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ICHRN Knowledge Library

Pillars & Programmes    Socio-Economic Welfare    International Centre for Human Resources in Nursing (ICHRN)

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Human Resource Management Rapid Assessment Tool for Public - and Private- Sector Health Organizations - A Guide to Strengthening HRM Systems Management Sciences for Health 2005 [Excerpt from publisher] The Human Resource Management (HRM) Assessment Tool offers a method for assessing what an organization's Human Resources Management system consits of and how well it functions. The HRM Assessment Tool helps users to develop strategies to improve the human resource system and make it as effective as possible. It can also serve as a basis for focusing dicusssions, brainstorming, and strategic planning. It is designed to be used in public and private-sector health organizations. Details
Gender Equality, Work and Health: A Review of the Evidence World Health Organization, Department of Women, Gender and Health 2006 Messing K and ?stlin P [Excerpt from Preface] This publication documents the relationship between gender inequality and health and safety problems. It reviews gender issues in research, policies and programmes on work and health, and highlights some specific issues for women, including the types of jobs they do, as well as their need to reconcile the demands of work and family. Biological differences between women and men also are considered in relation to hazards they face in the workplace. Implications of the findings and recommendations for legislation and policy are discussed. Details
Monitoring the Effect of the New Rural Allowance for Health Professionals Health Systems Trust; National Department of Health 2004 Reid S [Excerpt from author] The maldistribution of health professionals between rural and urban areas in South Africa demands specific strategies to address the imbalance. Financial and non-financial incentives have been used in other countries to recruit and retain health professionals in areas of need, and in 1994 a rural recruitment allowance was instituted in South Africa. However, this allowance was granted only to medical doctors and dentists, and remained at the same fixed rate since the time of its inception. It was perceived to be ineffective as an incentive for retention of professional staff, and despite the introduction of community service for all health professionals except nurses, it remains difficult to recruit and retain professional staff at rural hospitals, health centres and clinics. Details
Structural Empowerment, Magnet Hospital Characteristics, and Patient Safety Culture: Making the Link Lippincott Williams & Wilkins, Journal of Nursing Care Quality 2006 Armstrong KJ and Laschinger HKS [Excerpt from publisher] Nurse managers are seeking ways to improve patient safety in their organizations. At the same time, they struggle to address nurse recruitment and retention concerns by focusing on the quality of nurses' work environment. This exploratory study tested a theoretical model, linking the quality of the nursing practice environments to a culture of patient safety. Specific strategies to increase nurses' access to empowerment structures and thereby increase the culture of patient safety are suggested. Details
A Longitudinal Analysis of the Impact of Workplace Empowerment on Work Satisfaction John Wiley & Sons, Ltd., Journal of Organizational Behavior 2004 Laschinger H K S, Finegan J, Shamian J and Wilk P [Excerpt from publisher] A longitudinal predictive design was used to test a model linking changes in structural and psychological empowerment to changes in job satisfaction. Structural equation modeling analyses revealed a good fit of the data from 185 randomly selected staff nurses to the hypothesized model. Changes in perceived structural empowerment had direct effects on changes in psychological empowerment and job satisfaction. Changes in psychological empowerment did not explain additional variance in job satisfaction beyond that explained by structural empowerment. The results suggest that fostering environments that enhance perceptions of empowerment can have enduring positive effects on employees. Details
Relationships of Work and Practice Environment to Professional Burnout: Testing a Causal Model Lippincott Williams & Wilkins, Nursing Research 2006 Leiter M P and Laschinger H K S [Excerpt from publisher]Objective: To test a nursing worklife model that defined structured relationships among professional practice environment qualities and burnout. Results: A causal model was used to confirm the factor structure of the Professional Environment Scale (NWI-PES) on a subset of NWI items and the factor structure of the MBI-HSS. The analysis provided support for a structural model (nursing worklife model) linking the five worklife factors used to define a fundamental role for nursing leadership in determining the quality of worklife regarding policy involvement, staffing levels, support for a nursing model of care, and physician-nurse relationships. The analysis supported a direct path (negatively weighted) from staffing to emotional exhaustion and a direct path (positively weighted) from nursing model of care to personal accomplishment. Details
