Engaging Nurses in the Development and Implementation of a Professional Practice Model Through Nursing Salons.

Developing creative ways to solicit nurse input into practice is a challenge for nurse executives. Engaging nurses through the use of nursing salons was seen as an innovative way to engage nurses. Feedback from nurses participating in salons informed development of a Professional Practice Model that reflects nursing practice at this large academic medical center and provided a voice to nursing.

Developing indicators of nursing quality to evaluate nurse staffing ratios.

Concerns about the adequacy of patient care and safety in the state of California led to legislation that required the implementation of mandatory nurse staffing ratios. The authors describe a novel approach for identifying indicators that could be used to evaluate the impact of these regulations on quality of care and patient outcomes. The results of this project demonstrate that this is a useful method for identifying indicators appropriate for use in outcomes research with a focus on structural predictors of quality in healthcare.

Licensed caregiver characteristics and staffing in California acute care hospital units.

PURPOSE: Concerns about declining quality of care and nurse staffing shortages led to legislation mandating minimum nurse-to-patient ratios in the state of California. Although research finds that better registered nurse (RN) staffing results in higher quality of care, little evidence exists on which to base specific nurse-patient ratios. The authors describe the results of a California survey characterizing licensed caregivers, identifying staffing levels by unit type, and describing how staffing levels vary across hospital types. METHODS: A stratified random sample of general acute care hospitals was surveyed to collect cross-sectional data on hospitals' nursing workforce and staffing practices and to assess the impact of potential patient-to-nurse staffing ratios. All academic medical centers; rural, private, and city/county hospitals; and hospitals affiliated with a large group-model health maintenance organization (HMO) were eligible for inclusion. RESULTS: Eighty hospitals were surveyed, representing all major metropolitan areas in the state. Acute care hospitals in California have diverse nursing staffs with variations in education, experience, and employment status. Considerable variations in skill mix were identified, with the proportion of RNs ranging from 30% to 84%, depending on the unit type surveyed. CONCLUSIONS: As states struggle with an anticipated critical shortage of RNs, these results have several implications for health and education policy. Future studies of this type will be needed to evaluate the impact of anticipated changes in the regulation of nurse staffing.