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ICHRN Knowledge Library

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

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Outcomes of Variation in Hospital Nurse Staffing in English Hospitals: Cross-sectional Analysis of Survey Data and Discharge Records Elsevier, International Journal of Nursing Studies 2006 Rafferty AM, Clarke SP, Coles J, Ball J, James P, McKee M and Aiken L [Excerpt from authors] Objectives: To examine the effects of hospital-wide nurse staffing levels (patient-to-nurse ratios) on patient mortality, failure to rescue (mortality risk for patients with complicated stays) and nurse job dissatisfaction, burnout and nurse rated quality of care. Conclusions: Nurse staffing levels in NHS hospitals appear to have the same impact on patient outcomes and factors influencing nurse retention as have been found in the USA. Details
Overview of the Nursing Workforce in Latin America Pan American Health Organization; International Council of Nurses 2005 Malvarez SM and Agudelo MCC [Excerpt from authors]This paper was drafted by the Pan-American Health Organization (PAHO) as the basis for the examination of this important aspect of health care in the region of Latin America, and as a contribution to the International Council of Nurses (ICN). The analysis takes as its framework Pedro Brito Quintana's concept of field of human resources for health. That is, the health care workforce is structured and dynamised by all its aspects, activating processes, tensions and conflicts in accordance with the delivery of health care services. The four central aspects consist of work, education, the labour market and professionalisation processes. These variables are subject to and produce policies, regulations and management mechanisms. Different parties participate with various interests, abilities and degrees of power in the context of their social dynamics. Fran?ais: http://www.icn.ch/global/Issue6LatinAmericaFR.pdf Espa?ol: http://www.icn.ch/global/Issue6LatinAmericaSP.pdf Details
Nurse Retention and Recruitment: Developing a Motivated Workforce International Council of Nurses; World Health Organization 2005 Zurn P, Dolea C and Stilwell B [Excerpt from authors] Recruiting and keeping the right staff are key challenges for health policy-makers. The performance and quality of a health system ultimately depend on the quality and motivation of health human resources. Therefore, recruitment and retention problems should be appropriately addressed, as nursing staff shortages and low motivation are likely to have adverse effects on the delivery of health services and the outcome of care. The main objective of this paper is to examine how to develop and retain a motivated nursing workforce. Fran?ais: http://www.icn.ch/global/Issue4RetentionFR.pdf Espa?ol: http://www.icn.ch/global/Issue4RetentionSP.pdf Details
Nursing Workforce Planning: Mapping the Policy Trail International Council of Nurses 2005 O'Brien-Pallas L, Duffield C, Tomblin Murphy G, Birch S and Meyer R [Excerpt from authors] Planning for the efficient and effective delivery of health care services to meet the health needs of the populations is a significant challenge. Globally policy makers, educators, health service researchers, leaders of unions and professional associations, and other key stakeholders struggle with the best way to plan for a workforce to fulfil the health needs of populations. To meet this challenge, achieving the appropriate balance between human and non-human resources is important and requires continuous monitoring, careful attention to the country specific context in which policy decisions are made, and evidence-based decision-making. This paper provides an overview of current evidence and policy initiatives pertinent to the nursing workforce including: health human resource (HHR) planning, service planning and modelling; nursing workforce imbalances and internal migration; and approaches to nursing deployment and utilisation. Policy implications and recommendations are offered. Fran?ais: http://www.icn.ch/global/Issue2workforceFR.pdf Espa?ol: http://www.icn.ch/global/Issue2workforceSP.pdf Details
One Million More: Mobilising the African Diaspora Healthcare Professionals for Capacity Building in Africa Save the Children 2006 Blanchet K, Keith R and Shackleton P [Excerpt from authors] One Million More presents some of the interventions, debates, discussions and conclusions of a conference held in London from 21-22 March 2006.The conference was organised to create a stimulating and interactive forum to discuss the crisis in human resources for health, in an effort to influence national, regional and international policies for the promotion of sustainable skills capacity in Africa and to engage the African diaspora in innovative, practical steps to move the agenda forward. *This publication is no longer available online. Details
Advancing Nursing Leadership in long-term care Longwoods 2010 0'Brien j, Ringland M & Wilson S "Nurses working in the long-term care (LTC) sector face unique workplace stresses, demands and circumstances. Designing approaches to leadership training and other supportive human-resource strategies that reflect the demands of the LTC setting fosters a positive work life for nurses by providing them with the skills and knowledge necessary to lead the care team and to address resident and family issues." (extract from abstract) Details
How can optimal skill mix be effectively implemented and why? World Health Organization & the European Observatory on Health Systems & Policies 2008 2008 Bourgeault, L, Kuhlmann, E, Neiterman, E & Wrede, S "In this policy brief, we have described the major drivers of skill-mix initiatives, the types of skill-mix option pursued and the critical contextual facilitators and constraints to the implementation of these pursuits across several countries in the European region - all of which are experiencing a number of challenges to human resources for health, some similar and others country specific. Also, we have highlighted the evidence (or lack thereof) for the costs that can reasonably be expected of some of these decisions and initiatives." (excerpt from authors) This policy brief was written for the WHO European Minissterial Conference on health Systems, 25-27 June 2008, Tallinn, Estonia. Details
How Can the Migration of Health Service Professionals be Managed so as to Reduce any Negative Effects on Supply? WHO Regional Office for Europe 2008 Buchan J [Excerpt from author]This brief considers the policy implications in Europe of the international migration of health workers and addresses the question of how the migration of health service professionals can be managed in ways that reduce any negative effects on supply. Also available in French, German and Russian Details
Health Workers for All and All for Health Workers: An Agenda for Global Action Global Health Workforce Alliance 2008 The Global HealthWorkforce Alliance released its Agenda for Global Action during the First Global Forum on Human Resources for Health (HRH) held 2-7 March 2008 in Kampala, Uganda. The purpose of the Agenda is to "guide the initial steps in a coordinated global, regional and national response to the worldwide shortage and maldistribution of health workers, moving towards universal access to quality health care and improved health outcomes." It calls for action around six interrelated strategies. Also available in French http://www.who.int/workforcealliance/forum/1_Agenda_french_FIN.pdf Details
National NHS Staff Survey: Summary of Key Findings Healthcare Commission 2008 [Excerpt from publisher]The purpose of the survey is to look at the attitudes and experiences of NHS staff both nationally, because of the importance of the NHS, and by individual trust, so that employers can review any issues with their own staff and take action. To enable this, we have already provided each NHS trust with its own detailed report. This report outlines the principal findings from the survey for the NHS as a whole, and includes comparisons with the results of previous surveys wherever possible. Details
