up to February 2009." (excerpts from Abstract) Details
Code of Ethics for Nurses in Australia - August 2008 Australian Nursing and Midwifery Council, Royal College of Nurses, Australia, and the Australian Nursing Federation 2008 "This Code of Ethics for Nurses in Australia has been developed for the nursing profession in Australia.It is relevant to all nurses at all levels and areas of practice including those encompassing clinical,management,education and research domains." (excerpt0 Details
Code of Professional Conduct for Nurses in Australia - August 2008 Australian Nursing and Midwifery Council, Royal College of Nurses, Australia, and the Australian Nursing Federation 2008 "This Code of Professional Conduct for Nurses sets the minimum standards for practice a professional person is expected to uphold both within and outside of professional domains in order to ensure the 'good standing' of the nursing profession. These two companion Codes, together with other published practice standards (eg competency standards, decision-making frameworks, guidelines and position statements), provide a framework for legally and professionally accountable and responsible nursing practice in all clinical,management, education and research domains." (excerpt) Details
Code of Ethics for Midwives in Australia - August 2008 Australian Nursing and Midwifery Council, Royal College of Nurses, Australia, and the Australian Nursing Federation 2008 "This Code of Ethics for Midwives in Australia has been developed for the midwifery profession in Australia. It is relevant to all midwives in all areas of maternity services including those encompassing the midwifery practice,management, education and research domains." (excerpt) Details
Code of Professional Conduct for Midwives in Australia - August 2008 Australian Nursing and Midwifery Council, Royal College of Nurses, Australia, and the Australian Nursing Federation 2008 "The Code of Professional Conduct for Midwives in Australia is a set of expected national standards of professional conduct for midwives in Australia. It is supported by, and should be read in conjunction with its companion code, the Code of Ethics for Midwives in Australia and the Australian Nursing and Midwifery Council National Competency Standards for the Midwife. These three documents, together with other published practice standards (eg decision-making frameworks, guidelines and position statements), provide a framework for accountable and responsible midwifery practice in all clinical, management,education and research domains." (excerpt) Details
Factors Influencing Work Productivity and Intent to Stay in Nursing Jannetti Publications, Inc; Nursing Economics 2008 Letvak S and Buck R [Excerpt from publisher]There continues to be a shortage of registered nurses (RNs) with a possible predicted short fall of 36% by 2020 (U.S. Department of Health and Human Services [DHHS], 2006). Despite recent improvements in the hospital nursing short age, the average hospital vacancy rate for RNs in the United States is 8.5% to 14% with vacancy rates of over 14% in medical-surgical and critical care areas (American Hospital Association [AHA], 2004, 2006). Much of the employment growth of RNs employed in hospitals has been in nurses over age 50 (Buerhaus, Auerbach, & Staiger, 2007). How ever, 49% of hospitals surveyed stated it was more difficult to recruit RNs in 2005 than it was in 2004 (AHA, 2006). Hospital nurse staffing is a concern because of the effects a shortage has on patient safety and quality of care (Buerhaus, Donelan, Ulrich, Norman, & Dittus, 2005; Ulrich, Buerhaus, Donelan, Norman, & Dittus, 2005). Details
Foreign Nurses in Portugal Ordem Dos Enfermeiros 2008 Da Silva A and Fernandes R This study examines foreign nurses in Portugal. Also availble in Portuguese: http://www.ordemenfermeiros.pt/images/contents/uploaded/File/Sede-Internacional/Enfmigrantes_PT.pdf Details
Facilitating Acculturation of Foreign-Educated Nurses Online Journal of Issues in Nursing 2008 Emerson E. Ea [Excerpt from author]The United States (US) is in the midst of a critical nursing shortage that is projected to worsen unless long term and sustainable solutions are instituted. The hiring of foreign-educated nurses (FENs) has been identified in the literature as one of the practical and realistic solutions to the current nursing shortage. Although small in number compared to U.S.-prepared nurses, FENs play an integral role in the delivery of health care services and contribute to the diversity of the U.S. health care workforce. The literature suggests that successful acculturation of FENs to host cultures leads to work and life satisfaction. Further, there is evidence in the literature suggesting that registered nurses, U.S. or foreign educated, who are satisfied with their jobs and personal lives stay longer in their current jobs and contribute to better patient outcomes. Details
Electronic Rostering: Helping to Improve Workforce Productivity - A Guide to Implementing Electronic Rostering in Your Workplace NHS Employers 2007 [Excerpt from publisher]This guide highlights the productivity benefits of using electronic rostering systems to roster all staff groups, and to provide trusts with key information that will enable them to choose and then successfully implement an electronic rostering system. It is aimed at boards, chief executives, human resources directors, medical directors, nursing directors, and any others interested in improving the productivity of their workforce. Details
A Magnetic Strategy for New Graduate Nurses Jannetti Publications, Inc; Nursing Economics 2007 Halfer D [Excerpt from author]This case study describes how one urban, MagnetAE-designated pediatric academic medical center introduced an RN internship program to nurture new graduates in building their pediatric careers. The business impact of developing a magnetic strategy to attract and retain new graduate nurses is also discussed. Details
A Situation Assessment of Human Resources in the Public Health Sector in Nigeria The Partners for Health Reformplus Project, Abt Associates Inc. 2006 Chankova S, Nguyen H, Chipanta D, Kombe G, Onoja A and Ogungbemi K [Excerpt from authors] Nigeria has one of the largest stocks of human resources for health (HRH) in Africa. However, great disparities in health status and access to health care exist among the six geo-political zones, and between rural and urban areas. This assessment measures the size, skills mix, distribution, and growth rate of HRH in the public health sector in Nigeria. The assessment also quantifies the increase in HRH requirements in the public health sector necessary for reaching key PEPFAR targets and the health Millennium Development Goals. The findings are based on a survey conducted in April-May 2006 in 290 public health facilities representing all levels of care (primary, secondary, and tertiary). The study data enabled us to estimate the total number of doctors, nurses, midwives, lab and pharmacy staff, and community health workers currently employed in the public sector. The distribution of health workers by level of care, and HRH availability in rural and urban areas was also quantified. Staff attrition rates, measuring the number of those leaving the public sector as percent of total staff, were determined among all staff categories. The annual growth in HRH in the public sector from new graduates was also measured. Details