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The Interface Between Health Sector Reform and Human Resources in Health Human Resources for Health 2003 Rigoli F and Dussault G [Excerpt from authors] The relationship between health sector reform and the human resources issues raised in that process has been highlighted in several studies. These studies have focused on how the new processes have modified the ways in which health workers interact with their workplace, but few of them have paid enough attention to the ways in which the workers have influenced the reforms. The impact of health sector reform has modified critical aspects of the health workforce, including labor conditions, degree of decentralization of management, required skills and the entire system of wages and incentives. Human resources in health, crucial as they are in implementing changes in the delivery system, have had their voice heard in many subtle and open ways - reacting to transformations, supporting, blocking and distorting the proposed ways of action. This work intends to review the evidence on how the individual or collective actions of human resources are shaping the reforms, by spotlighting the reform process, the workforce reactions and the factors determining successful human resources participation. It attempts to provide a more powerful way of predicting the effects and interactions in which different "technical designs" operate when they interact with the human resources they affect. The article describes the dialectic nature of the relationship between the objectives and strategies of the reforms and the objectives and strategies of those who must implement them. Details
Making a Measurable Difference: Evaluating Quality of Work Life Interventions Canadian Nurses Association 2006 Lowe GS [Excerpt from author] This report provides a resource for nurses, nurse managers, and their co-workers who are involved in activities to improve healthcare work environments. It has two objectives:1. To support nurses involved in implementing and evaluating quality of work life programes with specific parameters and timelines. 2. To help in the evaluation of transformations in an organization's culture and work practices. Details
Skill Mix in the Health Care Workforce: Reviewing the Evidence World Health Organization - Bulletin of the World Health Organization 2002 Buchan J and Dal Poz M [Excerpt from authors] This paper discusses the reasons for skill mix among health workers being important for health systems. It examines the evidence base (identifying its limitations), summarizes the main findings from a literature review, and highlights the evidence on skill mix that is available to inform health system managers, health professionals, health policy-makers and other stakeholders. Details
Maxi Nurses - Advanced and Specialist Nursing Roles Royal College of Nursing, UK 2005 [Excerpt from publisher] The Department of Health and RCN have jointly funded this research to find out more about nurses in specialist and/or advanced roles. The project aims to describe the posts, the people in the posts, and the organisational infrastructure surrounding them, to be able to map the variety of roles that currently exists. The project has been designed to address the following specific objectives:To describe the roles of these nurses and the work settings in which they are situated. Do the post-holders see the posts as being advanced and/or specialist? How is this evidenced in their roles?To examine the working relationships of nurses in this group. How do these roles 'fit' within their organisations and relative to other staff? What teams are they part of? Who accesses their expertise? Are these new roles understood by other staff and patients?To describe the career patterns and paths of nurses in these roles. Why did they take up this role? What were they doing before? What preparation have they had and what do they think is needed? What do they see as their next career step?To find out from nurses in these roles how patients and clients benefit from these roles;Consider the infrastructure, facilities and conditions required to make these roles as successful as possible, from both a post-holder and service perspective. What support can employers offer to nurses in these roles to ensure the service gets the most out of these roles? Is anything further needed? Details
Evaluation of Patient Safety and Nurse Staffing Canadian Health Services Research Foundation 2005 Sanchez McCutcheon A, MacPhee M, Davidson JM, Doyle-Waters M, Mason S and Winslow W [Excerpt from authors] This report provides a synthesis of the best available evidence in the area of nurse staffing and patient safety. It also gathers policy recommendations in the area. Three questions guided the synthesis, which was based on 73 major research studies and several reviews: 1) Do decisions about nurse staffing make a difference to patient safety? How and why? 2) What attributes or other contextual factors have been found to show an effect on nurse staffing and/or patient safety? 3) What knowledge exists around the implementation of good staffing initiatives? Details