Model Nursing Act International Council of Nurses 2008 Wallace M [Excerpt from author]This material looks in detail at the preparation of a Nursing Act and is designed to offer guidance on the process of turning policy change in nursing into meaningful and effective legislation. A Nursing Act is required to establish an effective statutory regulatory system (i.e. a system underpinned by legislation) for nursing. This document has been prepared primarily to assist countries/jurisdictions who are either preparing legislation relating to nursing for the first time, or revising their existing legislation. It is intended to be used, in the main, by nursing professionals who may not be familiar with the process of making or changing legislation. Details
Human Resources for Health: A Gender Analysis Women and Gender Equity, and Health Systems, Knowledge Networks (KNs) of the WHO Commission on the Social Determinants of Health 2007 George A [Excerpt from author]In this paper I discuss gender issues manifested within health occupations and across them. In particular, I examine gender dynamics in medicine, nursing, community health workers and home carers. I also explore from a gender perspective issues concerning delegation, migration and violence, which cut across these categories of health workers. These occupational categories and themes reflect priorities identified by the terms of reference for this review paper and also the themes that emerged from the accessed literature. Details
Healthy Workplaces and Productivity: A Discussion Paper Minister of Public Works and Government Services Canada 2003 Lowe G [Description from publisher] A recent report prepared for Health Canada, Work Network Research Associate, Graham Lowe, explores the relationship between workplace health and productivity. Details
National Survey of NHS Staff 2006 Healthcare Commission 2007 [Excerpt from publisher] In October 2006, a total of 240,580 staff in the NHS were asked about their views and experiences of working for the NHS in England in the fourth annual survey of NHS staff. The survey is believed to be the largest annual staff survey in the world and this year 128,328 NHS employees took part, representing 53.6%. PCTs who were reconfigured in October 2006 were not required to participate in this year's survey and we will not use the data from the 2006 staff survey to assess these PCTs in the 2006/2007 annual health check. The 2006 survey provides information on the attitudes and experiences of staff in the NHS and can be used to improve working conditions and practices in healthcare services and therefore the quality of care provided to patients. All trusts have received their own survey results, along with detailed information about how these compare with other trusts. The results from this survey help to meet two of the Commission's objectives: (1)to provide local NHS trusts with information to improve the working conditions and experiences of their staff (2) to provide results for deriving measures of the performance of NHS trusts for use in the Healthcare Commission's annual health check Details
Health Worker Motivation in Jordan and Georgia: A Synthesis of Results Partnerships for Health Reform 2000 Franco LM, Bennett S, Kanfer R and Stubblebine P [Excerpt from authors] Health worker motivation has the potential to have a large impact on health systems performance, yet little is known about the key determinants and outcomes of motivation in developing and transition countries. This study, conducted in Jordan and Georgia (at two hospitals each), used a three-pronged approach to data collection: 1) a contextual analysis, 2) a 360 degree assessment, and 3) in-depth analysis focused on the individual determinants and outcomes of the worker's motivational process. Details
Public Sector Health Worker Motivation and Health Sector Reform Partnerships for Health Reform- PHR Primer for Policymakers 2000 Bennett S and Franco LM [Excerpt from authors] It is becoming increasing important that policymakers be aware of health worker motivation and it's impact on health sector performance. Health care delivery is highly labor-intensive, and service quality, efficiency, and equity are all directly mediated by workers' willingness to apply themselves to their tasks. While resource availability and worker competencies are essential, decision makers should know that they are not sufficient in themselves to ensure desired worker performance. Worker performance is also dependent on workers' level of moti-vation stimulating them to come to work regularly, work diligently, and be flexible and willing to carry out the necessary tasks. Details
Health Human Resources Development - ICN Position Statement International Council of Nurses 1999 [Excerpt from publisher] ICN judges that health human resources development (HHRD) requires an interdisciplinary, inter-sectorial and multi-service approach. This recognises the complementary roles of health service providers, and values the contribution of the different disciplines. Inputs are required from the key stake holders -- consumers, service providers, educators, researchers, employers, managers, governments, funders and health professions' organisations. Similarly, ICN acknowledges that integrated and comprehensive health human resources information systems and planning models are desired outcomes of this consulting process. When new categories of health workers are created or role changes are introduced, the possible consequences on national and local health human resources need to be identified and planned for at the outset.... Details
Human Resources for Health in Europe World Health Organization on behalf of European Observatory on Health Systems and Policies; Open University Press 2006 Dubois CA, McKee M and Nolte E (eds) [Excerpt from forward] This book is one of the first to address comprehensively many of the key issues for human resources development across Europe, in the EU, the new EU member states and the countries of the former Soviet Union. The authors also take a look at the action required at strategic, regional and local levels in Europe to strengthen skills, expertise and analysis of human resources for health and to strengthen the health professions' integration into health policy-making. The authors argue that new human resources systems, improved management and evidence-based training institutions are needed at regional and local levels in order to address new demands from patients as well as changing epidemiological and demographic contexts. Details
Human Resources for Health: Overcoming the Crisis Joint Learning Initiative; Global Equity Initiative, Harvard University 2004 [Excerpt from publisher] In this analysis of the global health workforce, the Joint Learning Initiative-a consortium of more than 100 health leaders-proposes that mobilization and strengthening of human resources for health is central to combating health crises in some of the world's poorest countries and for building sustainable health systems everywhere. This report puts forward strategies for the community, country, and global levels in overcoming this crisis through cooperative action. Details
Guidelines on Planning Human Resources for Nursing International Council of Nurses 1994 [Excerpt from publisher]Using a step-by-step approach, this document discusses the technical aspects of a comprehensive human resources planning process. Details