Job Satisfaction Among Nurses: A Literature Review Elsevier Ltd , International Journal of Nursing Studies 2004 Lu H, While AE and Barriball KL [Excerpt from publisher]The current nursing shortage and high turnover is of great concern in many countries because of its impact upon the efficiency and effectiveness of any health-care delivery system. Recruitment and retention of nurses are persistent problems associated with job satisfaction. This paper analyses the growing literature relating to job satisfaction among nurses and concludes that more research is required to understand the relative importance of the many identified factors to job satisfaction. It is argued that the absence of a robust causal model incorporating organizational, professional and personal variables is undermining the development of interventions to improve nurse retention. Details
The Motivation of Health Personnel in Uganda World Health Organization, Regional Office for Africa - Best Practices in Human Resources for Health Development 2006 This video examines Uganda's pay reforms and other financial and non-financial incentives for health personnel in the public sector. Note: Access to a media player is required to veiw this clip. Details
Wastage in the Health Workforce: Some Perspectives from African Countries Human Resources for Health 2005 Dovlo D [Excerpt from author] Background: Sub-Saharan Africa faces a human resources crisis in the health sector. Over the past two decades its population has increased substantially, with a significant rise in the disease burden due to HIV/AIDS and recurrent communicable diseases and an increased incidence of noncommunicable diseases. This increased demand for health services is met with a rather low supply of health workers, but this notwithstanding, sub-Saharan African countries also experience significant wastage of their human resources stock. Conclusion: The paper reviews strategies that have been proposed and/or implemented. It suggests areas needing further attention, including: developing and using indicators for monitoring and managing wastage; enhancing motivation and morale of health workers; protecting and valuing the health worker with enhanced occupational safety and welfare systems; and establishing the moral leadership to effectively tackle HIV/AIDS and the brain drain. Details
Preservice Implementation Guide: A Process for Strengthening Preservice Education JHPIEGO 2002 Schaefer L (ed) [Excerpt from Preface] This Preservice Implementation Guide describes the step-by-step process used to create a positive environment on the national level for strengthening preservice education and the steps taken on the institutional level to impove the existing curriculum and its implementation. Details
The Nine Step Guide to Implementing Clinic Supervision Health Systems Trust 2005 Davids S and Loveday M [Excerpt from authors] This booklet focuses on how to implement clinic supervision. Although it does not go into any great depth or detail, it aims to assist managers, programme coordinators, clinic supervisors and facility managers find their way in the day to day supervision of quality of care. The Nine Step Guide addresses implementation in an easy to follow method, using a number of tools and practical examples gathered from the districts where HST has worked over the last three years. Details
The Influence of Manager Behavior on Nurses' Job Satisfaction, Productivity, and Commitment Lippincott Williams & Wilkins, Journal of Nursing Administration 1997 McNeese-Smith DK [Excerpt from publisher] How do managers influence their nurses' job satisfaction, productivity, and commitment to the organization? The author discusses the findings of her study, drawing comparisons to other studies and suggesting implications for improving managerial supervision, organizational performance, and outcomes. Details
Pay and Non-Pay Incentives, Performance and Motivation World Health Organization 2001 Hicks V and Adams O [Excerpt from authors] This paper provides an overview of evidence of the effects of incentives on the performance and motivation of independent health professionals and health workers. Incentives are viewed in the context of objectives held by paying agencies or employers. The review defines the nature of economic incentives and of non-financial incentives. Particular attention is paid to the need for developing countries to understand the impacts of health reform measures on incentives. Details
Making Supervision Supportive and Sustainable: New Approaches to Old Problems Management and Leadership Program, Management Sciences for Health 2002 Marquez L, and Kean L [Excerpt from authors] This paper distills lessons from recent efforts to improve the supervision of family planning and health programs in developing countries and identifies approaches that may be more effective and sustainable. It describes supportive supervision, an approach to supervision that emphasizes joint problem-solving, mentoring, and two-way communication between supervisors and those being supervised. It also expands the concept of effective supervision by exploring how self-assessment and peer assessment, as well as community input, can be seen as vital components of results-oriented, supportive supervision. Details