Toward 2020: Visions for Nursing Canadian Nurses Association 2006 Villeneuve M and MacDonald J [Excerpt from authors] Toward 2020: Visions for Nursing is a futures study. It explores historical events that shaped the Canadian workforce, and talks about the serious policy challenges facing Canada today. Most importantly, it suggests scenarios that envision the kinds of roles nurses could play in the health-care system of 2020 and beyond. To obtain a complimentary copy of the full report in pdf format, please send an e-mail with your return e-mail address to: 2020@cna-aiic.ca Details
Impact of the Manager's Span of Control on Leadership and Performance Canadian Health Services Research Foundation 2004 Doran D, Sanchez McCutcheon A, Evans MG, MacMillan K, McGillis Hall LPringle D, Smith S and Valente A [Excerpt from authors] The purpose and objectives of this study are to 1) examine the extent to which the manager's span of control influences nurse, patient, and unit outcomes; and 2) investigate which particular leadership style contributes to optimum nurse, patient, and unit outcomes under differing spans of control. Details
Human Resources for Health: Requirements and Availability in the Context of Scaling-up Priority Interventions in Low-income Countries: Case Studies from Tanzania and Chad Health Economics & Financing Programme 2004 Kurowski C, Wyss K, Abdulla S, Y?madji N and Mills A [Excerpt from authors] The purpose of this study was to explore the role and importance of human resources for the scaling up of health services in low income countries. In two case studies, we (i) investigated the size, composition and structure of the current health work force; (ii) produced estimates of future human resource availability; (iii) estimated the quantity of human resources required significantly to scale up priority interventions towards 2015; and (iv) compared human resource availability and human resource requirements. Details
Human Resources for Health Policies: A Critical Component in Health Policies The International Bank for Reconstruction and Development / The World Bank 2005 Dussault G and Dubois CA [Excerpt from authors] In the last few years, increasing attention has been paid to the development of health policies. But side by side with the presumed benefits of policy, many analysts share the opinion that a major drawback of health policies is their failure to make room for issues of human resources. Current approaches in human resources suggest a number of weaknesses: a reactive, ad hoc attitude towards problems of human resources; dispersal of accountability within human resources management (HRM); a limited notion of personnel administration that fails to encompass all aspects of HRM; and finally the short-term perspective of HRM. Details
Evidence of Nurse Working Conditions: A Global Perspective Sage Publications - Policy, Politics, & Nursing Practice 2003 Stone PW, Tourangeau AE, Hughes F, Jones CB, O'Brien-Pallas L and Shamian J [Excerpt from authors] There is a global nursing shortage. Few health services decision makers have made the critical link between the number of human resources, the characteristics of the work environment and the impact on patients, nurses, and the system as a whole. The purpose of this article is to review evidence about nurse workload, staffing, skill mix, turnover, and organizational characteristics' effect on outcomes; discuss methodological considerations in this research; discuss research initiatives currently under way; review policy initiatives in different countries; and make recommendations where more research is needed. Overall, an understanding of the relationships among nurse staffing and organizational climate to patient safety and health outcomes is beginning to emerge in the literature. Little is known about nursing turnover and more evidence is needed with consistent definitions and control of underlying patient characteristics. Research and policy initiatives in Australia, Canada, New Zealand, and the United States are summarized. Details
Planning Human Resources in Health Care: Towards an Economic Approach - An International Comparative Review Canadian Health Services Research Foundation 2003 Bloor K and Maynard A [Excerpt from authors] Policy makers in Canada's healthcare system recognize the need to plan health human resources better, with more systematic and integrated planning. Many are looking to other healthcare systems for ideas and examples that might be useful in the Canadian context. To inform the design and development of improved workforce planning, a review of healthcare systems was done in five countries: Australia, France, Germany, Sweden and the United Kingdom. Details
Setting Safe Nurse Staffing Levels: An Exploration of the Issues Royal College of Nursing, UK 2003 Scott C [Excerpt from author] The paper was written in response to the concern expressed by RCN members about the lack of an objective and rational 'universal formula' for staffing, which could guarantee the delivery of safe and highquality nursing care. Although the main focus is on the nursing workforce in hospitals, many of the issues discussed are equally relevant to nurses in community and primary care services. Details