Vision, Grit and Collaboration: How the Wisconsic Centre for Nursing Acheived ASustainable Funding and Established Itself as a State Health Care Workfoce Leader SAGE journals online 2010 Acord LG, Dennik-Champion G, Lundeen S & Schuler S "In 2001, a dedicated group of nurses from across Wisconsin came together to discuss how to create a state center of expertise on key nursing workforce issues. The result was the establishment of the Wisconsin Center for Nursing (WCN) in 2005. ... This article will include the history of the WCN and the details of its journey toward sustainability including accomplishments and lessons learned" (excerpt from abstract). Details
Payment Regulations for Advanced Practice Nurses: Implications for Primary Care SAGE journals online 2010 Chapman SA, Wides CD & Spetz J "...Previous research suggests that Advanced Practice Registered Nurses (APRNs) can provide as high quality care and achieve the same health outcomes as physicians. However, APRNs are usually reimbursed at lower rates than physicians by both Medicare and Medicaid. ... A clear regulatory framework and payment rationale are needed along with data on the type and complexity of care provided by various practitioners to increase efficiencies and improve access to health care." (excerpt from abstract) Details
ICN Nursing Workforce Profiles (2002 - ) 0 Details
Joint Health Professions Statement on Task Shifting International Confederation of Midwives; International Council of Nurses; International Pharmaceutical Federation; World Confederation of Physical Therapists; World Dental Federation; World Medical Association 2008 [Excerpt from publishers] We, the representatives of more than 25 million health professionals, are committed to providing safe, accessible health care to the world's people. We understand all too well the impact of shortage of personnel, supplies and equipment on patients, families and providers. We witness the impact daily of not enough staff, not enough clean water, not enough drugs, not enough money to access services or to afford life's staples. We see health professionals mentally and physically exhausted daily. We struggle with the dilemma of resource restrictions and meeting the needs of everyone - and the evidence that shows that better health outcomes occur when higher numbers of professionals are engaged in direct care. We understand the need to address today's human resource crisis. At the same time we are concerned that task shifting and adding new cadres of workers result in fragmented and inefficient service through reductionist and vertical approaches. Details
Nursing Self Sufficiency/Sustainability in the Global Context International Centre on Nurse Migration and the International Centre for Human Resources in Nursing 2007 Little L and Buchan J [Excerpt from authors] The 2006 World Health Report has identified shortages of human resources as the critical obstacle to the achievement of the millennium development goals (MDGs). Nursing shortages are on the agenda in many countries, developed and developing, and the International Council of Nurses (ICN) has established a global workforce initiative which has highlighted that previous efforts to address nursing shortages have often been short term, fragmented and inadequate. One major challenge for all countries is to establish workforce planning mechanisms that effectively meet the demands for health care and provide workforce stability. However, few nations have developed strategic plans for meeting nursing resource requirements that effectively address supply and demand. Instead, many developed countries choose to implement short term policy levers such as increased reliance on immigration, sometimes to the detriment of developing countries. This has prompted calls for developed countries to employ a model of so-called "self sufficiency" in addressing nursing and other health human resource shortages. The aim of this paper is to examine what definitions and models of "self sufficiency" exist in a nursing workforce context, and discuss their implications for policy. There is broad agreement in the healt Details
Occupational Health and Safety Management Programme for Nurses International Council of Nurses 2007 Papp E [Excerpt from author]Nurses are falling ill, incurring workplace injuries, and suffering disabilities from exposure to workplace hazards. As a result, the global community is losing critical members of the health care team, compounding the already existing nurse staffing crisis and adversely affecting the health and well-being of the world's population. This needless attrition seriously impairs the fulfilment of the United Nations' Millennium Development Goals. As well, it adversely affects the world health community's ability to meet primary healthy care needs as defined in the 1978 WHO/UNICEF Alma Ata Declaration (WHO 1978). Details
Occupational Health and Safety for Nurses - ICN Position Statement International Council of Nurses 2006 [Excerpt from publisher]ICN is clear that a safe work environment in the health sector significantly contributes to patient safety and supports positive patient outcomes. To that end ICN promotes the development and application of international, national and local policies or instruments that will safeguard the nurses' right to a safe work environment, including continuing education, immunisation and protective clothing/equipment. ICN reconfirms its mandate to encourage research in this area and to circulate relevant information on a regular basis to appropriate stakeholders. Details
Abuse and Violence Against Nursing Personnel - ICN Position Statement International Council of Nurses 2006 [Excerpt from publisher] Sickness and potential life-threatening factors cause stress in patients, their family members, and personnel in the health workplace. Such stress can aggravate factors that lead to violence; the levels of which are reportedly on the increase in society in general, and in the health workplace in particular. Workplace violence is universal and pervasive. The impact of psychological violence is as great if not greater than physical violence. It is also more widespread. Working conditions in the health sector place nursing and other health personnel at greater risk of violence, because of:Staffing patterns, including inadequate staffing levels and supervision, the use of temporary and inexperienced staff, heavy workloads and being solely responsible for health care units.Shift work, including commuting to and from work at night.Poor security measures in health facilities.Interventions demanding close physical contact.Demanding workloads, often occurring in emotionally charged environments.Highly accessible worksites with little to no privacy.Home visiting with its associated isolation. Details
International Council of Nurses Nursing Workforce Profile 2002 International Council of Nurses 2002 Details
International Council of Nurses Nursing Workforce Profile 2005 International Council of Nurses 2005 Details
International Council of Nurses Nursing Workforce Profile 2004 International Council of Nurses 2004 Details
Nurse Wages and Their Context: Database Summary,ICN Asia Workforce Forum 2005 International Council of Nurses 2005 [Excerpt from publisher] The Nurse Wage Questionnaire was sent to 11 National Nurses' Associations, members of the ICN International Workforce Forum. Reponses were received from Hong Kong, Japan, Korea, Macau, Malaysia, Philippines, Singapore, Taiwan and Thailand. Most of the data throughout this analysis is presented in Purchasing Power Parity, or PPP. A PPP is a number that standardizes currency in order to facilitate international comparison. Purchasing power is equal when the ratio between countries' price level of a 'fixed basket of goods and services' is equal. In this analysis, PPPs will be used to represent wages and are a proxy for standard of living. Details