Health Sector Reform and Public Sector Health Worker Motivation: A Conceptual Framework Elsevier Science Ltd., Social Science and Medicine 2002 Franco LM, Bennett S and Kanfer R [Excerpt from authors] Motivation in the work context can be defined as an individual's degree of willingness to exert and maintain an effort towards organizational goals. Health sector performance is critically dependent on worker motivation, with service quality, efficiency, and equity, all directly mediated by workers' willingness to apply themselves to their tasks. Resource availability and worker competence are essential but not sufficient to ensure desired worker performance. While financial incentives may be important determinants of worker motivation, they alone cannot and have not resolved all worker motivation problems. Worker motivation is a complex process and crosses many disciplinary boundaries, including economics, psychology, organizational development, human resource management, and sociology. This paper discusses the many layers of influences upon health worker motivation: the internal individual-level determinants, determinants that operate at organizational (work context) level, and determinants stemming from interactions with the broader societal culture. Details
Addressing the Health Workforce Crisis: Towards a Common Approach Human Resources for Health 2006 Dal Poz MR, Quain E, O'Neil M, McCaffery J ,Elzinga G and Martineau T [Excerpt from authors] The challenges in the health workforce are well known and clearly documented. What is not so clearly understood is how to address these issues in a comprehensive and integrated manner that will lead to solutions. This editorial presents - and invites comments on - a technical framework intended to raise awareness among donors and multisector organizations outside ministries of health and to guide planning and strategy development at the country level. Details
HIV/AIDS, Human Resources and Sustainable Development Joint United Nations Programme on HIV/AIDS (UNAIDS) 2002 [Excerpt from publisher] AIDS is sapping vital components and attributes of potentially successful development strategies. By draining human resources, the epidemic distorts labour markets, disrupts production and consumption, and ultimately diminishes national wealth. Some countries bearing the brunt of such effects now face the prospect of 'un-developing'-of seeing their development achievements dissolve in the wake of the epidemic. Details
Exploring the Influence of Workplace Trust Over Health Worker Performance - Preliminary National Overview Report : South Africa Health Economics and Financing Programme, London School of Hygiene and Tropical Medicine 2004 Gilson L, Khumalo G, Erasmus E, Mbatsha S and McIntyre Di [Excerpt from authors]A study exploring the influence of workplace trust over health worker performance at primary care level was undertaken in South Africa and Tanzania in 2003. The study aimed to:review the policy environment and contextual factors influencing primary care delivery and health worker motivation;explore the managerial and organizational influences over workplace trust at primary care level;consider the influence of workplace trust over health worker motivation and performance, with particular regard to attitudes and behaviours towards patients;draw preliminary recommendations for improving primary care managementestablish a foundation for future investigation of the workplace trust and health worker performance. Details
Exploring the Influence of Workplace Trust Over Health Worker Performance - Preliminary National Overview Report: Tanzania Health Economics and Financing Programme, London School of Hygiene and Tropical Medicine 2004 Manzi F, Kida T, Mbuyita S, Palmer N and Gilson L [Excerpt from authors] A study exploring the influence of workplace trust over health worker performance at primary care level was undertaken in Tanzania and South Africa in 20031. The study aimed to:review the policy environment and contextual factors influencing primary care delivery and health worker motivation;explore the ma nagerial and organizational influences over workplace trust at primary care level;consider the influence of workplace trust over health worker motivation and performance, with particular regard to attitudes and behaviours towards patients;draw preliminary recommendations for improving primary care managementestablish a foundation for future investigation of the workplace trust and health worker performance. Details
Health Worker Motivation in Africa: The Role of Non-financial Incentives and Human Resource Management Tools Human Resources for Health 2006 Mathauer I and Imhoff I [Excerpt from authors] Background: There is a serious human resource crisis in the health sector in developing countries, particularly in Africa. One of the challenges is the low motivation of health workers. Experience and the evidence suggest that any comprehensive strategy to maximize health worker motivation in a developing country context has to involve a mix of financial and non-financial incentives. This study assesses the role of non-financial incentives for motivation in two cases, in Benin and Kenya. Details