Nursing Workforce Planning in Australia - A Guide to theAustralian Health Workforce Advisory Committee Process and Methods Used by the Australian Health Workforce Advisory Committee 2004 [Excerpt from authors]The aim of this paper is to provide a general resource document on nursing workforce planning in Australia for use by the Australian Health Workforce Advisory Committee(AHWAC), the National Health Workforce Secretariat and members of nursing workforce working parties established by AHWAC. While this paper outlines the processes and methods used by AHWAC in its national level nursing workforce planning, it is acknowledged that much nursing workforce planning in Australia is undertaken at the jurisdictional level using approaches other than that outlined in this paper. The paper may be of use to other individuals and organisations involved in health and nursing workforce planning. Details
Wisdom at Work: The Importance of the Older and Experienced Nurse in the Workplace Robert Wood Johnson Foundation 2006 Hatcher BJ (ed), Bleich MR, Connolly C, Davis K, O'Neill Hewlett P and Stokley Hill K [Excerpt from authors] With projections of a severe and looming nursing shortage, the Robert Wood Johnson Foundation (RWJF) commissioned the development of this Wisdom Works white paper to identify promising strategies and opportunities for retaining experienced nurses. One projection from a 2003 online survey conducted by the American Nurses Association revealed that, in the age cohort of 40 or older, more than 82 percent of nurses planned to retire in the next 20 years. This paper is a response to the current and increasingly daunting crisis resulting from the shortage of nurses. Details
The Health and Family Planning Manager's Toolkit - Performance Management Tool Family Planning Management Development Technical Unit, Management Sciences for Health 1998 This document discusses performance planning and its importance as well as how to develop performance objectives and job descriptions. Details
Skills-Mix and Policy Change in the Health Workforce: Nurses in Advanced Roles Organisation for Economic Co-operation and Development 2005 Buchan J and Calman L [Excerpt from authors] This report was commissioned by OECD to examine the evidence on role change and delegation from physicians to advanced practice nurses (APN)- nurse practitioners and nurses in other advanced roles in the hospital setting and primary care. The report has three components:- a literature review, an assessment of country responses to a questionnaire sent out by the OECD, and two more detailed country case studies, on England and US. Details
When Staff is Underpaid: Dealing With the Individual Coping Strategies of Health Personnel World Health Organization- Bulletin of the World Health Organization 2002 Van Lerberghe W, Conceicao, C ,Van Damme W and Ferrinho P [Excerpt from authors] Health sector workers respond to inadequate salaries and working conditions by developing various individual ''coping strategies''-some, but not all, of which are of a predatory nature. The paper reviews what is known about these practices and their potential consequences (competition for time, brain drain and conflicts of interest). By and large, governments have rarely been proactive in dealing with such problems, mainly because of their reluctance to address the issue openly. The effectiveness of many of these piecemeal reactions, particularly attempts to prohibit personnel from developing individual coping strategies, has been disappointing. The paper argues that a more proactive approach is required. Governments will need to recognize the dimension of the phenomenon and systematically assess the consequences of policy initiatives on the situation and behaviour of the individuals that make up their workforce. Details
What is the Access to Continued Professional Education Among Health Workers in Blantyre, Malawi? EQUINET-Network for Equity in Health in Southern Africa 2003 Muula A, Misiri H, Chimalizeni Y and Mpando D [Excerpt from authors] Objective: To describe the current status regarding continued professional development (CPD) of healthcare personnel serving within the Ministry of Health and Population (MoHP) health centres in Blantyre, Malawi. Conclusions: This study indicates that healthcare professionals are using mostly clinical handover meetings, seminars and workshops for their CPD. There is need to improve access to relevant professional journals. The regulatory or licensing boards for healthcare professional in Malawi should seriously consider mandatory CPD credits for re-certification. Details
Grow Your Own: Creating the Conditions for Sustainable Workforce Development King's Fund 2006 Malhotra G [Excerpt from publisher]Developing a sustainable and flexible workforce, using 'grow-your-own' approaches, could help the NHS face complex challenges as investment slows. This paper explores the conditions required to successfully implement these approaches. Details