The nurse labour and education markets in the English-speaking CARICOM: Issues and options for reform The World Bank 2009 The World Bank "The chief objective of this second research phase was to produce a comprehensive assessment of the nurse labor and education markets of the ES CARICOM. Despite major research efforts, data limitations remained a significant problem. However, information gathered was sufficiently robust and complete to provide for the first time a comprehensive picture. As we elaborate in this report, it shows a highly fragile supply-side equilibrium that will be increasingly insufficient to meet local demand." *excerpt from ducment) Details
Leader empowering behaviours, staff nurse empowerment and work engagement/burnout Longwoods 2006 Greco P, Spence HK, Laschinger S and Wong C "The purpose of this study was to test a model examining the relationship between nurse leaders' empowerment behaviours, perceptions of staff empowerment, areas of work life and work engagement using Kanter's theory of structural power in organizations." (excerpt from abstract) Details
Keeping the Best: A Practical Guide to Retaining Key Employees Institute for Employment Studies 1997 Bevan S, Barber L and Robinson D [Excerpt from publisher]This book, which is intended to assist human resource professionals and line managers in the United Kingdom, is a practical guide to retaining key employees. Discussed in the introduction are the relationship between downsizing and retention, problems that retention difficulties pose for human resource management, and the effects of retention problems on labor market buoyancy. The next four chapters are devoted to the following topics: understanding why retention is a concern (external influences, consequences of turnover); determining whether retention is a problem (measuring labor turnover, making external comparisons, identifying key people and key posts, calculating the costs of labor turnover); understanding why people leave (voluntary resignations, isolation of reasons for leaving, reasons often given for leaving); and determining what can be done (recruitment and selection, induction and training, job design/content, job satisfaction, career progression, development opportunities, supervision and management, pay and benefits, retention bonuses, different deals, examples of action taken by employees). The final chapter is a case study of how one information technology company worked to improve its retention of key employees. Appended are the following: checklist for determining the costs of labor turnover, form for analyzing retention risk, and exit interview questionnaire. Contains 16 references and useful addresses. Details
Learning for Performance: A Guide and Toolkit for Health Worker Training and Education Programs The Capacity Project 2007 Murphy C, Harber L, Kiplinger N, Stang A and Winkler J [Excerpt from Preface] This manual presents Learning for Performance, a systematic instructional design process based on IntraHealth's experience in designing reproductive health and HIV/AIDS training and performance improvement programs over the last 27 years in countries around the world. Our work in human resources for health, especially through the Capacity Project, also informs this document. The process outlined in this document is being used in many countries and continues to evolve as we learn additional lessons about what is most useful and practical in various contexts. Details
Management of Workplace Violence Victims International Labour Office; International Council of Nurses; World Health Organization and Public Services International 2003 Richards J [Excerpt from author] This study aims to summarise information, research and practice relating to the management of workplace violence victims under a set outline. The objectives are to confirm the importance of victim management to minimise the consequences of workplace violence in the health sector; to present the range of measures being used to meet the needs of victims, management and policy-makers; and where possible, provide data suggesting effectiveness and sustainability of the various measures. Details
International Council of Nurses Nursing Workforce Profile 2003 International Council of Nurses 2003 Details
Canadian oncology work environments: Part 1 Longwoods 2010 Bakker D, Conln M, Fitch M, Green E, Butler L, Olson K & Cummings G "The purpose of this research study was to examine oncology nursing work environments in Canada and to determine the presence of workplace and professional practice factors." (Excerpt from abstract) Details
Global Migration of Nurses Global Health TV 2009 Kingma, M A brief video interview from the 2009 Global Health Conference in Washington D.C., discussing key issues in the global health migration of nurses. Details
A Comparison of Stress factors in Home and Inpatient Hospice Nurses Medscape 2009 Martens, ML "The purpose of this study was to determine the perceived stress factors of inpatient and home hospice nurses and their correlation to perceived self-efficacy." (excerpt from abstract) Details
Financial incentives for return of service in underserved areas: a systematic review BMC Health Services Research 2009 Barnighausen T & Bloom D "In many geographic regions, both in developing and in developed countries, the number of health workers is insufficient to acheive population health goals. Financial incentives for return for service are intended to alleviate health worker shortages; A (future) health worker enters into a contract to work for a number of years in an underserved area in exchange for a financial pay-off...We carried out systematic literature searches..for studies evaluating outcomes of financial incentive programs published up to February 2009." (excerpts from Abstract) Details
Code of Ethics for Nurses in Australia - August 2008 Australian Nursing and Midwifery Council, Royal College of Nurses, Australia, and the Australian Nursing Federation 2008 "This Code of Ethics for Nurses in Australia has been developed for the nursing profession in Australia.It is relevant to all nurses at all levels and areas of practice including those encompassing clinical,management,education and research domains." (excerpt0 Details
Code of Professional Conduct for Nurses in Australia - August 2008 Australian Nursing and Midwifery Council, Royal College of Nurses, Australia, and the Australian Nursing Federation 2008 "This Code of Professional Conduct for Nurses sets the minimum standards for practice a professional person is expected to uphold both within and outside of professional domains in order to ensure the 'good standing' of the nursing profession. These two companion Codes, together with other published practice standards (eg competency standards, decision-making frameworks, guidelines and position statements), provide a framework for legally and professionally accountable and responsible nursing practice in all clinical,management, education and research domains." (excerpt) Details
Code of Ethics for Midwives in Australia - August 2008 Australian Nursing and Midwifery Council, Royal College of Nurses, Australia, and the Australian Nursing Federation 2008 "This Code of Ethics for Midwives in Australia has been developed for the midwifery profession in Australia. It is relevant to all midwives in all areas of maternity services including those encompassing the midwifery practice,management, education and research domains." (excerpt) Details
Code of Professional Conduct for Midwives in Australia - August 2008 Australian Nursing and Midwifery Council, Royal College of Nurses, Australia, and the Australian Nursing Federation 2008 "The Code of Professional Conduct for Midwives in Australia is a set of expected national standards of professional conduct for midwives in Australia. It is supported by, and should be read in conjunction with its companion code, the Code of Ethics for Midwives in Australia and the Australian Nursing and Midwifery Council National Competency Standards for the Midwife. These three documents, together with other published practice standards (eg decision-making frameworks, guidelines and position statements), provide a framework for accountable and responsible midwifery practice in all clinical, management,education and research domains." (excerpt) Details
