Health Care Environment and in Nursing Research Paper

Health Care Environment and in Nursing Research Paper

the role that organized labor and collective bargaining play in the health care environment and in nursing

Write a 700- to 1,050-word overview of the role that organized labor and collective bargaining play in the health care environment and in nursing.Health Care Environment and in Nursing Research Paper Your overview should:

define collective bargaining,
identify legal components of collective bargaining,
discuss the manager’s role in union organizing,
outline the role of the National Labors Relations Board (NLRB),
analyze the effect of unions on staffing ratios, benefits, and compensation, and Health Care Environment and in Nursing Research Paper
PLACE YOUR ORDER HERE
describe the role of the nurse manager in creating a collaborative labor-management relationship.

Research at least three peer-reviewed journal articles less than 5 years old to support your the role that organized labor and collective bargaining play in the health care environment and in nursing assignment.

Format your paper according to APA guidelines.

Click the Assignment Files tab to submit your the role that organized labor and collective bargaining play in the health care environment and in nursing assignment.Health Care Environment and in Nursing Research Paper

HSN 555 WEEK 6 Employee Benefits Brochure

Create a professional recruitment brochure for newly licensed nurses, nurses changing specialties, and nurses changing organizations. Use your analysis from the Week 5 Learning Activity to help. Emphasize the following aspects in the brochure:

The organization’s care delivery model
Employee benefits
Safety measures
Steps the organization takes to empower nurses at the bedside

Provide at least three peer-reviewed journal articles less than 5 years old to support your assignment. Incorporate in-text citations and references to recognize intellectual property.Health Care Environment and in Nursing Research Paper

Submit the assignment as instructed by your facilitator.

HSN 555 WEEK 6 Trends Executive Summary

Create a 1- to 2-page executive summary analyzing the effects of health care staff trends. Include your recommendations for hiring strategies that:

forecast and describe at least two health care trends,
analyze how the trends will affect human resources, and
identify three to five HRM strategies from the course readings to address the trends.Health Care Environment and in Nursing Research Paper

Research at least three peer-reviewed journal articles less than 5 years old to support your assignment.

Click the Assignment Files tab to submit your assignment.

HSN 555 WEEK 5 Nurse Manager as Coach

Reflect on a peer or new nurse who was struggling in their position.

Develop a 350- to 700-word plan to address their needs from the perspective of a nurse manager using principles of effective coaching. Include the following:

Complete a job analysis of the person’s job.
Describe the current performance, desired performance, strategies to ensure commitment to the change, and follow-up plans.
Align the action plan with organizational mission, vision, and goals along with rationale.
Develop a mentoring and education or training plan for the employee to help prepare him or her for the next role.

Research and provide at least two credible sources less than 5 years old, including the course textbooks, to support your plan.

Include an APA-formatted reference list.Health Care Environment and in Nursing Research Paper

ORDER HERE

Submit the assignment as instructed by your facilitator

Discussions of hospital quality, efficiency, and nursing care often taken place independent of one another.Health Care Environment and in Nursing Research Paper Activities to assure the adequacy and performance of hospital nursing, improve quality, and achieve effective control of hospital costs need to be harmonized. Nurses are critical to the delivery of high-quality, efficient care. Lessons from Magnet program hospitals and hospitals implementing front-line staff–driven performance improvement programs such as Transforming Care at the Bedside illustrate how nurses and staff, supported by leadership, can be actively involved in improving both the quality and the efficiency of hospital care.Health Care Environment and in Nursing Research Paper

The 1996 IOM report Nursing Staff in Hospitals and Nursing Homes: Is It Adequate? concluded that although nursing services are central to the provision of hospital care, “little empirical evidence is available to support the anecdotal and other informal information that hospital quality of care is being adversely affected by hospital restructuring and changes in [nurse] staffing patterns.” ⁴

Since that report, and in part in response to it, the number of studies examining the association of staffing and quality in hospitals has exploded. Major studies demonstrating the association of nurse staffing and patient outcomes, including lengths-of-stay, mortality, pressure ulcers, deep vein thromboses, and hospital-acquired pneumonia have been published in first-tier journals, and several major literature reviews, syntheses, and meta-analyses have been published confirming the association of nurse staffing with patient outcomes.Health Care Environment and in Nursing Research Paper ⁵ When the IOM revisited the issue of nurse staffing and patient care in 2004, it concluded: “Research is now beginning to document what physicians, patients, other health care providers, and nurses themselves have long known: how well we are cared for by nurses affects our health, and sometimes can be a matter of life or death.” ⁶

Research on these issues is continuing. Indeed, its scope has expanded through programs such as the Robert Wood Johnson Foundation (RWJF) Interdisciplinary Nursing Quality Research Initiative (INQRI), whose projects are examining how specific processes of care, such as care coordination, medication administration, or introduction of evidence-based protocols, are associated with nursing care and patient outcomes. ^{7Health Care Environment and in Nursing Research Paper}

Despite this research, the nature of nurses’ work in hospitals is not well understood by the public or policymakers. In a recent survey, 88 percent of the public agreed that making sure there are enough nurses to monitor patient conditions, coordinate care, and educate patients should be a part of efforts to improve quality, but focus groups find that the public is confused about what nurses do, the kind of training they receive, and what distinguishes them from nurse aides and other less trained personnel. ⁸ The public understands that nurses’ work is physically and emotionally demanding but may view this work as delivering care as ordered and providing physical and emotional comfort to patients and their families. Nurses do far more, and the work entails both substantial intellectual and organizational competence.Health Care Environment and in Nursing Research Paper Among the critical tasks carried out by nurses are (1) ongoing monitoring and assessment of their patients and, as necessary, initiating interventions to address complications or reduce risk; (2) coordinating care delivered by other providers; and (3) educating patients and family members for discharge, which can reduce the risk of posthospital complications and readmission.