The Last Straw: Explaining the NHS Nursing Shortage King's Fund 2000 Meadows S, Levenson R and Baeza J [Excerpt from publisher] Good levels of recruitment and retention among nurses are critical to the effectiveness of the NHS workforce. But significant numbers of nurses are unhappy with many areas of their work, and feel frustrated by issues such as lack of resources, poor pay and conditions, inflexible working times, and a grading system that makes career progression difficult. This publication argues that the NHS nursing shortage will not be solved unless all aspects of nurses' working lives - including roles, workload and conditions - are improved in an integrated way. It draws conclusions about what needs to change to reverse the current problems. Details
Guide to Health Workforce Development in Post-Conflict Environments World Health Organization 2005 Smith JH [Excerpt from publisher] This guide is intended to stimulate interest, understanding, discussion and sharing of experiences, both successful and unsuccessful, of post-conflict situations. It is designed to act as a bridge between the post-conflict human resources development scenario and the more advanced workforce strategies and tools that can be used in the development phase.In comparison with other sectors, little is available in the public domain in relation to experiences and lessons learnt pertaining to human resources development in post-conflict and disrupted environments. There is, however, a wealth of undocumented knowledge held by individual health professionals or in the records of organizations. The aim of this guide is to take the first steps in documenting relevant evidence, tools and experience of countries that have experienced conflict and disrupted environments over prolonged periods. Details
Counting the Smiles: Morale and Motivation in the NHS King's Fund 2002 Finlayson B [Excerpt from publisher] Good staff morale and motivation are critical for the Government to achieve its ambitious plans for modernising the NHS, but evidence suggests that morale among NHS staff is low. This research summary draws on a literature review and focus groups with NHS staff. It identifies three key factors affecting morale and motivation: resources and pay, the working environment, and whether people feel valued. It offers evidence that healthy morale and motivation have positive impacts on patient care and outcomes, and makes recommendations for achieving them. Details
The Global Shortage of Health Workers and Its Impact - WHO Fact Sheet World Health Organization 2006 This fact sheet provides information about the extent of the global shortage, its consequences and what is needed to tackle the crisis. Details
HR Mapping of the Health Sector in Kenya: The Foundation for Effective HR HLSP Institute 2006 [Excerpt from publisher] Accurate, detailed and up-to-date manpower data is a prerequisite for human resource (HR) management. This Technical Brief describes how the Ministry of Health (MoH), with support from HLSP, conducted a human resource mapping exercise of all public health staff in Kenya, and discusses the implications of the findings. The aim is to demonstrate the many practical uses of human resource data - data which is not too complex to collect. Details
Regional Strategy on Human Resources for Health 2006-2015 World Health Organization, Western Pacific Region 2006 [Excerpt from publisher] The purpose of the Regional Strategy is to provide Member States with a range of policy options and strategic actions from which to choose. It must be emphasized, however, that the Regional Strategy cannot and should not replace the need for country-specific strategies aimed at building a competent and supported health workforce and promoting equitable access to quality health services. The Strategy's framework for action is comprised of five interrelated strategic objectives organized around three key result areas, with suggested national actions to achieve them and WHO enabling responses. The key result areas are: (1) a health workforce that is responsive to population health needs, or demand; (2) effective and efficient workforce development, deployment and retention, or supply; and (3) workforce governance and management. Details
Career Development in Nursing - ICN Position Statement International Council of Nurses 2001 [Excerpt from publisher] It is essential that nurses' associations, governments and other bodies facilitate career development for nurses by means of articulated educational and career systems that provide opportunities for nurses to move from one category to another, or to other positions within or outside the health care system. To develop such systems, it is necessary to identify the core of knowledge, skills, attitudes and scientific principles for nursing practice. Details
Nurses and Overtime -ICN Fact Sheet International Council of Nurses, 2001 [Excerpt from publisher] This Nursing Matters fact sheet provides quick reference information and international perspectives from the nursing profession on nurses and overtime. Details
ICN Position Statement: Career Development in Nursing International Council of Nurses 2001 [Excerpt from publisher]The International Council of Nurses (ICN) firmly believes that career development is a major contributing factor in the advancement of health systems and the nursing profession worldwide, and is directly linked to the maintenance of high quality care delivery. Career development must therefore be supported and sustained by means of an articulated educational system, recognised career structures (including clinical ladders) flexible enough to provide career mobility, and access to nursing entrepreneurship and/or independent practice opportunities. Details