Factors Influencing Work Productivity and Intent to Stay in Nursing Jannetti Publications, Inc; Nursing Economics 2008 Letvak S and Buck R [Excerpt from publisher]There continues to be a shortage of registered nurses (RNs) with a possible predicted short fall of 36% by 2020 (U.S. Department of Health and Human Services [DHHS], 2006). Despite recent improvements in the hospital nursing short age, the average hospital vacancy rate for RNs in the United States is 8.5% to 14% with vacancy rates of over 14% in medical-surgical and critical care areas (American Hospital Association [AHA], 2004, 2006). Much of the employment growth of RNs employed in hospitals has been in nurses over age 50 (Buerhaus, Auerbach, & Staiger, 2007). How ever, 49% of hospitals surveyed stated it was more difficult to recruit RNs in 2005 than it was in 2004 (AHA, 2006). Hospital nurse staffing is a concern because of the effects a shortage has on patient safety and quality of care (Buerhaus, Donelan, Ulrich, Norman, & Dittus, 2005; Ulrich, Buerhaus, Donelan, Norman, & Dittus, 2005). Details
Foreign Nurses in Portugal Ordem Dos Enfermeiros 2008 Da Silva A and Fernandes R This study examines foreign nurses in Portugal. Also availble in Portuguese: http://www.ordemenfermeiros.pt/images/contents/uploaded/File/Sede-Internacional/Enfmigrantes_PT.pdf Details
Facilitating Acculturation of Foreign-Educated Nurses Online Journal of Issues in Nursing 2008 Emerson E. Ea [Excerpt from author]The United States (US) is in the midst of a critical nursing shortage that is projected to worsen unless long term and sustainable solutions are instituted. The hiring of foreign-educated nurses (FENs) has been identified in the literature as one of the practical and realistic solutions to the current nursing shortage. Although small in number compared to U.S.-prepared nurses, FENs play an integral role in the delivery of health care services and contribute to the diversity of the U.S. health care workforce. The literature suggests that successful acculturation of FENs to host cultures leads to work and life satisfaction. Further, there is evidence in the literature suggesting that registered nurses, U.S. or foreign educated, who are satisfied with their jobs and personal lives stay longer in their current jobs and contribute to better patient outcomes. Details
Electronic Rostering: Helping to Improve Workforce Productivity - A Guide to Implementing Electronic Rostering in Your Workplace NHS Employers 2007 [Excerpt from publisher]This guide highlights the productivity benefits of using electronic rostering systems to roster all staff groups, and to provide trusts with key information that will enable them to choose and then successfully implement an electronic rostering system. It is aimed at boards, chief executives, human resources directors, medical directors, nursing directors, and any others interested in improving the productivity of their workforce. Details
A Magnetic Strategy for New Graduate Nurses Jannetti Publications, Inc; Nursing Economics 2007 Halfer D [Excerpt from author]This case study describes how one urban, MagnetAE-designated pediatric academic medical center introduced an RN internship program to nurture new graduates in building their pediatric careers. The business impact of developing a magnetic strategy to attract and retain new graduate nurses is also discussed. Details
A Situation Assessment of Human Resources in the Public Health Sector in Nigeria The Partners for Health Reformplus Project, Abt Associates Inc. 2006 Chankova S, Nguyen H, Chipanta D, Kombe G, Onoja A and Ogungbemi K [Excerpt from authors] Nigeria has one of the largest stocks of human resources for health (HRH) in Africa. However, great disparities in health status and access to health care exist among the six geo-political zones, and between rural and urban areas. This assessment measures the size, skills mix, distribution, and growth rate of HRH in the public health sector in Nigeria. The assessment also quantifies the increase in HRH requirements in the public health sector necessary for reaching key PEPFAR targets and the health Millennium Development Goals. The findings are based on a survey conducted in April-May 2006 in 290 public health facilities representing all levels of care (primary, secondary, and tertiary). The study data enabled us to estimate the total number of doctors, nurses, midwives, lab and pharmacy staff, and community health workers currently employed in the public sector. The distribution of health workers by level of care, and HRH availability in rural and urban areas was also quantified. Staff attrition rates, measuring the number of those leaving the public sector as percent of total staff, were determined among all staff categories. The annual growth in HRH in the public sector from new graduates was also measured. Details
Designing Incentives for Rural Health Care Providers in Developing Countries The World Bank 2001 Hammer J and Jack W [Excerpt from authors]In many developing country settings, and particularly in rural areas, the implementation of anything more than very rudimentary contracts for medical care providers, including public employees, is virtually impossible. In this paper we examine the kinds of policy levers that governments might conceivably have available to induce physicians to serve in rural areas. Using simple models of screening and spatial competition we investigate how the government can sort between physicians with low and high opportunity costs of relocation, and how the quality of existing providers (e.g., traditional healers) might affect the government's training policies. Details
Australia's Health Workforce: Productivity Commission Research Report Australian Government Productivity Commission 2005 [Excerpt from publisher] This research study, commissioned by CoAG, reviews a range of workforce issues. These include: factors affecting the future supply of, and demand for, health workers; the efficiency and effectiveness with which the available workforce is deployed; and what reforms to health workforce arrangements might be undertaken to improve access across the community to quality and safe health care. Details
Career Planning and Development - It's Your Career: Take Charge International Council of Nurses 2001 Donner GJ and Wheeler MM [Excerpt from authors] It's Your Career: Take Charge, is directed towards individual nurses to help them take charge and be in control of their careers within the ever-changing world of health care. This is a training package that provides nurses with: - An overview of what career planning and development is and why it is important. - A five-phase career planning and development model and activities to guide career development. - A trainer guide for those who want to conduct an It's Your Career: Take Charge workshop and offer career coaching. These guidelines highlight the key dimensions of career planning and development and offer guidance to those who wish to evaluate the present and shape their future. Details
Career Planning and Development - Trainer's Manual International Council of Nurses 2001 [Excerpt from publisher]This kit provides a manual for career coaches to help them conduct an It's Your Career: Take Charge workshop and/or offer career coaching to individual nurses. It also offers ready to use teaching materials, including activity planning and worksheets, a power point presentation on floppy disk and the ICN Career Planning guidelines. Additional references and networking options for career coaches are also provided. Details
