RESUMEN
In 2004, The George Washington University received funding from the U.S. Department of Homeland Security to develop a web-based emergency preparedness course for nurses. The purpose of the course was to provide training that would be accessible regardless of work setting or location. In designing the course, the development team used algorithmic decision making as a conceptual framework to transcend the linear, didactic focus of traditional online preparedness training to provide learners with a learning experience crafted around the decision-making process. This article describes the design of the algorithmic practice maps underlying this course and provides a replicable structure for those interested in developing similar offerings for nurses.
Asunto(s)
Algoritmos , Educación Continua en Enfermería/métodos , Enfermería de Urgencia/educación , Personal de Enfermería en Hospital/educación , Desarrollo de Personal/métodos , Enfermería de Urgencia/métodos , Humanos , Modelos de EnfermeríaRESUMEN
The transition from high school to college begins a time of personal growth accompanied by normal developmental stressors. Some young women use smoking as a coping mechanism. The immediate danger for these students is nicotine dependence, with subsequent maternal and child morbidities. College provides an optimal time to break this devastating trajectory. With an understanding of psychosocial development, nurses who care for college-age women can effect changes in smoking behavior.
Asunto(s)
Rol de la Enfermera , Fumar , Estudiantes/psicología , Estudiantes/estadística & datos numéricos , Mujeres/psicología , Adaptación Psicológica , Adolescente , Adulto , Actitud Frente a la Salud , Femenino , Desarrollo Humano , Humanos , Grupo Paritario , Atención Preconceptiva , Fumar/epidemiología , Fumar/psicología , Cese del Hábito de Fumar/métodos , Cese del Hábito de Fumar/psicología , Prevención del Hábito de Fumar , Estrés Psicológico/complicaciones , Estrés Psicológico/prevención & control , Estrés Psicológico/psicología , Servicios de Salud para Estudiantes/organización & administración , Estados Unidos/epidemiología , Salud de la MujerRESUMEN
We interviewed hospital leaders and unit nurses in twenty-five hospitals between June and October 2008 to explore the effect of performance-based incentives. Interviewees expressed favorable impressions of the impact that incentive policies have on quality and safety. However, they raised concerns about the policies' effects on the nurse workforce. Their concerns included the belief that performance-based incentives would increase both the burden and the blame for nurses without corresponding improvements in staffing levels, work environment, salaries, or turnover. To maximize the intended policy impact without jeopardizing the workforce that holds the key to their adoption, we recommend that policy makers invest in implementation support, redesign hospital incentives to reward teamwork, and involve nursing leaders in the design of future incentive policies.
Asunto(s)
Personal Administrativo/psicología , Enfermeras Administradoras/psicología , Personal de Enfermería en Hospital/psicología , Formulación de Políticas , Calidad de la Atención de Salud , Reembolso de Incentivo/organización & administración , Actitud del Personal de Salud , Femenino , Humanos , Entrevistas como Asunto , Masculino , Enfermeras Administradoras/estadística & datos numéricos , Personal de Enfermería en Hospital/estadística & datos numéricos , Innovación Organizacional , Política Organizacional , Reorganización del Personal , Administración de la Seguridad/normas , Desarrollo de Personal , Análisis y Desempeño de TareasRESUMEN
Over the last decade, there has been a substantial investment in holding health care providers accountable for the quality of care provided in hospitals and other settings of care. This investment has been realized through the proliferation of national policies that address performance measurement, public reporting, and value-based purchasing. Although nurses represent the largest segment of the health care workforce and despite their acknowledged role in patient safety and health care outcomes, they have been largely absent from policy setting in these areas. This article provides an analysis of current nursing performance measurement and public reporting initiatives and presents a summary of emerging trends in value-based purchasing, with an emphasis on activities in the United States. The article synthesizes issues of relevance to advancing the current climate for nursing quality and concludes with key issues for future policy setting.