Workload Measurement in Determining Staffing Levels International Council of Nurses 2004 Wiskow C [Excerpt from publisher] Finding the appropriate tool to measure workload is key in deciding appropriate staffing levels that permit the delivery of quality services. Low staffing levels and increasingly heavy workloads threaten the delivery of quality patient care. The use of workload measurement tools to determine minimum nurse staffing levels has been given greater attention in recent years. This monograph reviews the complexity of nursing work and the challenge of determining safe staffing levels. Details
Recruitment of Nurses Working Outside Nursing Lippincott Williams & Wilkins, Inc., Journal of Nursing Administration 2006 Duffield C, O'Brien Pallas L, Aitken L, Roche M and Merrick ET [Excerpt from authors] Nurses have always left nursing for other jobs and careers. However, there is some evidence that suggests this occurs now more than ever before as new generations join the workforce, and non-health employers recognize the skills that nurses gain in the profession. The authors provide data on the movement of nurses to careers outside the nursing profession in Australia and reasons for this occurrence and propose solutions. Details
Effects of Critical Care Nurses' Work Hours on Vigilance and Patients' Safety American Association of Critical-Care Nurses, American Journal of Critical Care 2006 Scott LD, Rogers AE, Hwang WT and Zhang Y [Excerpt from authors] Objectives- To describe the work patterns of critical care nurses, determine if an association exists between the occurrence of errors and the hours worked by the nurses, and explore whether these work hours have adverse effects on the nurses' vigilance. Conclusions - The findings support the Institute of Medicine recommendations to minimize the use of 12-hour shifts and to limit nurses' work hours to no more than 12 consecutive hours during a 24-hour period. Details
Creating High-Quality Health Care Workplaces (Discussion Paper) Canadian Poilcy Research Networks; Canadian Health Services Research Foundation 2002 Koehoorn M, Lowe GS, Rondeau KV, Schellenberg G and Wagar TH [Excerpt from authors] Health human resources have emerged as a top priority for research and action. This paper echoes calls for a fundamentally new approach to the people side of the health care system - treating employees as assets that need to be nurtured rather than costs that need to be controlled. The question guiding the paper is: "What are the key ingredients of a high-quality work environment in Canada's health care sector and how can this goal be achieved?" Synthesizing insights from a variety of research streams, the paper identifies many ingredients are needed to create a high-quality workplace. We take a multidisciplinary and holistic approach, which complements other research initiatives on health human resources in three ways. The paper suggests that health care organizations can, and must, achieve a virtuous circle connecting work environments, individual quality of work life, and organizational performance. Details
Retention Strategies for Nursing: A Profile of Four Countries Nursing Health Services Research Unit 2006 Baumann B, Yan J, Degelder J and Malikov K [Excerpt from authors] This report is a brief overview of retention strategies and is of interest to health care planners at both the national and international level. Using Uganda, the United Kingdom (UK), Canada, and Thailand as exemplars, it demonstrates that progress has been made in nurse retention. For example, according to data from the UK (one of the major recipients of overseas trained nurses), only 18 nurses or 0.41% of Uganda's nursing stock were registered for practice in the UK in 2002 (Ross, Polsky, & Sochalski, 2005). A WHO commissioned study conducted in six African countries found that that only 18% of midwives and 24% of nurses from Uganda want to emigrate (Awases, Gbary, Nyoni, & Chatora, 2004). The current report outlines the effective retention practices used in the countries, as well as the background economics of each country, some of the overarching health policies, actual nursing retention policies, and relevant grey and published literature. Details
Towards an Integrated Approach for the Management of Ageing Nurses Blackwell Publishing, Inc., Journal of Nursing Management 2006 Lavoie-tremblay M., O'brien-pallas L, Viens C, Hamelin Brabant I and G?linas C [Excerpt from authors]The objective of this study is to provide an overview of the ageing of the nursing workforce and to explore retention strategies centred on the entire professional life and on all age groups. Details