Framework Guidelines for Addressing Workplace Violence in the Health Sector International Labour Office; International Council of Nurses;World Health Organisation; Public Services International 2002 [Excerpt from publishers] The objective of these Framework Guidelines is to provide general guidance in addressing workplace violence in the health sector. Far from being in any way prescriptive, the Guidelines should be considered a basic reference tool for stimulating the autonomous development of similar instruments specifically targeted at and adapted to different cultures, situations and needs. The Guidelines cover the following key areas of action:prevention of workplace violencedealing with workplace violencemanagement and mitigation of the impact of workplace violencecare and support of workers affected by workplace violencesustainability of initiatives undertakenAlso available in Russian at: http://www.icn.ch/WViolenceRussian.pdf Details
An Action Plan to Prevent Brain Drain: Building Equitable Health Systems in Africa Physicians for Human Rights 2004 Friedman EA [Excerpt from foreward] This paper by Physicians for Human Rights addresses the dual crises of violation of the human right to survival worsening in the face of severe shortages of human resources to meet our ethical obligations. This paper is exhaustively researched, adopts a comprehensive approach, and its release is very timely. As the report underscores, now is the time to act, for further delays will exact a huge human cost in millions of preventable deaths. The report's analysis penetrates to the root causes of the problem and it offers a set of strategies that must be embraced to address the crises. Effective solutions are available, not surprisingly. But these depend upon respect for basic human rights and the mutual meeting of our obligations - adapted and adjusted to new contexts. Details
Building the Future: An Integrated Strategy for Nursing Human Resources in Canada The Nursing Sector Study Corporation 2006 Med-Emerg Inc. [Excerpt from author] This report marks the culmination of the Nursing Sector Study. The five year study consisted of two phases, and examined the nursing workforce for all three regulated nursing professions in Canada (Licensed Practical Nurses (LPN) Registered Nurses (RN), and Registered Psychiatric Nurses (RPN)). Phase I, which concluded in December 2004, examined the state of nursing human resources in Canada. A series of 15 technical research reports were completed which covered areas such as nursing mobility, the international labour market, nursing education in Canada, and many others. Details
59th World Health Assembly Resolution WHA 59.27 Strengthening Nursing and Midwifery World Health Organization 2006 In May 2006, the Fifty-Ninth World Health Assembly adopted a resolution to strengthen nursing and midwifery. The resolution calls on member states to confirm their commitment to strengthen nursing and midwifery and lists a number of recommendations. Details
Enhancement of Patient Safety Through Formal Nurse-Patient Ratios: A Discussion Paper Canadian Federation of Nurses Unions 2005 Tomblin Murphy G [Excerpt from author] Nurses from across Canada are asking their leadership and bargaining agents to examine the feasibility of implementing formal Nurse-Patient Ratios as a strategy to address the ongoing problems of heavy workloads, workplace injuries, turnover, and burnout among the nurses. Moreover, mandatory Nurse-Patient Ratios are being viewed as an approach to promote patient safety by ensuring adequate nurse staffing levels. Based on the experience of other jurisdictions that have enacted legislation to mandate that health organizations adopt formal nurse-patient ratios, nurses in Canada are interested in knowing if a similar approach would be applicable in the Canadian context. In the fall of 2004 the National Executive Board of the Canadian Federation of Nurses Unions (CFNU), in partnership with the Office of Nursing Policy, Health Canada initiated a discussion which resulted in a project to determine if formal, mandated, Nurse-Patient Ratios would enhance patient safety while at the same time respect professional nursing judgement. The Report consists of a literature review of published and unpublished reports from government, the academic community and professional organizations from Canada and abroad. This Report examines the various definitions and dimensions (pros and cons) of Nurse-Patient Ratios as a staffing policy and reviews the experiences of other jurisdictions, in particular California in the United States and the State of Victoria in Australia. Details
The ALIVE program: developing a web-based professional development program for nursing leaders in teh home healthcare sector Longwoods 2010 Lankshear S, Huckstep S, Lefebre N, Leiterman J & Simon D "The ALIVE (Actively Leading In Virtual Environments) web-based program was developed to meet the needs of leaders working in virtual environments such as the home healthcare sector. The program, developed through a partnership of three home healthcare agencies, used nursing leaders as content experts to guide program development and as participants in the pilot. Evaluation findings include the identification of key competencies for nursing leaders in the home healthcare sector, development of program learning objectives and participant feedback regarding program content and delivery." (excerpt from abstract) Details
Using common work environment metrics to improve occupational health and safety in healthcare and community service organisations Longwoods 2010 MacDonald Mary-Lou & Slaunwhite Jason M "This commentary reviews the recommendations presented in the lead paper from the perspective of a safety association for healthcare and community services. We highlight the challenges of collecting employee safety-related data for comparative purposes. Preliminary research findings from AWARE-NS baseline assessments are presented to emphasize the situation in the province of Nova Scotia. An established provincial data management system that tracks occupational health and safety events and outcomes is reviewed to note its value to the healthcare system. Although the need to have a consistent framework for the healthcare sector is paramount, we argue that worker safety-related indicators are often overlooked or embedded within patient safety indicators. A call for more consistent employee safety-specific indictors is made." (excerpt from article) Details
Non-financial incentives for voluntary community health workers: A qualitative study JSI Research & Training Institute, Inc. 2009 Amare, Yared "This study utilizes in-depth interviews and focus group discussions to explore the potential efficacy of NFIs proposed by the project. The results of the study describe the factors motivating the vCHWs and concur with the NFIs proposed by the project. The study also proposes other NFI mechanisms for consideration and makes programmatic recommendations." Details
Health worker effectiveness and retention in rural Cambodia Rural and Remote Health 2010 Chhea C, Warren N & Manderson L "In this article the strategies of and barriers met by health workers who remain in rural areas and deliver public health services are elucidated. Ethnographic research conducted in 2008 with health providers involved in treating tuberculosis patients in Kampong Speu Province, Cambodia is drawn on." Details
The Nature of Nursing Quality of Work Life: An Integrative Review of Literature SAGE journals online 2010 Vagharseyyedin SA, Vanaki Z, & Mohammadi E "Thus, the current study was aimed to identify the predictors of the nurses' QWL and determine the definitions of QWL for nurses. The authors used an integrative review of the literature and identified six themes as the major predictors of the nurses' QWL: leadership and management style/decision-making latitude, shift working, salary and fringe benefits, relationship with colleagues, demographic characteristics, and workload/job strain." (excerpt from abstract) Details