Costs.

Much work has examined the association of nursing and quality; less has examined nursing’s impact on costs. A number of studies have assessed whether there is a business case for increasing nurse staffing in hospitals—that is, whether simply increasing staffing would pay for itself in reduced complications and lengths-of-stay. ⁹ One key finding of this work is that improving nurse staffing does not completely pay for itself, although recent efforts to reduce hospital payment for poor quality may change this conclusion.Health Care Environment and in Nursing Research Paper

These analyses also find that the biggest cost savings of increased staffing result from reduced lengths-of-stay. Shorter stays reflect not just reductions in complications that extend stays, but the ability of nurses to do their work and coordinate the work of others in a timely and effective manner. They reflect nurses’ ability to affect efficiency as well as quality.

A key limitation of these cross-sectional studies is that they do not consider how changes in nursing organization, systems, or work environment might improve outcomes or efficiency without increases in staffing. Other research studying nurses’ work environments suggests that such improvements are possible.

For example, in 2005 Arminée Kazanjian and colleagues found an association between work environment and patient safety in nineteen of twenty-seven studies. ¹⁰ The theoretical and methodological sophistication of the research needs to be strengthened before the mechanisms connecting nurse work environments to patient outcomes can be fully understood, and this research is still evolving; however, there is sufficient evidence to act. ¹^{1Health Care Environment and in Nursing Research Paper}

Hospital Nursing: Key Issues

Tapping nurses’ knowledge of the system.

Nurses develop substantial knowledge of the strengths and weaknesses of hospital systems and how they fail. Their ability to create workarounds to broken or dysfunctional systems is legendary in health care. ¹² As hospitals focus on increasing safety and reliability, patient-centeredness, and efficiency, nurses’ knowledge and commitment to their patients and institutions needs to be effectively mobilized. ¹³ To accomplish this, nurses’ perspectives must be represented at the highest levels of hospital leadership and integrated into hospital decision making.Health Care Environment and in Nursing Research Paper In addition, consistent with process-improvement research that identifies the active involvement of front-line staff as a critical factor in making and sustaining change, processes for engaging nurses and other front-line staff also need to be expanded.

PLACE YOUR ORDER HERE

Increasing the visibility and participation of nursing leadership within hospitals: Magnet accreditation.

One impetus for hospitals to give increased voice to nursing and nursing leadership has been the development and expansion of the Magnet accreditation program. Magnet hospitals are those recognized by the American Nurses Credentialing Center (ANCC) for recruiting and keeping nurses while providing high-quality care to patients. The framework for the Magnet appraisal process consists of fourteen characteristics, including (1) strong nursing representation in the organizational committee structure; (2) nurse leadership that is part of the hospital’s executive leadership; (3) a functioning system of shared governance in nursing; (4) empowerment of nurses at all levels of the hospital, with nurses able to effectively influence system processes; and (5) collegial working relationships among disciplines. ^{14 Health Care Environment and in Nursing Research Paper}

There are now 305 Magnet hospitals and, according to the ANCC, more than 150 applicants seeking recognition. In 2004, U.S. News and World Report added Magnet recognition as a factor in its hospital rankings, providing an additional incentive for hospitals to seek Magnet status. Although every hospital working toward Magnet recognition will not succeed, there is a “great deal of evidence that many nursing leaders have found portions of the criteria particularly helpful in their efforts to improve their own settings.” ¹⁵ Other hospitals that will not seek Magnet status might nonetheless be inspired by the program.Health Care Environment and in Nursing Research Paper

Magnet hospitals were initially identified based on their ability to attract and retain nurses, but there has been interest in whether Magnet characteristics are also associated with better quality and patient experiences. Although a 1994 study found lower Medicare mortality in magnet hospitals, few studies have directly examined magnet status and patient outcomes. ¹⁶ Some studies that have looked at Magnet status and nurses’ work environment find persistent differences between Magnet and other hospitals. ¹⁷ A growing number of studies find that Magnet characteristics are associated with patient outcomes. ¹⁸ This is an area of continuing research.

In the field, concerns have been raised about the cost of seeking Magnet status and whether, as implemented, the accreditation process assures full implementation of the Magnet vision. A new Magnet model of credentialing, yet to be evaluated, that focuses on outcomes was introduced in 2008; it will weight more heavily for organizations demonstrating improved and high-level patient satisfaction, nurse satisfaction, and clinical outcomes measures. ^{19Health Care Environment and in Nursing Research Paper}

The Magnet accreditation program is not the only vehicle for institutionalizing a more prominent role for nurse leadership at hospitals. Other accreditation programs should focus hospital leadership on the need to strengthen their nursing services. Nurses also need to be recruited to hospital and system boards and to board and leadership positions in national quality improvement organizations.Health Care Environment and in Nursing Research Paper