Educated and Underemployed: The Paradox for Nursing Graduands Nursing Health Services Research Unit, 2006 Baumann A, Blythe J, Cleverley K, Grinspun D and Tompkins C [Excerpt from authors] This report focuses on the supply and employment of nursing graduates in Ontario and their absorption into the workforce over the two-year period from 2003/4 to 2004/5. It begins with a review of labour market trends in the health care sector and discusses nursing supply, mobility, and cross-border migration in the recent past. The major repositories of data on nurse education are identified and an overview of the entry of new nurses into the workforce is provided. Based on a survey of new graduands, a profile of new nurses is presented. In addition, the employment market for newly graduated nurses is compared across Canada and provincial strategies for hiring new graduates are reviewed. Details
The Impact of Nurse Turnover on Patient, Nurse, and System Outcomes: A Pilot Study and Focus for a Multicenter International Study Sage Publications, Policy, Politics, & Nursing Practice 2006 O'Brien-Pallas L, Griffin P, Shamian J, Buchan J, Duffield C, Hughes F, Laschinger H K S, North N and Stone P W [Excerpt from authors] Research about the economic impact of nurse turnover has been compromised by a lack of consistent definitions and measurement. This article describes a study that was designed to refine a methodology to examine the costs associated with nurse turnover. Nursing unit managers responded to a survey that contained items relating to budgeted full-time equivalents, new hires, and turnover, as well as direct and indirect costs. The highest mean direct cost was incurred through temporary replacements, whereas the highest indirect cost was decreased initial productivity of the new hire. The study allowed the identification of the availability of data and where further refinement of data definition of variables is needed. The results provided significant evidence to justify increased emphasis on nurse retention strategies and the creation of healthy work environments for nurses. Details
Hospital Nurse Staffing and Quality of Care Agency for Health Research and Quality 2004 Stanton MW and Rutherford MK [Excerpt from authors] This report summarizes the findings of AHRQ-funded and other research on the relationship of nurse staffing levels to adverse patient outcomes. This valuable information can be used by decisionmakers to make more informed choices in terms of adjusting nurse staffing levels and increasing nurse recruitment while optimizing quality of care and improving nurse satisfaction. Details
National Report: Turnover in Nursing and Midwifery Department of Health and Children, Ireland - Nursing Policy Division 2002 This report examines turnover in nursing and midwifery in Ireland and identifies a number of recommendations. Details
Preventing Violence: A Guide to Implementing the Recommendations of the World Report on Violence and Health World Health Organization, Department of Injuries and Violence Prevention 2004 Butchart A, Phinney A, Check P and Villaveces A [Excerpt from authors]This guide complements both the World report on violence and health and the 2003 World Health Assembly resolution 56.24 on implementing its nine recommendations. Details
Defining and Creating Employee Commitment: A Review of Current Research Institute for Emplyoment Studies 2003 Robinson D [Excerpt fom publisher]Over the past ten years, the study of commitment has advanced in many different directions. A variety of disciplines have adopted the topic as a theme in their research and these have offered fresh and significant insights. These recent advances include new approaches to both the conceptualisation of employee commitment and the particular human resource practices intended to increase it. This review discusses the definition of commitment and its creation based on IES' extensive experience of working in this area and a comprehensive literature review. Details
Balanced Working Lives: A 'Can Do' Approach to Employing Nurses and Midwives Scottish Executive, Centre for Innovation and Change 2004 [Excerpt from publisher} A series of Booklets which support the development of flexible employment practices in NHS Scotland. Details
Role Stress and Role Ambiguity in New Nursing Graduates in Australia Blackwell Publishing, Inc., Nursing and Health Sciences 2003 Chang E and Hancock K [Excerpt from authors] The first few months of nursing have the potential to be the most challenging and stressful for new nursing graduates. The purpose of the present study was to examine sources of, and changes in, role stress 2-3 months after employment, and 11-12 months later in new graduate nurses. This study also investigated the relationship between job satisfaction and role stress. A factor analysis demonstrated that role ambiguity was the most salient feature of role stress in the first few months, while 10 months later, role overload was the most important factor explaining variance in role stress scores. There was no significant change in role stress scores over time. For the first survey, job satisfaction was significantly negatively correlated with role ambiguity and role stress. In the second survey there was still a significant negative correlation between role ambiguity and job satisfaction, but no significant correlation between role overload and job satisfaction. The findings are discussed in terms of implications for nursing education, practice and future research. Details