Decisional Involvement: Staff Nurse and Nurse Manager Perceptions SAGE journals online 2010 Sherb CA, Specht JKP, Loes JL & Reed D "Enhancing involvement in organizational decisions is one strategy to improve the work environment of registered nurses and to increase their recruitment and retention. Little is known about the type of decision making and the level of involvement nurses desire. This was a descriptive study exploring staff nurse and nurse manager ratings of actual and preferred decisional involvement and differences between staff nurses and nurse managers." (excerpt from abstract) Details
Health workforce responses to global health initiatives funding: a comparison of Malawi and Zambia Human Resources for Health 2010 Brugha R, Kadzandira J, Simbaya J, Dicker P, Mwapasa V, & Walsh A "Shortages of health workers are obstacles to utilising global health initiative (GHI) funds effectively in Africa. This paper reports and analyses two countries' health workforce responses during a period of large increases in GHI funds." (excerpt from abstract) Details
High Impact Action for Nursing and Midwifery The Essential Collection Institute for Innovation and Improvement, NHS 2010 "The Essential Collection has been specifically designed to provide a range of material which we hope will help you to adopt and implement some of these improvements into your own local context. There is a separate section dedicated to each of the eight High Impact Actions. Please Note: Copies are free to order or download for NHS England organisations This product is available to purchase by non NHS England organisations at www.institute.nhs.uk/bookshop" (excerpt from website). Details
Report of the First Meeting of the Health Workforce Information Reference Group World Health Organization 2010 World Health Organization "A technical meeting on strengthening health workforce information systems was held on 10-12 March 2010 in Montreux, Switzerland. The meeting was jointly convened by the World Health Organization's Department of Human Resources for Health, the Global Health Workforce Alliance and the Health Metrics Network, who have called for the establishment of a Health Workforce Information Reference Group (HIRG). The aim of this first meeting of HIRG members and stakeholders was to initiate discussion on how to promote a coordinated, harmonized and standardized approach to strengthening country health workforce information and monitoring systems to support policy, planning and research." (excerpt from document) Details
A Summary of the December 2009 Forum on the Future of Nursing: Care in the Community Robert Wood Johnson Foundation 2010 Robert Wood Johnson Foundation "The Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the IOM, seeks to build a blueprint for the future of nursing as part of larger efforts to reform the health care system. The Initiative held three public forums to explore challenges and opportunities in nursing. The second forum, which took place December 3, 2009, examined care in the community, focusing on community health, public health, primary care, and long-term care. Presenters described examples of best practices in the community that shed light on what is needed to meet the country's changing health needs." (excerpt from website) Details
Nurses in advanced roles: A description and evaluation of experiences in 12 developed countries OECD 2010 Delamaire M-L & Lafortune G "This paper reviews the development of advanced practice nurses in 12 countries (Australia, Belgium, Canada, Cyprus, Czech Republic, Finland, France, Ireland, Japan, Poland, United Kingdom and United States), with a particular focus on their roles in primary care. It also reviews the evaluations of impacts on patient care and cost." Details
Registered Nurses' views about work and retirement SAGE journals online 2010 Valencia, D & Raingruber B "The purpose of this study was to identify what motivates experienced nurses to continue workings and to consider retirement" (excerpt from abstract) Details
The nursing human resource planning best practice toolkit: Creating a best practice resource for nursing managers Longwoods 2010 Vincent L & Beduz MA "The Nursing Human Resource Planning Best Practice Toolkit project supported the creation of a network of teaching and community hospitals to develop a best practice toolkit in nursing human resource planning targeted at first line nursing managers. ... This paper will provide an overview of the process used to develop the toolkit, a description of the toolkit contents and a reflection on the outcomes of the project." (excerpt from abstract) Details
Health policy thoughtleaders' view of the health workforce in an era of reform Elsevier 2010 Donelan K, Buerhaus P, DesRoches C & Burke S "The purpose of this research was to understand the visibility and salience of the health workforce in general, gain an understanding about the effectiveness of messages concerning the nursing workforce in particular, and to understand why nursing workforce issues do not appear to have gained more traction in national health care policymaking." (excerpt from abstract) Details
Using the practice environment scal of the nursing work index on Asian nurses Lippincott Williams & Wilkins Inc. 2009 Liou s & Cheng C "The purpose of this study was to test the reliability and the validity of the PES-NWI scale when applied to Asian nurses working in the United States." Details
Nurse staffing and quality of patient care Agency for Healthcare Research and Quality 2007 Kane RL, Shamliyan Tm, Mueller C, Duval S & Wilt TJ "Objectives: To assess how nurse to patient ratios and nurse work hours were associated with patient outcomes in acute care hospitals, factors that influence nurse staffing policies, and nurse staffing strategies that improved patient outcomes." (extract from abstract) Details
A comparison of the nursing practive envirobnment in mental health and medical-surgical settings. Sigma Theta Tau International Honour Society of Nursing 2010 Roche MA & Duffield CM "The work environment of mental health nurses is different from that of their colleagues working in general settings. Specific areas of the mental health environment, such as participation in the hospital, leadership, and the foundations of quality, may be enhanced to improve nurses' job satisfaction and, potentially, other nurse and patient outcomes." (excerpt from abstract) Details
Cultural Similarity, Cultural Competence and Nurse Workforce Diversity SAGE journals online 2010 McGinnis SL, Brush BL & Moore J "This study examined the use of national racial/ethnic categories in both patient and registered nurse (RN) populations and found them to be a poor indicator of cultural similarity. Rather, we found that cultural similarity between RN and patient populations needs to be established at the level of local labor markets and broadened to include other cultural parameters such as country of origin, primary language, and self-identified ancestry." (excerpt from abstract) Details
Development and evaluation of an RN/RPN Utilization Toolkit Longwoods 2010 Blastorah M, Alvarado K, Duhn L, Flint F, McGrath P & VanDeVelde-Coke S "Purpose: To develop and evaluate a toolkit for Registered Nurse/Registered Practical Nurse (RN/RPN) staff mix decision-making based on the College of Nurses of Ontario's practice standard for utilization of RNs and RPNs." (excerpt from abstract) Details