A Comprehensive Systematic Review of Evidence on the Structure, Process, Characteristics and Composition of a Nursing Team that Fosters a Healthy Work Environment Blackwell Publishing, Inc., International Journal of Evidence-based Healthcare 2006 Pearson A, Porritt K, Doran D, Vincent L, Craig D, Tucker D and Long L [Excerpt from authors] The overall aim of this systematic review was to identify the best available evidence on the relationship between the knowledge, competencies and behaviours of nurses exhibiting professional practice in their workplace; and the development of a healthy work environment. The results of the review suggest a number of recommendations for practice and research on creating a healthy work environment. Details
Worlds Apart? The UK and International Nurses Royal College of Nursing, UK 2006 Buchan J and Seccombe I This interim commentary provides an overview briefing on the UK nursing labour market, with a specific focus on international issues. The commentary is being published in advance of a full labour market review, due out later in the year. Details
Managing Health Professional Migration from sub-Saharan Africa to Canada: A Stakeholder Inquiry into Policy Options Human Resources for Health 2006 Labont? R, Packer C and Klassen N [Excerpt from authors] Background: Canada is a major recipient of foreign-trained health professionals, notably physicians from South Africa and other sub-Saharan African countries. Nurse migration from these countries, while comparatively small, is rising. African countries, meanwhile, have a critical shortage of professionals and a disproportionate burden of disease. What policy options could Canada pursue that balanced the right to health of Africans losing their health workers with the right of these workers to seek migration to countries such as Canada? Details
The Globalization of the Labour Market for Health-Care Professionals International Labour Organization, International Labour Review 2006 Clark PF, Stewart JB and Clark DA [Excerpt from publisher]The worldwide shortage of health-care workers has led to a brain drain that is negatively affecting the health-care systems of less affluent countries. The authors study the factors encouraging nurses and doctors to migrate, measure the costs and benefits of such migration and analyse methods of foreign recruitment. They then look at the theories that help explain this phenomenon: human capital theory, theories of neo-colonialism and of globalization. They conclude with a policy discussion of possible strategies, which include addressing the "push" factors motivating migration, focusing training on local health-care needs, signing bilateral agreements that limit migration, etc. Details
Positive Practice Environments - Key Considerations for the Development of a Framework to Support the Integration of International Nurses International Centre on Nurse Migration 2006 Adams E and Kennedy A [Excerpt from authors]This paper focuses on nurses who have migrated and are registered/licensed/authorised to practice, post-adaptation/orientation, and are working as a nurse in a given country. The term international nurse is used for nurses who have been educated abroad and have either been recruited or have chosen to migrate. This paper aims to provide an overview of the influences of international policies and agreements, the social and personal benefits and costs of migration for international nurses based on their experiences, and to outline a possible framework to develop positive practice environments to support long-term integration and the retention of this valuable resource. Details
ICN on Occupational Stress and the Threat to Worker Health International Council of Nurses 0 This Nursing Matters fact sheet provides quick reference information and international perspectives from the nursing profession on occupational stress. Details
The Financial Losses from the Migration of Nurses from Malawi BMC Nursing 2006 Muula AS, Panulo B Jr and Maseko FC [Excerpt from authors]Background: The migration of health professionals trained in Africa to developed nations has compromised health systems in the African region. The financial losses from the investment in training due to the migration from the developing nations are hardly known. Conclusion: Developing countries are losing significant amounts of money through lost investment of health care professionals who emigrate. There is need to quantify the amount of remittances that developing nations get in return from those who migrate. Details
Assessing Human Resources for Health: What Can Be Learned From Labour Force Surveys? Human Resources for Health 2003 Gupta N, Diallo K, Zurn P and Dal Poz M [Excerpt from authors]Background: Human resources are an essential element of a health system's inputs, and yet there is a huge disparity among countries in how human resource policies and strategies are developed and implemented. The analysis of the impacts of services on population health and well-being attracts more interest than analysis of the situation of the workforce in this area. This article presents an international comparison of the health workforce in terms of skill mix, sociodemographics and other labour force characteristics, in order to establish an evidence base for monitoring and evaluation of human resources for health. Details