Organizational Attributes Valued by Hospital, Home Care, and District Nurses in the United States and New Zealand Blackwell Publishing, Inc., Journal of Nursing Scholarship 2005 Flynn L, Carryer J, Budge C [Excerpt from authors]Purpose:To determine whether hospital-based, home care, and district nurses identify a core set of organizational attributes in the nursing work environment that they value as important to the support of professional practice. Details
Mapping the Organizational Culture Research in Nursing: A Literature Review Blackwell Publishing, Inc., Journal of Advanced Nursing 2006 Scott-Findlay S and Estabrooks CA [Excerpt from authors] This paper reports a critical review of nursing organizational culture research studies with the objectives of: (1) reviewing theoretical and methodological characteristics of the studies and (2) drawing inferences specific to the state of knowledge in this field. Details
How Can Employment-Based Benefits Help The Nurse Shortage? Project Hope; Health Affairs 2006 Spetz J and Adams S [Excerpt from authors] During a labor shortage, employment-based benefits can be used to recruit and retain workers. This paper provides data on the availability of benefits to registered nurses (RNs), reports on how health care leaders are approaching the provision of employment-based benefits for nurses, and considers what nurses have to say in focus groups about benefits. Because of the ongoing nurse shortage, many employers are trying to enhance the benefits they offer to support recruitment and retention efforts. We offer recommendations for health care leaders that follow from our findings about the current state of nurses' employment-based benefits. Details
New Graduate Nurses' Perceptions of Mentoring: Six-year Programme Evaluation Blackwell Publishing, Inc., Journal of Advanced Nursing 2006 Beecroft PC, Santner S, Lacy ML, Kunzman l. and Dorey F [Excerpt from authors] This paper reports data from an evaluation study to determine whether new graduate nurses: (1) were satisfactorily matched with mentors; (2) received guidance and support; (3) attained socialization into the nursing profession; (4) benefited from having a role model for acquisition of professional behaviours; (5) maintained contact with mentors; and (6) were satisfied with the mentorship. Details
Are Teamwork and Professional Autonomy Compatible, and Do They Result in Improved Hospital Care? Quality and Safety in Health Care; BMJ Publishing Group Ltd 2001 Rafferty AM, Ball J and Aiken LH [Excerpt from authors]A postal questionnaire survey of 10 022 staff nurses in 32 hospitals in England was undertaken to explore the relationship between interdisciplinary teamwork and nurse autonomy on patient and nurse outcomes and nurse assessed quality of care. The key variables of nursing autonomy, control over resources, relationship with doctors, emotional exhaustion, and decision making were found to correlate with one another as well as having a relationship with nurse assessed quality of care and nurse satisfaction. Nursing autonomy was positively correlated with better perceptions of the quality of care delivered and higher levels of job satisfaction. Analysis of team working by job characteristics showed a small but significant difference in the level of teamwork between full time and part time nurses. No significant differences were found by type of contract (permanent v short term), speciality of ward/unit, shift length, or job title. Nurses with higher teamwork scores were significantly more likely to be satis- fied with their jobs, planned to stay in them, and had lower burnout scores. Higher teamwork scores were associated with higher levels of nurse assessed quality of care, perceived quality improvement over the last year, and confidence that patients could manage their care when discharged. Nurses with higher teamwork scores also exhibited higher levels of autonomy and were more involved in decision making. A strong association was found between teamwork and autonomy; this interaction suggests synergy rather than conflict. Organisations should therefore be encouraged to promote nurse autonomy without fearing that it might undermine teamwork. Details
Nursing Staff Dynamics and Implications for Maternal Health Provision in Public Health Facilities in the Context of HIV/AIDS Frontiers in Reproductive Health; Population Council 2005 Penn-Kekana L, Blaauw D, Chege J, Tint K and Onareng M [Excerpt from authors] This study aimed to document nursing staff dynamics in maternal health services, and to explore the factors associated with these dynamics. We have used the term nursing staffing dynamics to encompass a range of human resource processes including staff turnover, absenteeism, average length of stay in a facility, vacancy rates and workload. The study was carried out in Limpopo, KwaZulu-Natal and Mpumalanga provinces in South Africa. Details
Nurse-Staffing Levels and the Quality of Care in Hospitals Massachusetts Medical Society, New England Journal of Medicine 2002 Needleman J, Buerhaus P, Mattke S, Stewart M and Zelevinsky K [Excerpt from publisher] Background: It is uncertain whether lower levels of staffing by nurses at hospitals are associated with an increased risk that patients will have complications or die. Conclusion: A higher proportion of hours of nursing care provided by registered nurses and a greater number of hours of care by registered nurses per day are associated with better care for hospitalized patients. Details