Forging partnerships to ex[pand nursing education capacity ajnonline.com 2010 Cleary BL, Hassmiller SB, Reinhard SC, Richardson EM, Veenema TG & Werner S "Nursing in America (CCNA) at AARP, the Robert Wood Johnson Foundation (RWJF), the U.S. Department of Labor's Employment and Training Administration, and the U.S. Department of Health and Human Services' Health Resources and Services Administration collaborated to address this growing crisis in nursing education. Within the past 18 months, these strategic partners cosponsored two national summits on nursing education capacity. These summits addressed the critical issues every state faces in trying to teach sufficient numbers of nurses the skills required in the 21st century. In this article, the first in a series of seven, we discuss the major messages that emerged from these two national summits." (excerpt from document) Details
Is transition of Internationall Educatioed Nurses a Regulatory Issue? SAGE journals online 2010 Xu Y, "Given the absence of global nurse regulation, the questionable credibility in many areas where national regulation does operate, and more important, the commercialization of nurse training in some countries to meet international demand, the quality and competence of IENs are likely to be varied in both quantitative and qualitative terms. This variability in quality and competence affect their ability and readiness to practice with direct implications for patient safety and quality of care. After description of a transition program as a proposed regulatory mechanism modeled after the National Council of State Boards of Nursing's Transition Initiatives, this article calls for comparative outcomes research on IENs and U.S. educated nurses to definitively determine if transition of IENs is a regulatory issue. " (excerpt from abstract) Details
A Summary of the October 2009 Forum on the Future of Nursing: Acute Care Robert Wood Johnson Foundation 2010 Robert Wood Johnson Foundation "The Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the IOM, seeks to transform nursing as part of larger efforts to reform the health care system. As part of this Initiative, three forums were held to explore challenges and opportunities in nursing. The first forum, on October 19, 2009, focused on quality and safety, technology, and interdisciplinary collaboration in acute care; and speakers offered new strategies to allow nurses to provide higher-quality care. The IOM will use the perspectives and ideas summarized in this document to inform a final report on the future of nursing, expected to release in fall 2010." (excerpt from website) Details
Gone south: why canadian nurses migrate to the United States Longwoods 2009 McGillis-Hall L, Pink GH, Jones C, Leatt P, Gates M, Pink L, Peterson J, & Seto L "The movement of Canadian nurses to the United States increased over the past decade and is an ongoing concern of health policy analysts. This study examines why Canadian nurses emigrate to the United States and whether there is interest in returning to work in Canada. A survey of Canadian-educated nurses in North Carolina showed that lack of full-time work opportunities played a key role in emigration. Focus groups of respondents revealed deep dissatisfaction with many aspects of nursing practice in Canada, particularly undervaluing of the profession. There is an urgent need for healthcare policy makers to explore what should be done to reduce the loss of this critical human resource." (abstract) Details
Implications of the California Nurse Staffing Mandate for Other States John Wiley & Sons, Ltd 2010 Aiken LH, Sloan DM, Cimiotti JP, Clarke SP,Flynn L, Seago JA, Spetz J & Smith HL "In 2004, California became the first state to mandate minimum nurse staffing levels for various nursing units, specifying how many patients each nurse can care for at any one time. As other states look to enact nurse staffing legislation or regulations, California's example provides some insight. Researchers compared the outcomes for nurses and quality of care in California and two states without legislation-Pennsylvania and New Jersey. They surveyed 22,336 nurses in all three states and examined patient outcomes, including 30-day inpatient mortality and failure to rescue across hospitals according to whether the nurses cared for fewer or more patients each." Details
Healthcare Restructuring: The Impact of Job Change Longwoods 2010 Bauman A, Giovannetti P, O'Brien-Pallas C, Mallette C, Deber R, Blythe J, Hibberd J & DiCenso A "Restructuring, particularly redeployment and job change, had a dramatic impact on the working conditions and practices of nursing personnel. This study was conducted to determine whether nurses (RNs and RPNs) who experienced job change perceived their work-lives differently than those who did not undergo job change and, whether nurses who experienced different types of job change (new role, new unit, or new hospital) varied in their perceptions." (excerpt from abstract) Details
Costing the scaling-up of human resources for health: Lessons from Mozambique and Guinea Bissau Human Resources for Health 2010 Tyrrell AK, Russo G, Dussault G & Ferrinho P "In the context of the current human resources for health (HRH) crisis, the need for comprehensive Human Resources Development Plans (HRDP) is acute, especially in resource-scarce sub-Saharan African countries. However, the financial implications of such plans rarely receive due consideration, despite the availability of much advice and examples in the literature on how to conduct HRDP costing. Global initiatives have also been launched recently to standardise costing methodologies and respective tools." (exceprt from abstract) Details
NHS Health and Well-being: Final Report Department of Health 2009 Boorman, S "This report, and our earlier Interim Report, sets out a major change agenda for the NHS, designed to put staff health and wellbeing at the heart of its work. We believe that this is justified by the importance of this issue, both for staff themselves and for the delivery of high-quality patient care." (excerpt from report) Details
Internationally Educated Workers Jeopardy: Answers and Questions Longwoods 2010 Deber R Commentary: "Selecting policies for integrating internationally educated healthcare professionals (IEHPs) into the healthcare workforce depends on how the underlying policy questions are defined and how the resulting trade-offs are managed" (excerpt from article). Details
The BC Educator Pathway Collaborative Framework: Creating the Foundation for Nursing Education Capacity Longwoods 201 Semeniuk P, Mildon B, Purkis ME, Thorne S and Wejr P "This paper describes the conceptual structure and organizational framework of the Educator Pathway Project (EPP)...In this paper, we describe the overall program design, explain the collaborative partnership mechanisms through which we have been implementing the project and articulate a range of processes through which we are working together to enact significant system-level adjustments aimed at a genuine practice-education continuum." (excerpt from abstract) Details
Transformational Leadership to Promote Cross-Generational Retention Longwoods 2010 Lobo, V "This paper describes some of the challenges that managers encounter in their dealings with the contemporary multigenerational workforce - including the baby boomers, generation X and generation Y (the "millennials"). A review of research findings suggests the insufficiency of a single leadership approach to nurse management compared to more tailored generational strategies. Application of the transformational leadership model provides the background and tenets from which solutions are proposed for multigenerational management." (excerpt from abstract) Details
International Nurse Migration to Canada: Are We Missing the Bigger Picture? Longwoods 2010 Kolawole, B Commentary piece highkighting "'brain wastage' resulting from the inability of internaitonally educatioed nurses (IENs) to integrate into the Canadian halthcare system" Details