Qualitative Study of Iranian Nurses' Understanding and Experiences of Professional Power Human Resources for Health 2004 Hagbaghery MA , Salsali M and Ahmadi F [Excerpt from authors] Nurses are expected to empower their clients, but they cannot do so if they themselves feel powerless. They must become empowered before they can empower others. Some researchers have emphasized that understanding the concept of power is an important prerequisite of any empowerment program. While many authors have tried to define the concept of power, there is no comprehensive definition. This paper is an attempt to clarify the concept of power in nursing. It also would present a model describing the factors affecting nurse empowerment. Details
The Match Between Motivation and Performance Management of Health Sector Workers in Mali Human Resources for Health 2006 Dieleman M ,Toonen J , Tour? H and Martineau T [Excerpt from authors]Human resources for health (HRH) play a central role in improving accessibility to services and quality of care. Their motivation influences this. In Mali, operational research was conducted to identify the match between motivation and the range and use of performance management activities. Details
Identifying Factors for Job Motivation of Rural Health Workers in North Viet Nam Human Resources for Health 2003 Dieleman M , Viet Cuong P , Le Vu Anh2 and Tim Martineau3 [Excerpt from authors] Background: In Viet Nam, most of the public health staff (84%) currently works in rural areas, where 80% of the people live. To provide good quality health care services, it is important to develop strategies influencing staff motivation for better performance. Method: An exploratory qualitative research was carried out among health workers in two provinces in North Viet Nam so as to identify entry points for developing strategies that improve staff performance in rural areas. The study aimed to determine the major motivating factors and it is the first in Viet Nam that looks at health workers' job perception and motivation. Apart from health workers, managers at national and at provincial level were interviewed as well as some community representatives. Results: The study showed that motivation is influenced by both financial and non-financial incentives. The main motivating factors for health workers were appreciation by managers, colleagues and the community, a stable job and income and training. The main discouraging factors were related to low salaries and difficult working conditions. Conclusion: Activities associated with appreciation such as performance management are currently not optimally implemented, as health workers perceive supervision as control, selection for training as unclear and unequal, and performance appraisal as not useful. The kind of non-financial incentives identified should be taken into consideration when developing HRM strategies. Areas for further studies are identified. Details
Factors Affecting the Performance of Maternal Health Care Providers in Armenia Human Resources for Health 2004 Fort AL and Voltero L [Excerpt from authors] Over the last five years, international development organizations began to modify and adapt the conventional Performance Improvement Model for use in low-resource settings. This model outlines the five key factors believed to influence performance outcomes: job expectations, performance feedback, environment and tools, motivation and incentives, and knowledge and skills. Each of these factors should be supplied by the organization in which the provider works, and thus, organizational support is considered as an overarching element for analysis. Little research, domestically or internationally, has been conducted on the actual effects of each of the factors on performance outcomes and most PI practitioners assume that all the factors are needed in order for performance to improve. This study presents a unique exploration of how the factors, individually as well as in combination, affect the performance of primary reproductive health providers (nurse-midwives) in two regions of Armenia. Details
Improving Motivation Among Primary Health Care Workers in Tanzania: A Health Worker Perspective Human Resources for Health 2006 Manongi RN, Marchant TC and Bygbjerg IC [Excerpt from authors]In Tanzania access to urban and rural primary health care is relatively widespread, yet there is evidence of considerable bypassing of services; questions have been raised about how to improve functionality. The aim of this study was to explore the experiences of health workers working in the primary health care facilities in Kilimanjaro Region, Tanzania, in terms of their motivation to work, satisfaction and frustration, and to identify areas for sustainable improvement to the services they provide. The primary issues arising pertain to complexities of multitasking in an environment of staff shortages, a desire for more structured and supportive supervision from managers, and improved transparency in career development opportunities. Further, suggestions were made for inter-facility exchanges, particularly on commonly referred cases. The discussion highlights the context of some of the problems identified in the results and suggests that some of the preferences presented by the health workers be discussed at policy level with a view to adding value to most services with minimum additional resources. Details