Evaluating Teaching Effectiveness in Nursing Education: An Iranian Perspective BioMed Central Ltd 2005 Salsali M [Excerpt from author] The main objective of this study was to determine the perceptions of Iranian nurse educators and students regarding the evaluation of teaching effectiveness in university-based programs. Details
Workers Who Care: A Graphical Profile of the Frontline Health and Health Care Workforce (USA) Robert Wood Johnson Foundation; Health Workforce Solutions LLC 2006 Schindel J, Cherner D, O'Neil E, Solomon K, Iammartino B and Santimauro J [Excerpt from authors]This chartbook provides comprehensive employment data on frontline health and health care workforce occupations. The data offer a profile of the frontline workforce at the national level, as well as a more nuanced description of the ways in which the frontline occupational outlook varies across states and regions. The researchers gathered the core occupational data presented here from federal sources, such as the Bureau of Labor Statistics, and from state sources, such as state labor market information databases. Details
Healthy Work Environments - Collaborative Practice Among Nursing Teams Registered Nurses' Association of Ontario - Nursing Best Practice Guidelines Program 2006 [Excerpt from Foreward]This is one of a series of six Best Practice Guidelines (BPGs) on Healthy Work Environments (HWE), developed by the nursing community. The aim of these guidelines is to provide the best available evidence to support the creation of thriving work environments. Details
Healthy Work Environments Best Practice Guidelines - Developing and Sustaining Nursing Leadership Registered Nurses' Association of Ontario - Healthy Work Environments Best Practice Guidelines Project 2006 [Excerpt from Foreward]This is one of a series of six Best Practice Guidelines (BPGs) on Healthy Work Environments (HWE), developed by the nursing community to date. The aim of these guidelines is to provide the best available evidence to support the creation of healthy and thriving work environments. Details
Retention: Health Workforce Issues and Response Actions in Low-Resource Settings The Capacity Project 2005 Yumkella F [Excerpt from author]This paper seeks to provide a compelling evidence base to reveal the factors that lead to high turnover and to promote tested responses to retain health workers. The literature researched is presented to support country-level action. Details
Creating High-Quality Health Care Workplaces Canadian Policy Research Networks Inc.; The Canadian Health Services Research Foundation 2002 Koehoorn M, Lowe GS, Rondeau KV, Schellenberg G and Wagar TH [Excerpt from authors] Health human resources have emerged as a top priority for research and action. This paper echoes calls for a fundamentally new approach to the people side of the health care system - treating employees as assets that need to be nurtured rather than costs that need to be controlled. The scope of the human resources crisis in health care is multi-dimensional in its symptoms, underlying causes, and consequences. Finding solutions to these problems starts with the recognition that the performance of any health care organization depends on motivated, knowledgeable, and well-resourced employees. Especially important are relationships among co-workers and between employees and employers. Furthermore, the same work environment factors that help to meet organizational goals (i.e., a 'healthy' or well-functioning organization), also contribute to positive worker outcomes ranging from physical well-being to skill development and job satisfaction. Details
Creating Healthy Health Care Workplaces in British Columbia: Evidence for Action Provincial Health Services Authority 2006 Lowe GS [Excerpt from author] A human resource crisis threatens the viability of Canada's health system. Workforce aging and unhealthy, low-quality work environments pose significant risks to achieving health system goals. Creating healthy work environments is not optional - it must be viewed as an essential prerequisite for building future health human resource capacity. Retention, development, and better utilization of existing staff has to be a top priority, and for this to happen, work environments must be healthy. To move in this direction, health system decision-makers need answers to very practical questions. Foremost among these are the following:Which interventions will make the biggest improvements in employee health and wellness?How can healthy workplace change be designed for maximum positive impact on system outcomes, particularly patient care and operational effi ciency and eff ectiveness?What combination of human resource management, health and safety, and work organization practices will contribute most to a more sustainable and high-performing health system?In short, while improving the health and well-being of people working in the health system is important in its own right, health authority boards and executive teams require a business case for making these investments. Details