Public Sector Nurses in Swaziland: Can the Downturn be Reversed? Human Resources for Health 2006 Kober K and Van Damme W [Excerpt from authors] The lack of human resources for health (HRH) is increasingly being recognized as a major bottleneck to scaling up antiretroviral treatment (ART), particularly in sub-Saharan Africa, whose societies and health systems are hardest hit by HIV/AIDS. In this case study of Swaziland, we describe the current HRH situation in the public sector. We identify major factors that contribute to the crisis, describe policy initiatives to tackle it and base on these a number of projections for the future. Finally, we suggest some areas for further research that may contribute to tackling the HRH crisis in Swaziland. Emigration and attrition due to HIV/AIDS are undermining the health workforce in the public sector of Swaziland. Short-term and long-term measures for overcoming this HRH crisis have been initiated by the Swazi government and must be further supported and increased. Scaling up antiretroviral treatment (ART) and making it accessible and acceptable for the health workforce is of paramount importance for halting the attrition due to HIV/AIDS. To this end, we also recommend exploring ways to make ART delivery less labour-intensive. The production of nurses and nursing assistants must be urgently increased. Although the migration of HRH is a global issue requiring solutions at various levels, innovative in-country strategies for retaining staff must be further explored in order to stem as much as possible the emigration from Swaziland. Details
The Importance of Human Resources Management in Health Care: A Global Context Human Resources for Health 2006 Kabene SM, Orchard C, Howard JM , Soriano MA and Leduc R [Excerpt from authors]This paper addresses the health care system from a global perspective and the importance of human resources management (HRM) in improving overall patient health outcomes and delivery of health care services. Various key success factors emerge that clearly affect health care practices and human resources management. This paper will reveal how human resources management is essential to any health care system and how it can improve health care models. Challenges in the health care systems in Canada, the United States of America and various developing countries are examined, with suggestions for ways to overcome these problems through the proper implementation of human resources management practices. Details
Iranian Staff Nurses' Views of Their Productivity and Human Resource Factors Improving and Impeding It: A Qualitative Study Human Resources for Health 2005 Nayeri ND, Nazari AA, Salsali M and Ahmadi F [Excerpt from authors] Nurses, as the largest human resource element of health care systems, have a major role in providing ongoing, high-quality care to patients. Productivity is a significant indicator of professional development within any professional group, including nurses. The human resource element has been identified as the most important factor affecting productivity. This research aimed to explore nurses' perceptions and experiences of productivity and human resource factors improving or impeding it. Details
Identifying Nurses' Rewards: A Qualitative Categorization Study in Belgium Human Resources for Health 2006 De Gieter S , De Cooman R, Pepermans R, Caers R , Du Bois C and Jegers M [Excerpt from authors]Rewards are important in attracting, motivating and retaining the most qualified employees, and nurses are no exception to this rule. This makes the establishment of an efficient reward system for nurses a true challenge for every hospital manager. A reward does not necessarily have a financial connotation: non-financial rewards may matter too, or may even be more important. Therefore, the present study examines nurses' reward perceptions, in order to identify potential reward options. Details
Economic Incentive in Community Nursing: Attraction, Rejection or Indifference? Human Resources for Health 2003 Kingma M [Excerpt from author] It is hard to imagine any period in time when economic issues were more visible in health sector decision-making. The search for measures that maximize available resources has never been greater than within the present decade. A staff payroll represents 60%-70% of budgeted health service funds. The cost-effective use of human resources is thus an objective of paramount importance. Using incentives and disincentives to direct individuals' energies and behaviour is common practice in all work settings, of which the health care system is no exception. The range and influence of economic incentives/disincentives affecting community nurses are the subject of this discussion paper. The tendency by nurses to disregard, and in many cases, deny a direct impact of economic incentives/disincentives on their motivation and professional conduct is of particular interest. The goal of recent research was to determine if economic incentives/disincentives in community nursing exist, whether they have a perceivable impact and in what areas. Details
Nurse: Patient Ratios - ICN Fact Sheet International Council of Nurses 2003 [Excerpt from publisher] This Nursing Matters fact sheet provides quick reference information and international perspectives from the nursing profession on nurse: patient ratios. Details
Health Human Resources Trends in the Americas: Evidence for Action (Draft for Discussion) Pan American Health Organization's Observatory of Human Resources in Health - PAHO/WHO 2006 Cameron R [Excerpt from author] This collaborative review of human resources for health in the Americas was undertaken in follow-up to the Toronto Call to Action, the Seventh Regional Meeting of the Pan American Health Organization's Observatory of Human Resources in Health, held in Toronto, Ontario, Canada, October 4-7, 2005 [....] The report recommends that: a clear determination of the region's supply of health human resources be undertaken; a code of practice for the management of the internal recruitment of health care professionals be collaboratively developed and implemented; community-based workforce recruitment and retention mechanisms be supported that are responsive to local workforce needs; total enrollments and student mix in professional schools be closely linked to identified community needs and that policies and incentives be introduced to reduce student attrition and to enhance the geographic distribution of the health workforce; primary health care delivery teams, that emphasize an increase in both nursing numbers and their competency ranges to maximize service delivery flexibility should be supported and promoted at the community level; and, an inter-regional expert team be struck to develop a human resource planning framework, to identify regional planning priorities, to conduct country assessments in the areas of highest need, and, to promote the development of a health human resource minimum data set to support the region's current and long-term planning processes. Details
Workplace Violence in the Health Sector: Country Case Studies: Brazil, Bulgaria, Lebanon, Portugal, South Africa, Thailand, and an Additional Australian Study International Labour Office; International Council of Nurses; World Health Organization; Public Services International 2002 Di Martino V [Excerpt from author]The International Labour Office (ILO), the International Council of Nurses (ICN), the World Health Organization (WHO) and Public Services International (PSI) launched in 2000 a joint programme in order to develop sound policies and practical approaches for the prevention and elimination of violence in the health sector. When the programme was first established and information gaps were identified, it was decided to launch a number of country studies as well as cross-cutting theme studies and to conclude by drafting guidelines to address workplace violence in the health sector. This working paper presents the Synthesis Report of the commissioned country reports to stimulate further discussion in the area of workplace violence, encourage fact-finding research in other countries and support sound policy-making. Details
ILO Nursing Personnel Convention No.149 - Recognize Their Contribution Address Their Needs International Labour Office 2005 [Excerpt from publisher] In 2002, the ILO classified the Nursing Personnel Convention (C 149) as an up-to-date instrument, reaffirming its relevance in today's socio-economic realities. This Convention is nearly 30 years old, yet sadly not much progress has been made in many countries towards improving working conditions in nursing. The same concerns that prompted international attention on working conditions in health services in the 1970's unfortunately still prevail today. The health care profession is not attracting enough recruits in both developed and developing countries to keep up with demand, and in addition, it is also losing large numbers of trained personnel to areas outside the sector. Details
Framework Guidelines for Addressing Workplace Violence in the Health Sector - The Training Manual International Labour Organization; International Council of Nurses; World Health Organization; Public Services International 2005 di Martino V [Excerpt from author] The Guidelines provide definitions of workplace violence and guidance on general rights and responsibilities; best approaches; violence recognition; violence assessment; workplace interventions; monitoring and evaluation. This Training Manual is a complement to the Framework Guidelines. It is a practical, user-friendly tool that builds on the policy approach of the Framework Guidelines. Representatives of governments, employers and workers would be well served to use the Manual in training situations, so as to encourage social dialogue among health sector stakeholders and develop, in consultation, approaches to address violence in the workplace. Details
Working Well: A Call to Employers - A summary of the RCN Royal College of Nursing, UK 2002 [Excerpt from publisher] [This paper provides]a summary of the RCN Working well survey into the wellbeing and working lives of nurses, plus recommendations for employer. This document summarises the key findings from the survey. It looks at: - the rationale for undertaking the survey - what makes a good employer - detailed findings from each of the employment practices covered in the survey - nurses' psychological health and wellbeing - recommendations for consulting on and implementing employee-friendly working for nurses, negotiators and employers. Details
Dealing With Bullying and Harassment : A Guide for Nursing Students Royal College of Nursing UK, Working Well Initiative 2002 [Excerpt from publisher]This guide is aimed mainly at nursing students. It should help you to:recognise if you or a colleague are being bullied or harassedtake action against bullying and harassment We also want to:raise awareness of the problem of employers and educators as well as students-if people are aware of the problem, then they can take steps to stop it happeningencourage nursing educators and employers to carry through anti-harassment policies. Details
Implications of Organizational Learning for Nursing Managers From the Cultural, Interpersonal and Systems Thinking Perspectives Blackwell Publishing, Inc., Nursing Inquiry 2001 Chan C-PCA [Excerpt from author] This paper discusses the implications of organizational learning to healthcare administrators, in particular nursing managers, from the cultural, interpersonal and systems thinking perspectives. In the various perspectives the reasons for organizational ineffectiveness and remedies are presented. There is little doubt that pressure for nurses to perform is escalating as healthcare institutions attempt to improve the quality of service through restructuring and change, which leads to greater job dissatisfaction, higher turnover, lower morale and increased industrial actions of nurses. An integrated approach to organizational learning is arguably important for the effective management of nurses during periods of transition. Details
Primary Nurses' Performance: Role of Supportive Management Blackwell Publishing, Inc., Journal of Advanced Nursing 2004 Drach-zahavy A [Excerpt from author] Background: Most studies examining primary nursing focus on outcome variables such as enhanced patient and staff satisfaction with care, perceived autonomy and quality of care, whereas only limited research has examined processes of implementing and maintaining primary nursing. In addition, the few studies that have explored process variables discuss only direct relationships between the design of the primary nursing care-delivery system, process and nurse outcomes, and disregard how such variables interact. Aim: This study sought to address previous inconsistent findings about the impact of primary nursing care-delivery models on the performance of nurses by incorporating the moderating role of supportive management practices. Details
Framework for Developing Nursing Roles Scottish Executive Health Department 2005 [Excerpt from publisher] The purpose of this document is twofold. It presents a generic framework which can be used to guide the development of new roles. The framework has been developed in partnership with representatives from other staff groups. It may be applied equally to role development in nursing as well as, for example, the Allied Health Professions or Pharmacy. It can be used to assist in the planning process to ensure that roles are needs led, meet governance requirements, are sustainable, as well as ensuring that the development is supported by the whole team thus ensuring its success. The rest of the document contains a rationale for structured role development in nursing. It describes the context and drivers for change, principles which should underpin nursing roles, and emphasises the importance of a career structure within which new roles may sit comfortably. The framework is aimed at four key groups:Patients and carers, their representatives and voluntary organisationsNurses, midwives, other health professionals and social care professionalsEducation providers and researchersManagers of services and service providers. Details
A Methodology for Assessing the Professional Development Needs of Nurses and Midwives in Indonesia: Paper 1 of 3 Human Resources for Health 2006 Hennessy D, Hicks C, Hilan A and Kawonal Y [Excerpt from authors] Despite recent developments, health care provision in Indonesia remains suboptimal. Difficult terrain, economic crises, endemic diseases and high population numbers, coupled with limited availability of qualified health care professionals, all contribute to poor health status. In a country with a population of 220 million, there are currently an estimated 50 nurses and 26 midwives per 100 000 people. In line with government initiatives, this series of studies was undertaken to establish the training and development needs of nurses and midwives working within a variety of contexts in Indonesia, with the ultimate aim of enhancing care provision within these domains. Details
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